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朱铭来:解决医保基金压力可借鉴“福建模式”

2016-12-28 18:12:11   

另外,利用商业健康保险分担居民医疗费用负担,提高商业健康保险在医疗保障体系中的作用也变得很有必要。虽然近几年商业健康险发展迅速,但被寄予厚望的税优型健康险并没有如预期的快速发展。截至2016年11月20日,全国税优健康险承保44035人,保费规模仅为7124万元,人均保费1618元。被群众和业界都给予高度评价的税优健康险出现了“叫好不叫座”的尴尬局面,一方面,是当前每年2400元的税优额度对需求的刺激作用显得太弱,另一方面,税优健康险的赔付率很高,而且允许带病投保,容易出现道德风险因素,这使一些保险公司在开展业务时顾虑较多。

2015年,我国城镇职工医疗个人账户积累达到4429亿元,根据《国民经济和社会发展第十三个五年规划纲要》,下一步要“改进个人账户”,在此之前,一些地区已经进行了职工医疗个人账户改革的探索和实践,包括辽宁大连、广东、浙江等省市探索了使用个人账户购买商业健康保险。

笔者认为,与个人账户改革接轨是走活税优健康险这盘棋的途径之一,拓展个人账户功能时,鼓励使用个人账户资金购买以保大病为核心的保障型商业健康保险,而税优健康险产品主要以保大病为主,在未来税优健康险产品覆盖更多的大病保障时,使用个人账户资金购买商业健康保险将成为拉动税优健康险保费增长的动力之一。同时,税优健康险采用了“医疗+个人账户”的形式,医疗险与基本医保、补充医疗保险相衔接,用于补偿被保险人在经基本医保、补充医疗保险补偿后自负的医疗费用,个人账户积累可用于退休后购买商业健康保险和个人自负医疗费用支出。未来个人账户的改革应将个人账户从社会保障性质的账户改为有积蓄功能的个人账户,保证长期的看病开支。(中新经纬APP)

【专家简介】朱铭来,南开大学金融学院教授、博士生导师,南开大学卫生经济与医疗保障研究中心主任,长期从事医疗保障、保险经济学等领域的研究。

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