中国医疗保障发展报告（2020）
| 书 名： |
中国医疗保障发展报告（2020） |
| 英 文 名： |
ANNUAL REPORT ON CHINA’S HEALTH CARE DEVELOPMENT （2020）
|
| 作 者： |
郑功成 申曙光 |
| I S B N： |
978-7-5201-7197-7 |
| 丛 书 名： |
医疗保障蓝皮书
订阅
|
| 关 键 词： |
医疗保健制度 发展挑战 发展前景 |
| 出版日期： |
2020-09-01 |
中文摘要
医疗保障是解除人民疾病医疗后顾之忧和提高全民健康素质的重大民生保障制度，也是现代社会保障体系中的主要制度安排。经过20多年的探索，我国的医疗保障改革取得了很大成就，目前正在从长期试验性改革状态走向促使医保制度基本成熟、定型的关键时期，但还面临着诸多问题与挑战，深化改革必须以调整既有的利益格局为条件。
本书作为首部聚焦于2018年以来中国医疗保障改革与制度建设情况的报告，对上述问题做出全面、客观的反映和评价。国家医疗保障局的成立，扫除了长期制约医疗保障改革的体制性障碍，打开了医保制度改革和发展的新局面。中央关于全面深化医疗保障制度改革的顶层设计出台；城乡分割的居民基本医疗保险制度稳步整合；取消居民医保个人账户等方面取得重要进展；医保信息化和标准化建设全面推进；医保欺诈、药价虚高等现象得到初步遏制；医疗保障制度的保障功能持续增强，特别是在脱贫攻坚、抗击新冠肺炎疫情中发挥了充分有效的保障功能，人民群众获得感明显增强；等等。但与此同时，新时代我国医疗保障制度改革与体系建设面临的挑战也是多方面的，包括以往形成的筹资责任失衡、待遇差异和统筹层次低等制度性缺陷日益显性化，人口老龄化和疾病谱变化等影响因素日益复杂化，以及对已经形成的利益格局进行深刻调整而带来的改革风险的显著加大等。在新局面打开后，必须直面现行医保制度的内在缺陷和不足，并在全面深化改革中加快制度优化的步伐。深化医保改革的核心任务是在“十四五”期间促使中国特色的医疗保障制度走向基本成熟、定型，重点是要强化制度建设，加快矫正现存的制度性缺陷，加快健全重特大疾病医疗保障制度和医保应急机制建设，全面优化多层次医保制度体系及其结构与功能，同时加快医保领域的法制建设步伐。
本书涵盖了中国医疗保障总体发展、医疗保险筹资机制、医疗保障待遇、医疗保险支付方式、药品集中招标采购、医疗保险经办机制、医疗保险反欺诈、医疗救助、长期护理保险试点、商业健康保险等关键领域的发展情况，剖析了当前存在的主要问题及面临的主要挑战，并就中国特色医疗保障制度体系建设提出理性建议和做出相应的展望。同时，本书还收录了在实地调研基础上形成的浙江、吉林、广东、湖南等典型地区医疗保障相关实践报告，并对全国医疗保障统计公报与相关数据资料进行梳理和汇编。
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