基本医疗服务与基本医疗保险制度相协同的法治化路径
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引用本文:单飞跃,祝沁磊.基本医疗服务与基本医疗保险制度相协同的法治化路径[J].财经理论与实践,2022,(2):147-153
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作者单位
单飞跃,祝沁磊 (上海财经大学 法学院上海 200433) 
中文摘要:我国基本医疗保险基金主要用于保障公民的基本医疗服务。基本医疗服务与基本医疗保险制度之间呈现法律法规不协同、参保人权益和医疗服务需求方权益保障脱节、基本医保标准和服务供给内容不统一、财政支持权力分散以及基本医保个人账户阻碍基本医疗服务发展的现实困境。要使基本医疗服务与基本医疗保险制度有效协同,应当制定“基本医疗保险实施条例”,实现制度之间相衔接。每年基本医疗服务供给内容应当经过人代会审议,从而保障参保人和服务需求方的知情权、参与权、决策权、监督权。中央政府应当上收基本医疗保险基金的筹集权,确保筹资标准的统一性,实现基本医疗服务供给的均衡性。要加大对基层医疗机构的财政支持力度,保障基本医疗服务供给的公平性。逐步取消基本医疗保险个人账户制度,发挥基本医疗保险基金共济互助作用。
中文关键词:基本医疗服务  基本医疗保险  衔接  个人账户  基金
 
Legal Path of Coordination between Basic Medical Service and Basic Medical Insurance Systems
Abstract:Nowadays the laws and regulations of basic medical service and basic medical insurance systems are not coordinated. The protection of rights and interests of the insured and the demand of basic medical supply are not efficient. The standard of basic medical insurance and supply of the basic medical service are not unified. The powers of financial support to basic medical insurance fund are decentralized. Individual account of basic medical insurance hinders the development of basic medical services. We shall enact the Regulation of Basic Medical Insurance to make the coordination between basic medical service and basic medical insurance. The supply of basic medical service shall be deliberated by the National People’s Congress annually to ensure the rights to stay informed about to participate, to make their decisions and to supervise by the insured and the demand side. The central government should collect the fund raising right of basic medical insurance to ensure the uniformity of raising standards to achieve the equillibrium of the supply of the basic medical service. We shall increase financial support for basic medical institutions to ensure the fairness of basic medical service supply. We shall gradually abolish the individual account of basic medical insurance to make full play of the mutual aid role of basic medical insurance funds.
keywords:basic medical service  basic medical insurance  coordination  individual account  fund
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