CAJ | 학술논문

制定科学合理的社会医疗保险补偿范围是保证其可持续性的重要前提.随着城乡一体化的进程,新型农村合作医疗与城市职工和居民医疗保险的并轨必将展开,制定统一的社会医疗保险显得十分必要.详细介绍了美国医疗照顾制度和德国法定医疗保险项目的服务遴选原则和决策过程,分析了社会医疗保险补偿范围制定的关键,提出了制定过程中的相关建议,以供借鉴.
제정과학합리적사회의료보험보상범위시보증기가지속성적중요전제.수착성향일체화적진정,신형농촌합작의료여성시직공화거민의료보험적병궤필장전개,제정통일적사회의료보험현득십분필요.상세개소료미국의료조고제도화덕국법정의료보험항목적복무린선원칙화결책과정,분석료사회의료보험보상범위제정적관건,제출료제정과정중적상관건의,이공차감.
It is an important presupposition of ensuring the sustainability of the social medical insurance that to formulate reasonable social medical insurance compensation range. With the development of urban and rural integration, the new rural cooperative medical system and medical insurance for urban workers and residents will be merged. therefore, it's necessary to formulate unified social medical insurance. This paper introduced in detail American medicare system and the service select rule and decision-making process of legal medical insurance items in Germany. It analyzes the key of social medical insurance compensation range formulation, then proposes related suggestions as a reference.