城市贫困人口医疗救助运行实践分析——以江苏省盐城市为个案.pdf

摘 要 从 2003 年开始，我国就开展了全国性城市医疗救助试点工作，取得了一 定的进展和效果，但就目前而言，因病致贫、因病返贫现象依然突出，“看病 难、看病贵”问题仍然是普通群众特别是贫困人群的最大一块心病。本文以江 苏省盐城市城市贫困人口医疗救助实践为个案，利用几年来的实证数据和案 例，对医疗救助的内容、提供方式、对象和标准以及救助基金的运营等医疗救 助的关键环节进行逐个剖析和效果评价。在此基础上，讨论现行国内城市贫困 人口医疗救助模式的经验和缺陷，同时，从理论层面进行思考和探索，提出我 国城市贫困人口医疗救助的发展思路。 当前，在推进政府主导和市场机制相结合、以保障公民基本医疗为首要任 务的医疗卫生体制改革的大背景下，本文提出现行的医疗救助制度应当是建立 在全民医保基础上的辅助型医疗保障制度，一是在为贫困人口建立基本医疗保 险基础上，为救助对象提供包括门诊等基本医疗服务在内的综合医疗服务；二 是救助对象的覆盖面以低保对象为中心逐步向边缘扩大；三是采取针对不同人 群采取分类分层的医疗救助形式，推行医前、医中、医后相结合的人性化救助 提供；四是建立以社区卫生服务为运行平台、社会保障部门主体经办的医疗救 助运行机制，从而极大提高医疗救助基金的运行效率，最终将充分保障包括城 市贫困人口在内的所有公民的医疗待遇。 ［关键词］：城市贫困人口 医疗救助 实践 I Abstract The pilot program of urban medical assistance was launched in our country in 2003, and ever since a considerable amount of progress has been achieved. At the moment, however, poverty due to illness remains a social problem, and it is still difficult and expensive for the average people to get the needed medical care. This thesis is an attempt to analyze the Chinese system of providing medical assistance to the urban poor in force and propose a modified approach to this system, in the form of a case study of the practice of the medical assistance to the urban poor in the city of Yancheng in the Jiangsu Province. We evaluate such critical parts as the contents, the forms, the beneficiaries, the various rates, and the operation of the medical assistance to the urban poor. In the present reform context of the health care system in which the government takes the major responsibility of providing all the citizens with the basic medical with the help of the market mecha