图书简介
《流动人口医疗保障的社会学研究》专著是盛昕研究员主持的,2010年国家社科基金项目的最终成果之一。这部专著在充分运用文献资料和实证调查资料的基础上,对流动人口医疗保障制度进行了实证研究,具有后续的针对性,充分体现了应用研究的特点,同时也有一定理论深度,为城市化、社会保障,社区等理论应用于分析实际问题提供了范例。一该专著的选题非常好,具有前沿性。流动人口的医疗保障问题是当今社会关注的热点、难点问题之一,我国正经历人类历史上最大规模的人口流动,在改革开放、城市化、市场经济等一系列因素作用下,大量人口从乡村流入城市,第二次人口普查全国有流动人口2.6亿,剔除市辖区人户分离人口,则流动人口为2.2亿,而现在仍有增长趋势。流动人口的社会保障特别是医疗保障却远远滞后,不适应流动人口的需要,而流动人口医疗保障的解决也具有一定难度。流动人口医疗保障需求的刚性,与流动人口的流动性,给流动人口医疗保障制度的制定与实施造成了障碍。该专著抓住这一难题,通过借鉴国内外经验与实证调查,提出了解决流动人口医疗保障的制度模式,具有重要的现实意义,解决流动人口社会保障,特别是医疗保障将促进经济的发展,历史和现实都证明,流动人口对地区经济发展的贡献是巨大的,国外经济发达的城市都是移民城市,我国经济发达的广州、深圳、东莞、上海等地都是流动人口最多的城市。流动人口对流入地国内生产总值的贡献率在百分之二十以上。解决流动人口医疗保障问题将促进社会的稳定,因为医保需求是刚性的,没有医保,一旦发生大病就可能因病返贫,影响流动人口对流入地的认同。解决流动人口医疗保障问题将促进社会的公平正义。公平正义是社会正义的本质特征,流动人口参与医保,解决“看病贵,看病难”的问题,也就是向普惠制迈出了一大步。该专著的可贵之处就在于对解决“热点”、“难点”问题做出了自己的可贵努力。二任何研究都是在前人研究成果的基础上进行拓展、创新。该专著在这方面做得比较突出,对国内流动人口社会保障研究进行了述评。对流动人口社会保障的发展、内在结构、制度模式、不同地区制度差异都做了述评,对于流动人口社会保障好的经验与做法也都做了评析,为研究流动人口的医疗保障提供了基础。特别是该专著对国外流动人口医疗保障制度进行了详细的疏理与述评,为国内解决这一问题提供了借鉴与参考。“他山之石,可以攻玉。”该书对不同类型医疗保障制度下流动人口的医疗保障如以英国为代表的国家医疗保障制度下流动人口医保;以德国为代表的社会医疗保险制度下流动人口医保;以美国为代表商业医疗保险制度下流动人口医保;以新加坡为代表的储蓄型医疗保险制度下流动人口医保;对其流动人口医疗保障制度的优缺点及改革方向也做了评析,并对我国流动人口医疗保障制度的启示作了思考。该专著的最突出特点是突出实证调查研究,课题组在东北老工业基地城市哈尔滨、长春、沈阳,以及发达城市北京、上海、成都、深圳七个城市,抽取1534个流动人口样本,进行了问卷调查。对于流动人口医疗保障参保意愿,服务需求以及不同类型流动人口医疗保障需求进行调查与评估。并且对于老工业基地城市流动人口参保意愿,服务需求与发达地区流动人口的参保意愿,服务需求进行了比较研究,对不同经济发展模式对流动人口医疗保障的影响也做出评估。为党和政府部门决策提供了实践基础。三该专著重点设置了对策建议篇,占全书三分之一,这是在实证调查的基础上提出了“怎么办?”的问题,体现了社会学的规范功能,也体现了作者们的担当意识。对策建议中,既有对流动人口医保制度、政策提出方向性、指导性的概括层次较高的建议,也有比较具体、可操作性强的建议。对流动人口医疗保障制度的建设具有重要的参考价值。由于我国相当长一段时间社会结构呈现城乡二元结构,无论是养老保障制度还是医疗保障制度都是城乡分设。而处于流动状态的流动人口,主要是农民工,没有专门的医疗保险制度,在制度上处于空白状态,各地虽然都相应建立了一些具体办法,又基本处于“碎片化”状态。因此,该专著从城乡统筹角度,医疗保险转移接续、救助体系实现途径、法律制度建构、医疗服务均等化,环境公平与健康权益保障等方面提出了多方面建议,许多建议针对性强对流动人口医疗保障制度建设具有指导意义。当然,作为流动人口医疗保障制度研究,涉及众多学科,该专著从社会学视角对其进行了透视,今后尚需多学科、多视角进行综合研究。而且由于各地经济发展不平衡,流动人口的医疗保障体系也有不同特点,需要进行深入研究。希望作者们在现有研究基础上不断拓展、深入,拿出更多更好的成果。董鸿扬2014.7.12
The monograph "Sociological Research on Medical Security for Migrant Populations" is one of the final results of the 2010 National Social Science Foundation project chaired by researcher Sheng Xin. On the basis of making full use of literature and empirical survey data, this monograph conducts empirical research on the medical security system of the floating population, which has follow-up pertinence, fully reflects the characteristics of applied research, and also has a certain theoretical depth, providing examples for the application of urbanization, social security, community and other theories to practical problems. First, the selection of the topic of this monograph is very good and cutting-edge. The medical security of the floating population is one of the hot and difficult issues of today's society, our country is experiencing the largest population flow in human history, under the influence of reform and opening up, urbanization, market economy and other factors, a large number of people from the countryside to the city, the second census of the country has a floating population of 260 million, excluding the municipal district of the separated population, the floating population is 220 million, and there is still a growing trend. The social security of the floating population, especially the medical security, lags far behind and does not meet the needs of the floating population, and it is also difficult to solve the medical security of the floating population. The rigidity of the medical security needs of the floating population and the mobility of the floating population have created obstacles to the formulation and implementation of the medical security system for the floating population. The monograph grasps this difficult problem, through drawing on domestic and foreign experience and empirical investigation, put forward a system model to solve the medical security of the floating population, which has important practical significance, to solve the social security of the floating population, especially medical security will promote economic development, history and reality have proved that the contribution of the floating population to regional economic development is huge, foreign economically developed cities are immigrant cities, China's economically developed Guangzhou, Shenzhen, Dongguan, Shanghai and other places are the cities with the largest floating population. The contribution rate of migrants to the GDP of the inflow area is more than 20%. Solving the problem of medical security for the migrant population will promote social stability, because the medical insurance demand is rigid, and without medical insurance, once a serious illness occurs, it may return to poverty due to illness, which will affect the identity of the migrant population to the place of inflow. Solving the problem of medical security for the migrant population will promote social fairness and justice. Fairness and justice are the essential characteristics of social justice, and the participation of the floating population in medical insurance to solve the problem of "expensive medical treatment and difficult medical treatment" is a big step towards the Generalized System of Preferences. The value of this monograph lies in its own valuable efforts to solve "hot spots" and "difficult points". Second, any research is based on the research results of predecessors to expand and innovate. The monograph has done a prominent job in this regard, and reviews the research on social security of domestic migrant population. The development, internal structure, institutional model, and institutional differences of social security for the floating population were reviewed, and the good experience and practice of social security for the floating population were also reviewed, which provided a basis for studying the medical security of the floating population. In particular, this monograph provides a detailed review of the medical security system of foreign migrants, which provides reference and reference for solving this problem in China. "He is the stone of the mountain, and he can attack the jade." The book provides medical insurance for migrants under different types of medical security systems, such as medical insurance for migrants under the national medical security system represented by the United Kingdom; Medical insurance for migrants under the social medical insurance system represented by Germany; Medical insurance for migrants under the commercial medical insurance system represented by the United States; Medical insurance for migrants under the savings medical insurance system represented by Singapore; The advantages and disadvantages of the medical security system for the floating population and the direction of reform also commented, and the enlightenment of the medical security system for the floating population in China was considered. The most prominent feature of the monograph is the empirical investigation and research, in which the research team collected 1534 floating population samples and conducted questionnaire surveys in Harbin, Changchun and Shenyang, as well as the developed cities of Beijing, Shanghai, Chengdu and Shenzhen. Investigate and evaluate the medical insurance willingness and service needs of the floating population, as well as the medical security needs of different types of floating population. In addition, the willingness of urban migrants in old industrial bases, service demand and developed areas to participate in insurance and service demand were comparatively studied, and the impact of different economic development models on the medical security of the migrant population was also evaluated. It provides a practical basis for decision-making by the Party and government departments. Third, the monograph focuses on countermeasure suggestions, which account for one-third of the book, which is based on empirical investigation and puts forward "What to do?" The question reflects the normative function of sociology and the sense of responsibility of the authors. Among the countermeasure suggestions, there are not only suggestions with a high level of direction and guidance on the medical insurance system and policies of the floating population, but also more specific and operable suggestions. It has important reference value for the construction of the medical security system for the floating population. Because China's social structure has shown a dual structure of urban and rural for a long time, both the old-age security system and the medical security system are divided between urban and rural areas. The floating population in a mobile state, mainly migrant workers, does not have a special medical insurance system, and is in a blank state in the system, although some specific measures have been established in various places, they are basically in a "fragmented" state. Therefore, from the perspective of urban and rural coordination, the monograph puts forward a variety of suggestions on the transfer and continuation of medical insurance, the way to realize the rescue system, the construction of the legal system, the equalization of medical services, environmental fairness and the protection of health rights and interests, and many of the suggestions are of guiding significance for the construction of the medical security system for the floating population. Of course, as a study of the medical security system of the migrant population, involving many disciplines, this monograph provides a sociological perspective, and multidisciplinary and multi-perspective comprehensive research is needed in the future. Moreover, due to the uneven economic development of various places, the medical security system of the floating population also has different characteristics, which needs in-depth research. It is hoped that the authors will continue to expand and deepen on the basis of existing research and come up with more and better results. Dong Hongyang, July 12, 2014(AI翻译)
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