我国城镇基本医疗保险基金结余问题研究

摘要

This paper analyzes the current balance problems by comparing the fund utilization rate and balance rate in different region and different account for Chinese urban social medical insurance. The study shows that the fund utilization rate of urban workers is low and fund balance rate is high,especially personal account. Although the fund utilization rate of urban residence has been increased since the medical reform,the security level is low. Based on the analysis, the paper puts forwards suggestions that different functions of the fund should be distinguished and managed respectively,and balance scale should be matched with the function of different account to further strengthen the fund balance rate management of urban social medical insurance.%本文对我国不同类型、不同地区城镇基本医疗保险基金结余现状进行了比较分析。研究结果表明，城镇职工医疗保险资金利用率较低，基金结余过高，存在经济落后地区向沿海发达地区的逆向再分配。城镇居民医疗保险基金利用率虽然有所提高，但是保障水平较低，未能有效分散风险。在此基础上，提出了厘清城镇职工医保基金不同职能，制定与各职能相匹配的结余标准，加强城镇居民医保基金结余率管理，实现属地参保等建议。