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德国医疗保障制度的现状、问题与改革

作者:丁纯 出版日期:2009年01月 报告页数:18 页 报告大小: 报告字数:14814 字 所属丛书:国际政治论坛 所属图书:德国·欧盟·世界 浏览人数: 下载人数:

文章摘要:1883年6月15日,俾斯麦时期的德国国会通过《工人疾病保险法》,借此德国建立起了全球第一个法定社会医疗保险制度。此后,经过(尤其是第二次世界大战以来的)不断发展完善,形成了以法定疾病保险为主干的,包括医疗保险(含法定、私人疾病保险)、医疗服务和医药提供体系在内的完整、高效的医疗保障体制(见图1),成为中国等全球80余个国家和地区的竞相仿效对象。从医保覆盖来看,截至2007年3月,法定疾病保险覆盖了全德人口的近88%,约7034万人,1440857其中78%的人群属... 展开

文章摘要:1883年6月15日,俾斯麦时期的德国国会通过《工人疾病保险法》,借此德国建立起了全球第一个法定社会医疗保险制度。此后,经过(尤其是第二次世界大战以来的)不断发展完善,形成了以法定疾病保险为主干的,包括医疗保险(含法定、私人疾病保险)、医疗服务和医药提供体系在内的完整、高效的医疗保障体制(见图1),成为中国等全球80余个国家和地区的竞相仿效对象。从医保覆盖来看,截至2007年3月,法定疾病保险覆盖了全德人口的近88%,约7034万人,1440857其中78%的人群属于义务保险者及其家属,10%为自愿参保者及其家属,其余近10%的人参加了私人医疗保险,约840万人。医保覆盖人口中有4%为享受国家津贴的公务人员(包括退休者及其家属),剩下约2%的人口属于享受国家免费提供医疗的联邦国防军军人、民事服役者、警察、社会救济接受者和避难申请者等,只有0.2%的人没有保险,医保基本覆盖了全民。 图1 德国现行医疗保障制度结构 从医保筹资和偿付来看,据《2006世界卫生报告》的数据,2003年德国的卫生总费用支出占GDP的11.1%,人均约3204(购买力平价)美元。其筹资和偿付主要来源为法定疾病保险

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德国

Abstract:>German Health Care System is a famous model that is most widely imitated throughout the world.However,as German economic growth slows down,aging of population deteriorates and globalization impinges,the systematic problems of financing,social solidarity and efficiency of health care provider gradually emerge.Reform on health care system seems inevitable and becomes the stress of economic and social reforms implemented by the Merk... 展开

Abstract:>German Health Care System is a famous model that is most widely imitated throughout the world.However,as German economic growth slows down,aging of population deteriorates and globalization impinges,the systematic problems of financing,social solidarity and efficiency of health care provider gradually emerge.Reform on health care system seems inevitable and becomes the stress of economic and social reforms implemented by the Merkel government.But there remains broad controversy on how to reform it.Based on the introduction to the status quo and basic structure of German Health Care System,the paper analyzes the background of the health care reform carried out by the Merkel government,different reform protocols proposed by separate parties and different notions underlying each protocol.The paper also comments on the main contents of the finally act “Health Care Reform 2007”,and points out the validity of this reform which uses competition enhancement as the main instrument,involves unprecedented broad fields and is oriented by multiple objectives.However,as an act enabled by coalition and compromises,the finally consequences of its implementation is unforeseen and may not be favorable.

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作者简介

丁纯:丁纯,复旦大学经济学院