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在部门利益和医保经办机构利益融合的背景下,我国城乡医保实践探索的四种统筹模式都不利于基本医疗保险制度的良性发展。运用社会法学的利益分析的方法,我国城乡医保管理统筹,应通过立法拆解政府部门利益,将政府从医疗保险的“举办者”转变为医、患、保三方利益的规划者、监管者、调控者,以实现基本医疗保险各方利益平衡,促使医保管理良性运转。
Under the background of the combination of departmental interests and medical insurance agencies’ interests, the four kinds of overall mode of exploring medical insurance in urban and rural areas in our country are not conducive to the sound development of the basic medical insurance system. Using the method of benefit analysis of social jurisprudence, the medical insurance administration in urban and rural areas in our country should be integrated and the interests of government departments should be dismantled through legislation to transform the government from the “sponsor” of medical insurance to the planner of the tripartite interests of medicine, Who regulators, in order to achieve the balance of interests of all parties involved in basic medical insurance, and promote the healthy operation of health insurance management.