社会医疗保险政策效果评估的理论与实证研究动态

医疗保险政策效果评估是医疗保险制度发展的必然要求,也是医疗保险制度管理的重要手段和核心内容。文章对国内外医疗保险政策效果评估的理论和实证研究成果进行梳理和评述,发现目前关于社会医疗保险政策效果评估的研究存在理论研究不足、研究深度不够以及缺乏对新型医疗保险制度的关注三个主要问题。需在理论研究方面综合考虑我国医疗保险制度发展的实际,突出理论研究的本土化特色;在研究内容方面深入考察医疗保险制度效应产生的内在机理,提高政策建议的科学性;同时还应关注新型医疗保险制度的发展进程,加强对城乡居民医疗保险制度的评估研究。     

基本医疗保险促进了居民健康与公平感吗

城乡居民对基本医保制度的主观公平感是衡量该制度成功与否的重要依据。基于2015年中国综合社会调查的数据,本文采用有序多分类回归模型实证分析参加基本医疗保险对城乡居民健康与公平感的影响。结果显示,参加基本医疗保险显著提升了城乡居民的主观公平感。基于中介效应分析发现,基本医疗保险通过身体健康和心理健康显著提升主观公平感。基于平均边际效应分析发现,基本医疗保险对主观公平感的影响存在城乡差异,参保对农村居民主观公平感有显著的促进作用,对城镇居民则没有显著影响。由此,本文提出在保证医保基金安全可持续的基础上降低起付线、提高报销比例及支付限额,完善制度设计,简化报销手续,依据城乡差异实行不同的倾斜政策等建议。     

我国医疗保险制度对新生儿健康的影响

医疗保险制度作为一项重要公共政策,对提升新生儿健康水平具有重要作用。国外学者关于医疗保险对新生儿健康的影响做了详尽研究。我国医疗保险制度与国外模式不同,但国内却鲜有研究关注此领域。本文采用倾向性评分匹配法,探讨医疗保险制度对新生儿健康的影响。本文的基本判断是:现行的医疗保险制度显著提高了新生儿的健康水平,并且对于流动人口及城职保参保对象等群体的新生儿健康的促进作用更大。这为进一步提高医保覆盖率、完善医疗保险制度提供了理论依据与决策支持。     

社会公平正义视角下的我国基本医疗保险制度改革历程分析

公平正义是基本医疗保险制度的核心价值原则之一。通过回顾分析发现,我国基本医疗保险改革演进过程实质上是一个不断走向更高层次公平正义的过程。主要体现在三个方面:第一,明确了基本医疗保险"全覆盖"的目标,将全体公民都纳入基本医疗保险的安全网来缓冲疾病可能带来的各类风险;第二,在责任主体上强调政府的主导作用,明确政府在基本医疗保险制度中的筹资责任来切实增强基本医疗保险制度的公共性;第三,通过构建城乡一体化的医疗保险制度使全体人民群众都能获得公正平等的医疗保障待遇。因此,未来应继续强化政府在基本医疗保险中的主体责任,继续加快城乡一体化的基本医疗保险制度建设进程,进一步扩大基本医疗保险制度的报销范围,进而促进新时代下我国基本医疗保险制度走向更高层次的公平与正义。     

社会保障公平性的测量准则与效果评估

社会保障公平性具有重要的理论价值和现实意义。本文以保证原则、事前原则、事后原则和调剂原则为测量准则,通过构建指标体系,对我国社会保障制度公平性进行全面评估。评估结果显示,2015年我国社会保障公平性指数为41.60。其中,养老保险、医疗保险、最低生活保障三项基本制度,在覆盖范围、准入条件、待遇水平、政府补助四个公平性维度上的差异较大。建立更加公平的社会保障制度,应明确我国社会保障发展的基本逻辑。尤其在公民和保险、有工作者和无工作者几个子变量之间,构建明晰的制度发展路径。     

收入差距与最优社会医疗保险制度设计——一个理论模型

目前我国的社会医疗保险市场中呈现出低收入者低保障,高收入者高保障的局面。本文采用福利分析方法研究社会医疗保险市场内存在收入差距时的社会最优医疗保险制度设计,结果表明,当前我国的基本医疗保险制度安排会产生效率和公平的双重损失。模型分析发现,医疗保险的收入效应和道德风险的强度在高低收入人群之间存在显著差异,当保险项目存在组内收入差异时会引起收益分配不公;当存在组间收入差异时,低收入人群的医疗保险项目的社会最优保障水平应严格高于高收入人群的保险项目。因此,将基本医疗保险体系向低收入者拥有更高的医疗保障的方向推进,有利于社会福利的提升。     

医保城乡统筹的实现路径

新医改实施5年来,我国基本医疗保险制度已实现全民覆盖,在制度全覆盖后,我国基本医疗保险制度面临着从城乡分立到城乡统筹的转型,从人人享有转向人人公平享有。特别是城镇化背景下,需要通过参保登记全民化、制度架构统一化、基本待遇均等化、经办服务一体化和管理体制垂直化等城乡统筹的制度安排,建立统一的更加公平。     

处理好公平与效率的关系

公平指平等、正义、公平,是人类追求的一种理想状态;效率指以较少或较小的投入获得较多或较大的产出,以满足人们对效率的需求。公平与效率之间是一种互为存在条件,相互依赖、相互影响、相互制约、相互促进的统一关系。一方面,效率是实现公平的条件,公平离不开效率。另一方面公平是提高效率的条件,没有公平就没有效率。在一个国家的特定发展阶段上,受特定现实社会条件的制约,会因社会物质生活条件的不同、人们对公平与效率关系的实际需求的侧重点不同等主客观因素的影响,人们处理公平与效率关系的具体原则及其侧重点也会有所不同,或以公平为…     

“医疗不公平”争论存在误区

党的十八届三中全会对医疗保险制度改革发展提出的新要求是"更加公平可持续",关于医疗公平性的问题再度成为社会议论的焦点。比如,有人将医疗的公平性定位为"均等化",比较不同收入、职业、地位人群之间的待遇差距,人群之间存在"不均等"因而医疗不公平;有人将城乡医疗保险制度的报销水平作为尺度,因为存在报销水平的差异而认定医疗不公平;更有甚者将公费医疗制度和其他人群的医疗保险制度     

建立城乡基本卫生保健制度的改革设想

从提高医疗卫生资源利用效率和促进基本医疗卫生服务公平可及的角度出发,我们提出建立城乡基本卫生保健制度的总体设想是适当整合不同医疗保险板块的资金,在基本层面建立一个覆盖全体城乡居民的基本卫生保健制度。在此基础上,再发展多层次的医疗保险体制。     

Almanac of anticipations: The age of affluence—of anticipation—of anxiety—of automation—of discontinuity—of longing—of overkill—of space exploration

With this survey of developments in the futures field since 1945, I.F. Clarke completes his present series for Futures. He makes two major points: that forecasting techniques have become essential tools in the management of change; and that nuclear weapons and ecological problems have added a moral dimension to the study of the future. In the next issue of Futures he will start a new series on the range of future-thinking in the USA, from the expectations of the first settlers to the Star Wars programme.     

基金公司经营融资融券业务的问题审视

融资融券业务正式运营已经开展,为证券市场带来了革命性的改革,作为证券市场的一大主体,基金公司面对融资融券也迎来了新的发展方向和挑战,本文从融资融券业务的运行机制入手,分析了基金公司融资融券的新契机,并对其即将面临的问题进行审视和剖析,进而提出策略建议.     

对基层人民银行科技工作的几点建议

银监会分设后,人民银行将专司货币政策、金融稳定、金融服务三大职能。作为人民银行的分支机构,基层人民银行的工作重心也将从金融监管调整到这三大职能上来。人民银行的科技部门,就要积极运用科技手段,为人民银行履行新的职能发挥“服务、支持、促进、发展”的作用。一、围绕三大职能搭建五大平台经过“六五打基础、七五作准备、八五大发展”几个阶段后,人民银行相继实现了核算电算化、清算网络化和办公信息化。特别是近一两年来,陆续开通了大额支付系统、信贷登记咨询系统、会计四集中系统、金融信息服务网站等系统,人民银行信息化水平又…     

The Usefulness of Measures of Consistency of Discretionary Components of Accruals in the Detection of Earnings Management

Abstract:  Prior research has shown the prevalence of measurement error in models used to estimate aggregate discretionary accruals. In these models, the incremental information content of the various components of accruals is ignored. Limited prior research and data gathered from firms under Securities and Exchange Commission (SEC) litigation indicate that managers use either one or more than one component of accruals simultaneously, in a consistent way to manipulate bottom-line earnings in a given direction. I propose two measures that capture the consistency between the discretionary components of accruals and test their significance in earnings management (EM) detection in firms that have artificially added accrual manipulation and firms that were targeted by the SEC for accrual manipulation. There is evidence that this information is incrementally useful in detecting EM. This finding paves the way for improvements in the discretionary accruals measure by including consistency information from the components of aggregate accruals.     

社会主义所有制形式的改革、完善与共产党执政能力的提高

在中国,所有制形式的调整、改革与完善,先进生产力的发展,党的执政能力建设,是社会主义建设过程中密切结合在一起的三个不同层面的发展关系.应在相互促进和共同提高中促进社会的和谐发展,保证社会主义现代化建设战略目标的顺利实现.     

Summary of Results of Survey of Seminar Attendees

Abstract

The Society of Actuaries undertook a three-phase research project on mortality improvement in the three NAFTA countries: Canada, Mexico, and the U.S. Phase 1 consisted of a literature review of papers on projecting mortality levels in the future and a study of the trend in mortality improvement during this century. Phase 2 consisted of a discussion of different facets of modeling mortality rates at a seminar attended by 79 experts (actuaries, demographers, economists, and medical researchers) representing different countries. The last session of the seminar consisted of the completion of a survey by the attendees to obtain input for Phase 3, which would analyze the impact of mortality improvement on the social security system of each country. This paper summarizes the results of the survey.

The survey results illustrate the difficulty in forecasting mortality levels, because the effects of many factors that could have significant impact on mortality rates are unknown. This suggests the need for dynamic forecasting, which allows for the possibility of random shocks. A majority of the survey respondents believe that stochastic forecasting models, despite their complexity, have significant potential to add value. Respondents also believe that both historical data and cause-specific mortality forecasts are useful as input and also in validating forecasts of the aggregate levels of mortality. The challenge is to develop more sophisticated forecasting models to produce results that are relatively easy to interpret and to communicate these results to the desired audiences, including the public and policymakers.

The survey results suggest that the aggregate effect of lifestyle changes, medical advances, diseases, catastrophe, and physical environmental changes is an increase in life span. However, there is much uncertainty about the future. Respondents expect that beyond the year 2020 the mean annual rate of reduction in mortality for males age 65 and over will average about 0.58% for Canada, 0.76% for Mexico, and 0.67% for the U.S. The results for the female age 65 and over population are 0.64%, 0.83%, and 0.70%, respectively. The age 65 and over population is expected to see larger percentage reductions in mortality than the 0–14 and 15–64 populations. The reductions in male and female mortality will be ultimately the same, and the mortality levels in the three countries will ultimately converge, although differences may persist for decades.     

银行软件项目外包管理分析

一、引言随着国民经济的不断发展,银行业务与外部企业的联系越来越密切。银行正逐步成为现代经济活动的中心,作为数据处理核心的银行业务应用也越来越大型化、越来越复杂化,因此许多银行也把软件项目逐步由原来的自主开发转变为与公司合作的方式,或直接外包开发的方式,银行本身的技术人员也逐步由开发转向项目管理。二、项目外包的分类银行项目的外包有以下几种情况:①部分子系统外包,有时由于银行的软件项目太大,单靠银行自身的开发力量基本无法在预定的时间内完成项目,只好把相对独立的部分外包;②直接购买软件公司的成熟产品,有些金融软…     

银行管理信息平台建设发展的思考

一、目前国内银行IT发展现状及面临的问题 银行数据集中工作的完成,标志着银行的业务由电子化建设阶段转入信息化建设阶段.一方面银行数据的集中提供了丰富全面的基础数据,面对日益庞大的数据源,如何将数字转化为对银行有用的信息,并从中发现知识,为银行的经营决策提供支持,是摆在银行IT人员面前的一个亟待解决的问题.另一方面用户对银行信息的需求日益增长,如果银行没有一套完整、实用的信息管理系统,将对业务发展非常不利.南京爱立信公司倒戈花旗银行事件曾经轰动一时,其中一个重要原因就是中国本地银行不能满足爱立信全球总部对南京爱立信公司的要求:每周财务上报和每天贷款限额管理.这一事件为中国商业银行的未来发展敲响了警钟,如果不加快管理信息系统的开发,迅速提升业务管理水平,类似的事件还会接连不断地发生,并最终导致国内商业银行在同国外商业银行的竞争中全面溃败.     

Separation of Unit of Account from Medium of Exchange

The separation of a unit of account (UoA) from a medium of exchange (MoE) in the commodity–money system is investigated by considering explicitly a seller's choice of UoA in terms of either an MoE or a unit of metal weight. If the likelihood of debasement of an MoE and its rate are high enough, the price is posted in terms of a unit of metal weight rather than an MoE. Interestingly, this MoE–UoA separated equilibrium yields the flexible nominal price, whereas an MoE–UoA integrated equilibrium yields the sticky one. This implies the nominal price rigidity in the fiat‐money system where MoE and UoA are integrated.     

Properties of time-series estimates of degree of leverage measures

Empirical studies suggest that time-series regression estimates of the degrees of operating and financial leverage have a tendency to produce measures less than one. According to ex ante theory, these measures should be greater than one for firms operating above the breakeven point. There have also been suggestions that the biases in these estimates may be attributable to an underlying increase in unit sales. This work presents evidence that these counter-intuitive measures are produced by changes in the firm's operating parameters (unit price, variable cost, fixed cost and interest payments). It further suggests that attempts to control for the underlying change in unit sales substantially increase the volatility of predicted estimates.