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随着社会和经济的发展,以往我国实行的公费医疗制度正而临向医疗保险制度的变革。那么,国外存医疗保险制度的建立与改革方面有哪些经验和教训呢? 日本现行的医疗保险制度,分为“雇员健康保险”和“国民健康保险”两大类。前者的通用对象主要是全国拥有5人以上的企事业单位的雇员及其家属。后者的对象则为农民、个体经营者、无业者、退休人员以及上述人员的抚养家属。近年来,随着高龄人口不断增加,医疗费用大幅增长以及国民经济增长的减速,保险费收入增长缓慢,财政负担越来越重、因此,日本最近已修改了《健康保险法》、《国民健康保险法》和《老人保健法》,调整各方之间的医疗费负担比率。修改后的《健康保险法》首先提高了政府管理的健康保险费,同时将被保险者自己负担的医疗费部分从10%提高到20%。另外,日本还计划从诊断报酬体系、药价标准、医疗设施配备、医疗保险制度体系、消除医疗费用的不当开支等方面改革日本的医疗保险制度。
With the social and economic development, the public health care system practiced in China in the past is moving toward the reform of the medical insurance system. So, what are the experiences and lessons in the establishment and reform of foreign medical insurance system? The current medical insurance system in Japan is divided into two categories: “employee health insurance” and “national health insurance”. The former is mainly targeted at the employees and their dependents of enterprises and public institutions that have more than 5 people in the country. The latter target farmers, self-employed, unemployed, retirees, and dependents of these personnel. In recent years, Japan has recently amended the Health Insurance Law, the National Health Insurance Law, the National Health Insurance Law, the National Health Insurance Law, the National Health Insurance Law, the National Health Insurance Law, the National Health Insurance Law, the National Health Insurance Law, “And” Health Care for the Elderly Law "to adjust the burden ratio of medical expenses among all parties. The amended Health Insurance Law first increases the government-run health insurance premiums and increases the portion of the medical expenses borne by insured persons from 10% to 20% at the same time. In addition, Japan plans to reform Japan’s medical insurance system from the aspects of the system of diagnosis and remuneration, price standards, the provision of medical facilities, the system of medical insurance, and the improper expenses of eliminating medical expenses.