健康管理全民需求——专访中华医师协会副秘书长陆君

我们寄希望于一些经济发达地区,开展全民健保.比如只要是我这个市的公民,就有权利享受政府提供的健康保障服务,政府有一定的投入,而老百姓只需要投入很少的钱.     

全民医保目标下的制度选择

本文在分析我国医疗保障制度现状和面临问题的基础上,提出了构建全民医保制度的设想,从提高制度公平性及管理效率的目的出发,阐述通过"三步走",在我国建立以覆盖城乡全体公民为目标,以保大病、保基本为重点,实现一体化管理的医疗保险制度。     

新加坡医疗保障制度及其对我国的借鉴

新加坡的医疗保障制度主要包括保健储蓄、健保双全和保健基金3大计划。这一医疗保障制度较为适合该国的国情,体现了公平与效率的原则,形成了多元化和较合理的医疗筹资机制．注重了政府与市场在医疗保障资源配置中的不同作用。新加坡医疗保障制度的模式,为我国新一轮的医疗保障制度改革提供了可资借鉴的经验。     

《社会保险法》出台后的养老保险问题刍议

《社会保险法》坚持广覆盖、保基本、多层次、可持续的社会保险基本方针,将城乡各类用人单位和居民都纳入基本养老保险的适用范围,将新型农村社会养老保险制度和城镇居民社会养老保险制度正式提出,勾画了全民养老的制度框架。但由于各种历史和现实因素的影响,当前养老保险制度改革依然面临诸多挑战,克服这些困难和挑战,依然需要国家层面的制度设计,并统筹推进。     

中国医疗保障制度改革:全民医保的三支柱框架

本文在分析当前中国医疗保障体系突出矛盾的基础上,阐释中国医疗保障制度改革的时机和目标,提出有关改革框架和实施路径,并对未来医疗保障制度的整合进行讨论。本文认为,为实现医疗保障的全民覆盖,应采取"三支柱"的医疗保障制度框架,即公共医疗保险、社会医疗救助和商业健康保险。改革的基本思路是:同步推进扩大覆盖面与医疗保障制度自身的深化改革。改革的路径主要包括:(1)深化现有制度改革,提高运行效率;(2)扩大覆盖面,实现全民医疗保障;(3)大力发展商业健康保险,满足民众多层次保障需求。     

澳大利亚卫生保健制度的私有化：公费医疗制度的终止

卫生保健政策是战后福利国家政策的重要组成,它代表的是一种不分社会等级面对全民的、超越市场机制、以收入补贴形式向民众提供医疗服务的方案。在澳大利亚,一直到公共健康保险机构以及继而公费医疗制度实施以后,全民卫生保健系统才得以确立。从此以后,公费医疗一直承受缩减资金的压力。自二十世纪七十年代中期开始,缩减政策一直是福利国家发展的主导政策。本文旨在追溯澳大利亚卫生保健系统的发展过程,揭示卫生保健系统的主要发展趋势,包括私有化过程,国民保健责任由集体承担转变为由私人承担的过程。这种发展趋势代表的是一种残余体制,它将威胁到以提供公平医疗保健待遇为宗旨的全民公费医疗制度的实施。     

共绘体育产业发展新篇章

<正>“体育强国”,在于强体魄,更在于强精神。随着体育改革的全面深化,《体育强国建设纲要》《“十四五”体育发展规划》《全民健身计划》等一系列纲领性政策文件的实施,全民健身公共服务体系不断完善,民众健康意识不断增强,2022冬奥会的成功举办,以及一系列国际、国内、大众体育赛事恢复举办,进一步激发了民众的参与热情,我国运动员在竞技体育表现出来的积极向上的精神风貌也增强了民众的自信心。     

大众健康美操在全民健身中发展的动因剖析

文章从社会学、心理学、体育学等多维角度,通过对大众健美操在全民健身中开展的现状、作用及其二者之问的关系进行分析,重点探讨了大众健美操在全民健身中开展的动因,旨在为全面贯彻实施<全民健身计划纲要>,促进我国群众体育的广泛开展,引起广大民众对健美操运动的普遍关注等提供有益的参考.     

大众健美操在全民健身中发展的动因剖析

文章从社会学、心理学、体育学等多维角度，通过对大众健美操在全民健身中开展的现状、作用及其二者之间的关系进行分析，重点探讨了大众健美操在全民健身中开展的动因，旨在为全面贯彻实施《全民健身计划纲要》，促进我国群众体育的广泛开展。引起广大民众对健美操运动的普遍关注等提供有益的参考。     

医疗保险总额预付制度与医疗行为博弈相关问题研究

社会保险法的颁布实施进一步提供了法律保障,国家医改方案坚持"强基层、保基本、建机制、广覆盖、可持续的"方针,强调国家义务和政府责任,系统规划医疗保险、公共卫生服务、基本药物制度、基本医疗服务体系、公立医院改革等医疗改革发展目标,更加具体细化。建立完整的全民医保体系是初步解决十三亿国民医疗保健这一世界难题的基本方法,具有极强的历史意义。     

DO ADULT CHILDREN MATTER?—THE EFFECTS OF NATIONAL HEALTH INSURANCE ON RETIREMENT BEHAVIOR: EVIDENCE FROM TAIWAN

This paper examines the effect of the 1995 implementation of National Health Insurance (NHI) on retirement behavior in Taiwan. The identification strategy is based on the fact that, in Taiwan, adult children offer significant insurance to elderly parents. The results suggest that NHI had significant effects on retirement among the elderly lacking an adequate traditional "safety net." NHI raised the conditional probability that a male, private sector worker over the age of 51 would retire by more than 60%. However, men with a stronger safety net in the form of adult sons were less responsive to NHI. ( JEL I18, J14, J26)     

社会医疗保障改革的福利效应:以中国城镇为例

This paper evaluates Chinese public health insurance reform enforced since 1998 in terms of its welfare effects. We evaluate China health insurance reform since 1998 using the China Health and Nutrition Surveys (CHNS) data with relevant econometric models. The results of empirical studies show that the public health insurance status has significant impact on medical service utilization and expenditure. The reform reduces the positive effect of public health insurance on medical service utilization, meaning the utilization gap is narrowed after the reform. However, the empirical studies find that the medical expenditure growth of the sample individuals in urban China has not been controlled after the Basic Medical Insurance (BMI) program even if a new co-payment is enforced. Two main reasons for this failure might be the rising cost of medical service and physician’s severe moral hazard, while both of them come from no managed care mechanism for medical service providers in China.      

印度农业保险制度初探

印度是农业大国,经济欠发达,农民抵御自然风险的能力不高,购买商业保险的能力有限.为保护农业利益,印度政府在支持农业保险发展上采取了积极措施,并在实践中取得了成效.本文对印度国家农业保险项目、政策性农业保险公司以及农业保险立法进行了介绍,并对我国农业保险事业的发展提出了建议.     

A Critique of the Private Health Insurance Regulations

The private health insurance sector is one of the most regulated sectors in Australia. The Private Health Insurance Incentives Scheme, along with community rating, is intended to make private insurance equitable, profitable and popular. We argue that the subsidy to health insurance ought to be a very effective tool for increasing insurance–but it was ineffective because community rating was ineffective. Using data from the Household Expenditure Survey we find that despite community rating rules which prohibit age‐adjusted premiums, young adults paid considerably less for their insurance than older adults. We conclude that insurers circumvented community rating through plan design, screening older consumers into more expensive plans. We also find that the penalty of 2 per cent per year for delaying insurance, introduced as part of the lifetime cover plan, is too low to be effective. We reflect on the New Zealand experience, where a completely deregulated insurance industry continues to be profitable and enjoys similar rates of coverage to those of Australia, and we ask whether Australia too could not benefit from complete deregulation.     

Health,Social Insurance and Income

Health, a form of human capital, can be defined by longevity and physical wellbeing. Social policy decisions require an understanding of the factors that contribute to the creation of health inequalities. To learn more about socioeconomic variables and health capital, this paper examines the relationship between three key variables: health, social insurance, and income, for the Swedish population. Using a randomized research survey design, data from 3,600 participants of a larger Swedish study, conducted in 2005, was analyzed. A linear model of Three Stage Least Squares was chosen to correct for simultaneous bias in the Health, Social Insurance, and Income (HSI) Model. Findings confirm the importance of socioeconomic, behavioral and environmental factors in explaining health inequalities. The results clearly show men, educated people, nonsmokers, individuals that exercise and youngsters possess higher health status than other people. The dependency on social insurance is mainly caused by poor health; a higher degree of social insurance dependency was offset by income increases due to age and higher professional level.      

Adverse Selection and the Decline in Private Health Insurance Coverage in Australia: 1989–95

The decline in private health insurance coverage over the period 1989–95 is analysed using the ABS National Health Surveys. Individuals' health status and health risk behaviours are found to be significant determinants of their decision to purchase private health insurance. At a point in time, the pool of the insured is very heterogeneous, with a mix of both good and bad health risks. It is found that the decline in insurance coverage over the period 1989–95 coincided with an increase in the degree of 'adverse selection' within the insured population.     

The determinants of the demand for private health insurance under Medicare

Since the introduction of Medicare in 1984, the proportion of the Australian population with private health insurance has declined considerably. Insurance for health care consumption is compulsory for the public health sector but optional for the private health sector. In this paper, we explore a number of important issues in the demand for private health insurance in Australia. The socio-economic variables which influence demand are examined using a binary logit model. A number of simulations are performed to highlight the influence and relative importance of various characteristics such as age, income, health status and geographical location on demand. A number of important policy issues in the private health insurance market are highlighted. First, evidence is provided of adverse selection in the private health insurance pool, second, the notion of the wealthy uninsured is refuted, and finally it is confirmed that there are significant interstate differences in the demand for private health insurance.     

中国城镇社会医疗保障改革的理论探索

With its transition to a market-oriented economy, China has gone through significant changes in health care delivery and financing systems in the last three decades. Since 1998, a new public health insurance program for urban employees, called Basic Medical Insurance Program (BMI), has been established. One theme of this reform was to control medical service over-consumption with new cost containment methods. This paper attempts to evaluate the effects of the reformed public health insurance on health care utilization, with in-depth theoretical investigation. We formulate a health care demand model based on the structure of health care delivery and health insurance systems in China. It is assumed in the model that physicians have pure monopoly power in determining patients’ health care utilization. The major inference is that the insurance co-payment mechanism cannot reduce medical service over-utilization effectively without any efforts to control physicians’ behavior. Meanwhile, we use the calibrated simulation to demonstrate our hypothesis in the theoretical model. The main implication is that physicians’ incentive to over utilize medical services for their own benefits is significant and severe in China.      

医疗保险与城乡反贫困:1989-2006

文章利用中国健康与营养调查(CHNS)数据,估计了1989-2006年医疗保险对中国城乡家庭的反贫困效应。结果发现:发生灾难性卫生支出的城乡家庭比例较高,最穷的群体其医疗费用超过收入的比例增加,医疗保险对减少收入不平等只起到微弱作用。TIP贫困曲线表明,近几年,医疗保险补偿后,城乡患病家庭的贫困并没有减轻,医疗保险在减少贫困上的作用很小。分析贫困特征的多元回归模型显示,家庭成员数量、教育程度、抚养比率、参保人数等都影响了贫困,而条件多元回归模型则显示,医疗保险对贫困的变动没有影响。     

我国健康保险反欺诈的博弈分析及其政策建议

在健康保险领域,由于信息不对称导致的保险欺诈问题已成为影响我国保险业健康发展的毒瘤。本文运用博弈论的相关知识对健康保险欺诈问题进行分析,找出影响保险欺诈成本支出的主要因素,再运用最优化方法分析,提出建立有效的健康保险反欺诈机制的政策建议。