身份群体与医疗保障制度——以新疆生产建设兵团第S师为例
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摘要
社会保障制度的公平性问题一直是社会各界广泛关注的焦点。在考察兵团医疗保障制度"公费医疗"与"劳保医疗"时期、医疗保障改革试点时期和医疗保险制度体系建立时期不同身份群体保障差异的基础上,对25名居民、团场职工和师部职工的医疗资源获取方面采取了非结构式访谈,研究发现:1.医疗保障制度对不同群体的保护程度不同:师部职工的保护最优,团场职工的保护次之,居民的保护略显不足。2.不同身份群体对制度的利用策略不同:师部职工能运用较强的市场能力和社会资本,获得最好的医疗保障资源;团场职工可以利用一定的市场能力和社会资本获取较好的医疗保障资源;居民只能被动利用保障制度所给予的底线保护。研究判断:医疗保障制度在现实运行中实现的仅仅是底线公平,给不同身份群体带来的"好处"还是不尽相同的,身份群体的市场能力越强,拥有的社会资本越多,质量越高,医疗保障程度才会越高。
The fairness of the social security system has become the social widespread focus.Based on the study of Public Medical Care,Labor Medical Care,Medical Security System Experimental Reform,Medical Security System,non-structure interview was conducted among 25 Shi workers,corp workers and residents.Founding:1.It is different for the medical security system to protect different group:the degree of protection is the best for the Shi workers,the degree of protection is the medium level for the corp workers,the degree of protection is insufficient.2.The strategy the status group gets from medical security is different,Shi workers can make good use of market capability and social relationship,and can get excellent health care service.Corp workers can use market capability and social relationship to get some medical services which is outside the medical security system.The corps internal residents can use passive security system to get the bottom line protection.Study judgment:Medical Security System is only to guarantee the Baseline Equality,it brings different benefits to different status group.The status group who has stronger market capability,more social relationship,the degree of medical security protection will be higher.
The fairness of the social security system has become the social widespread focus.Based on the study of Public Medical Care,Labor Medical Care,Medical Security System Experimental Reform,Medical Security System,non-structure interview was conducted among 25 Shi workers,corp workers and residents.Founding:1.It is different for the medical security system to protect different group:the degree of protection is the best for the Shi workers,the degree of protection is the medium level for the corp workers,the degree of protection is insufficient.2.The strategy the status group gets from medical security is different,Shi workers can make good use of market capability and social relationship,and can get excellent health care service.Corp workers can use market capability and social relationship to get some medical services which is outside the medical security system.The corps internal residents can use passive security system to get the bottom line protection.Study judgment:Medical Security System is only to guarantee the Baseline Equality,it brings different benefits to different status group.The status group who has stronger market capability,more social relationship,the degree of medical security protection will be higher.
引文
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[2]关信平.当前我国社会保障制度公平性分析[EB/OL]. http://society.people.com.cn/BIG5/n/2013/0311/c168256-20745857.html.
[3]何文炯.社会保险从“人人享有”走向“人人公平享有”[EB/OL].http://www.chinadaily.com.cn/hqgj/jryw/2012-03-12/content_5391034.html.
[4]李路路.制度转型与分层结构的变迁——阶层相对关系模式的“双重再生产”[J].中国社会科学,2002(6).
[5]Max Weber."Class,Status and Party.”In Class,Status and Power:Social Stratification in Comparative Perspective[M].New York:The Free Press,1966.
[6]黄祖辉,王敏,宋瑜.农村居民收入差距问题研究——基于村庄微观角度的一个分析框架[J].管理世界,2005(3).
[7]宋娟.社会分层视角下社会保障质量提升研究[J].社会保障研究,2012(6).
[8]李强.职业共同体:今日中国社会整合之基础——论“杜尔克姆主义”的相关理论[J].学术界,2006(3).
[9]王锡金.我国现行医疗保障制度的差异及成因分析[J].浙江纺织服装职业技术学院学报,2010(3).
[10]Heller,P.A Model of the Demand for Medical and Health Services in Peninsular Malaysia[J].Social Science and Medicine,1982.
[11]Grossman,J.and Hart,O..The Costs and Benefits ofOwnership:A Theory of Vertical and Lateral Integration[J].of PoliticalEconomy,1986.
[12]宋娟.社会分层视角下社会保障质量提升研究[J].社会保障研究,2012(6).
[13]董海军,郭云珍.中国社会福利分层:一个多维结构视角的分[J].中共天津市委党校学报,2010(1).
[14]侯慧丽.两种户籍身份外来人口及其社会医疗保障获得[J].人口与经济,2008(6).
[15]张玉华.新疆兵团农牧团场选择深化改革突破口的探讨[J].社会经济,1993(6).