'十二五'期间城镇居民基本医疗保险功能评估

摘要

为城市非就业居民建立城镇居民基本医疗保险制度,是我国实现基本建立覆盖城乡全体居民的医疗保障体系目标的战略举措."十二五"期间城居保发展迅速.但是从资金筹集、风险集合与购买服务的基本功能角度看,城居保仍然面临一些挑战,包括资源动员能力不足,缴费机制不够公平和有效,保障不充分,受益的公平性有待提高,风险集合分割,医疗服务购买机制不完善,与医疗服务体系的互动不足等.为了提高城居保的绩效,必须有效应对上述挑战.%Establishing a basic medical insurance system for the urban unemployed residents is a strategic act to achieve an all-covered insurance system for urban and rural the residents. During the period of the "Twelfth Five-year", the insurance system for the urban residents has being rapidly developed. But from fund raising, risk pooling and service purchasing points of view, it still faces some challenges, such as insufficient resource mobilization ability, unfair and ineffective payment mechanism, inadequate protection, benefit fairness under improving, imperfect risk segmentation and medical services buying mechanism, and lack of interaction with medical service system. In order to improve the performance of urban resident insurance, we must effectively deal with these challenges.