论文部分内容阅读
目的:检验“多缴多得”政策对参保的经济激励效果。方法:基于参保人理性选择视角,建立个人缴费及赔付的精算现值模型,借助补偿收益率指标,测算不同缴费档次模式下的成本收益情况。结果:在医疗消费支出高的年龄参保、低档次缴费是理性选择,该政策起到了相反的经济激励效果,即多缴并未多得。结论:“多缴多得”的政策设计违背了基本医疗保险的公平性原则,不利于制度的良好稳定发展及社会公平,应当从完善长效筹资机制,实行强制参保入手,消除参保过程中的逆向选择。
Objective: To test the economic incentive effect of the “overpayments” policy on insured. Methods: Based on the perspective of rational choice of insured persons, an actuarial present value model of individual contributions and claims was established. With the index of compensation rate of return, the cost-benefit under different contribution scales was calculated. Results: In the age of high medical expenditure, insured and low-grade payment is the rational choice. The policy has the opposite economic incentive effect, ie overpaying not much. Conclusion: The policy design of “overpayments” violates the principle of fairness of basic medical insurance and is not conducive to the sound and stable development of the system and social fairness. It should start with perfecting long-term fund-raising mechanism, imposing compulsory insurance, Adverse Selection in the Process of Security.