Research On The Equity Of Basic Medical Insurance For Urban Employees

The strategic objective of the reform of medical insurance system and system of medical care insurance is to realize dreams that “everyone can have basic medical insurance” and “cure all of the diseases ” in 2020.The basic medical insurance for workers,which is an important part of the social medical insurance system,can have a social value that “everybody is in good condition ”and keep our society in justice.In this paper,we start with the re-exploration of the meaning of justice and try to construct the index system of evaluating the fairness of the basic medical insurance by tapping the fairness of the basic medical insurance in order to design 5 primary indicators as following: the fairness of the opportunities of taking part in the insurance,financing,the policy of treatment,benefit and the provision of the basic medical service.And there’re 18 secondary indexes,such as to construct the ration of taking part in the basic medical insurance,the differential index and concentration index of the medical fee and the number of visits in the different salaries on the aspect of inpatient and outpatient clinics and the Gink coefficient of designated hospita l configuration on the aspect of employee ensured.According to these indexes to evaluate the fainess of Q ingdao basic medical insurance for workers,the conclusions are as following:Firstly,the fairness of taking part in insurance of basic medical insura nce for workers in cities,the fairness of benefit of outpatient medical insurance for serious illness,the fairness of provision of medical insurance services and procurability are better than that in countries.Then,there’re some limitations of the fairness of basic medical insurance: the same ratio of contribution in Q ingdao leads to the standard of financing is segmental regressive,which leads to the financing of the medical insurance is in injustice;retirees don’t pay the fee leads to the injustice among generations;the same standard of starting payments leads to the fact that treatment policy lack of horizontal justice;there’re some differences in fairness of providing medical insurance service among different distircts.According to these limitations,there’re following suggestions to improve the fairness of basic medical insurance for workers in cities in the paper: Firstly,to formulate the contribution rate which is matched with the salaries and healthy situation of insured people and encourage retirees to pay the fees;Then,to formulate the different standards of starting lines which are matched with people in different levels of salaries and different ratio of reimbursing aimed to vertical equity,to make the policy to regulate retirees to pa y the fees properly;Thirdly,to enhance the allocation of medical resources in high quality of new urban areas and important functional areas to contribute to the medical resources distribute properly;Finally,to establish the policy of special basic med ical insurance funding mechanism which aims to insured group in low income.