我国工伤保险管理制度初探
摘要
2003年4月27日国务院颁布了《工伤保险条例》并于2004年1月1日起付诸施行。由于我国《工伤保险条例》的实施刚刚开始，迫切需要解决的主要问题之一是建立和完善相应的管理制度。工伤保险的管理制度从层次上来讲，可以分为制度管理、监督管理和操作管理，而本文是按照工伤保险业务的运行环节来论述其管理制度的建设的，即从工伤认定和劳动能力鉴定、基金的筹集、基金支付几个方面来展开讨论管理问题的。
全文由引言和四章正文组成。
作为构建工伤保险管理制度的起点，论文第一章归纳和介绍了我国工伤保险的基本原则与主要内容。基本原则引言阐述了选题的目的与意义，研究的方法和在理论上力图做出的创新之处。包括八个方面：与社会主义初级阶段生产力发展水平相适应的原则；倡导社会主义道德风尚的原则；切实维护和保障劳动者的基本权益的原则；中央确定基本政策与地方制定具体政策相互衔接的原则；权利与义务相对应的原则；无责任补偿的原则；以支定收，收支平衡的原则；新老制度和政策平稳过渡的原则。主要内容可归纳为四个方面：工伤保险制度的适用范围与认定工伤的范围；工伤认定、劳动能力鉴定与待遇保障；制度管理、监督管理与操作管理；行政人与行政相对人的责任。
第二章研究了工伤事故的认定与劳动能力的鉴定管理。先有工伤事故然后才有工伤保险，工伤保险的一切活动都是围绕工伤事故而展开的。因此本部分首先鉴定了工伤事故概念、工伤事故的特点和构成要素、工伤事故与伤亡事故比较，而后论述了认定工伤的机关及其程序，工伤认定的申请程序和工伤认定的方法。
对于劳动能力鉴定，在给出了劳动能力鉴定概念后，提出了劳动能力鉴定工作应遵循的原则以及劳动能力鉴定的标准。
第三章论述了工伤保险基金的筹集管理问题。集中分析了工伤保险基金的筹集原则和工伤保险基金的征缴管理与监督检查以及工伤保险费率的确定。基金的筹集原则包括：统一征收，分级管理原则；收支平衡，约有储备原则；实行差别费率原则；实行浮动费率原则；要切实考虑企业的实际承受能力的原则；以企业总工资额作为征收依据的原则；用人单位(雇主)缴费原则。工伤保险
基金的征缴管理与监督检查主要讨论了征缴管理的内容;监督检查的形式和内
容;缴费管理中的规制。工伤保险费率的确定从两个方面进行了分析，一是世
界各国一般作法，二是我国的工伤保险费率制度的具体做法。
第四章讨论了工伤保险基金支付管理，主要分析了工伤保险基金支付的含
义、项目、水平和支付的条件。并列出了在我国进行工伤保险支付操作时所应
遵循的一些指标性规范。
The State Council issued " Regulations of insurance for employment injury and occupational disease " on April 27, 2003 and have put it in practice since January 1 , 2004. Because of the newly implementing of " Regulations of workers compensation, insurance " in our country, one of the subject matters needing solving urgently is to set up and perfect the corresponding management system. The management system of workers compensation insurance can be divided into institutional management, supervisory management and operational management from hiberarchy. This text will discuss the construction of management system of t workers compensation insurance according to its function. That is to say, the article will discuss the problem of management from four parts: the cognition of workers compensation, appraisal of labor capacity, financing of funds and payment of funds.
The full text is made up of introduction, conclusion and other four chapters. Introduction expounds the purpose and meaning of selected title, methods of research and the innovations of the theory.
As the starting point of designing management system of workers compensation insurance, chapter one introduce and sum up the basic principle and main content of workers compensation insurance in our country. The basic principle includes eight respects: Principle of conformity with development level of productivity in primary stage of socialism; Principle of advocating socialist morality; principle of safeguarding and ensuring the laborer's basic rights and interests faithfully; principle that the establishment of basic policy by Central authorities is conformity with the establishment of concrete policy by local authority; Principle that the right corresponds to obligation; Principle that there is no responsibility to compensate; principle that income is determined by consumption and the balance between revenue and expenditure ; principle that old system and policies transit smoothly into new system and p policies. The main content can be summed up for four respects: application Scope of workers compensation
insurance system and the range of cognizing workers compensation; the cognition of workers compensation, appraisal of labor capacity and guarantee of treatment; institutional management, supervisory management and operational management; Responsibility of administrative people and relative people of administration.
Chapter two will study the cognition of worker accident and the management of
appraisal of labor capacity. Workers compensation insurance is after worker accident, so all activities of Workers compensation insurance are surrounded worker accident. Therefore, this part defines firstly the concept of worker accident, the characteristics and key elements of worker accident, comparing of worker accident with casualty accident, and then expounded the institution and procedure that cognizing worker compensation, the application procedure and the methods of cognizing worker compensation.
As to appraisal of labor capacity, after providing the concept of appraisal labor capacity, this text discussed the principles that appraising labor capacity must follow and the standards of appraising labor capacity .
Chapter three will discuss raise and management of workers compensation insurance fund. This part mostly discusses the principal of raising workers compensation insurance fund, the management and supervision of collection the workers compensation insurance fund and pricing of premium rate of workers compensation insurance. The principle of raising the fund includes: The principle of collection in unison and management in grades; The principle of balance between revenue and expenditure, but nearly having storing ; The principal of premium rate in difference; The principle of floating premium rate; The principal of considering the enduring abilities of companies; The principle that raising fund is according to the total amount of wages of enterprises; The Principle that the employer pays the fees. The management and supervision of raising the workers co
全文由引言和四章正文组成。
作为构建工伤保险管理制度的起点，论文第一章归纳和介绍了我国工伤保险的基本原则与主要内容。基本原则引言阐述了选题的目的与意义，研究的方法和在理论上力图做出的创新之处。包括八个方面：与社会主义初级阶段生产力发展水平相适应的原则；倡导社会主义道德风尚的原则；切实维护和保障劳动者的基本权益的原则；中央确定基本政策与地方制定具体政策相互衔接的原则；权利与义务相对应的原则；无责任补偿的原则；以支定收，收支平衡的原则；新老制度和政策平稳过渡的原则。主要内容可归纳为四个方面：工伤保险制度的适用范围与认定工伤的范围；工伤认定、劳动能力鉴定与待遇保障；制度管理、监督管理与操作管理；行政人与行政相对人的责任。
第二章研究了工伤事故的认定与劳动能力的鉴定管理。先有工伤事故然后才有工伤保险，工伤保险的一切活动都是围绕工伤事故而展开的。因此本部分首先鉴定了工伤事故概念、工伤事故的特点和构成要素、工伤事故与伤亡事故比较，而后论述了认定工伤的机关及其程序，工伤认定的申请程序和工伤认定的方法。
对于劳动能力鉴定，在给出了劳动能力鉴定概念后，提出了劳动能力鉴定工作应遵循的原则以及劳动能力鉴定的标准。
第三章论述了工伤保险基金的筹集管理问题。集中分析了工伤保险基金的筹集原则和工伤保险基金的征缴管理与监督检查以及工伤保险费率的确定。基金的筹集原则包括：统一征收，分级管理原则；收支平衡，约有储备原则；实行差别费率原则；实行浮动费率原则；要切实考虑企业的实际承受能力的原则；以企业总工资额作为征收依据的原则；用人单位(雇主)缴费原则。工伤保险
基金的征缴管理与监督检查主要讨论了征缴管理的内容;监督检查的形式和内
容;缴费管理中的规制。工伤保险费率的确定从两个方面进行了分析，一是世
界各国一般作法，二是我国的工伤保险费率制度的具体做法。
第四章讨论了工伤保险基金支付管理，主要分析了工伤保险基金支付的含
义、项目、水平和支付的条件。并列出了在我国进行工伤保险支付操作时所应
遵循的一些指标性规范。
The State Council issued " Regulations of insurance for employment injury and occupational disease " on April 27, 2003 and have put it in practice since January 1 , 2004. Because of the newly implementing of " Regulations of workers compensation, insurance " in our country, one of the subject matters needing solving urgently is to set up and perfect the corresponding management system. The management system of workers compensation insurance can be divided into institutional management, supervisory management and operational management from hiberarchy. This text will discuss the construction of management system of t workers compensation insurance according to its function. That is to say, the article will discuss the problem of management from four parts: the cognition of workers compensation, appraisal of labor capacity, financing of funds and payment of funds.
The full text is made up of introduction, conclusion and other four chapters. Introduction expounds the purpose and meaning of selected title, methods of research and the innovations of the theory.
As the starting point of designing management system of workers compensation insurance, chapter one introduce and sum up the basic principle and main content of workers compensation insurance in our country. The basic principle includes eight respects: Principle of conformity with development level of productivity in primary stage of socialism; Principle of advocating socialist morality; principle of safeguarding and ensuring the laborer's basic rights and interests faithfully; principle that the establishment of basic policy by Central authorities is conformity with the establishment of concrete policy by local authority; Principle that the right corresponds to obligation; Principle that there is no responsibility to compensate; principle that income is determined by consumption and the balance between revenue and expenditure ; principle that old system and policies transit smoothly into new system and p policies. The main content can be summed up for four respects: application Scope of workers compensation
insurance system and the range of cognizing workers compensation; the cognition of workers compensation, appraisal of labor capacity and guarantee of treatment; institutional management, supervisory management and operational management; Responsibility of administrative people and relative people of administration.
Chapter two will study the cognition of worker accident and the management of
appraisal of labor capacity. Workers compensation insurance is after worker accident, so all activities of Workers compensation insurance are surrounded worker accident. Therefore, this part defines firstly the concept of worker accident, the characteristics and key elements of worker accident, comparing of worker accident with casualty accident, and then expounded the institution and procedure that cognizing worker compensation, the application procedure and the methods of cognizing worker compensation.
As to appraisal of labor capacity, after providing the concept of appraisal labor capacity, this text discussed the principles that appraising labor capacity must follow and the standards of appraising labor capacity .
Chapter three will discuss raise and management of workers compensation insurance fund. This part mostly discusses the principal of raising workers compensation insurance fund, the management and supervision of collection the workers compensation insurance fund and pricing of premium rate of workers compensation insurance. The principle of raising the fund includes: The principle of collection in unison and management in grades; The principle of balance between revenue and expenditure, but nearly having storing ; The principal of premium rate in difference; The principle of floating premium rate; The principal of considering the enduring abilities of companies; The principle that raising fund is according to the total amount of wages of enterprises; The Principle that the employer pays the fees. The management and supervision of raising the workers co
引文
1．邓大松主编．社会保险．中国劳动社会保障出版社．2001．
2．邓大松主编．社会保障若干重大问题研究．海天出版社．2000．
3．邓大松主编．保险经营与管理．中国金融出版社．1999．
4．李珍主编．社会保障理论．中国劳动社会保障出版社．2001．
5．李珍．社会保障制度与经济发展．武汉大学出版社．1998．
6．王东进主编．中国社会保障制度的改革与发展．法律出版社．2001．
7．穆怀中主编．社会保障概论．辽宁大学出版社．2000．
8．郑功成著．社会保障学．商务印书馆．2000．
9．丛树海著．社会保障经济理论．上海三联书店．1996．
10．林义主编．社会保险基金管理．中国劳动社会保障出版社．2001．
11．孙树菡主编．工伤保险．中国人民大学出版社．2000．
12．唐霁松．工伤保险解答．改革出版社．1995．8．
13．张礼文，贾振江岸编．工伤保险权益维护．中国劳动社会保障出版社．2000．
14．周元洪主编．工伤保险生育保险．机械工业出版社．2004．
15．王盛东主编．事故处理与工伤保险．中国石化出版社．2004．
16．杨立范主编．企业职工工伤保险与医疗保险实务全书．中国环境科学出版社．1996．
17．侯文若著．社会保障理论与实践．中国劳动出版社．1991．
18．赵曼．社会保障制度结构与运行分析．中国计划出版社．1997．
19．卡尔·H．博尔奇．保险经济学．商务印书馆．1999．5
20．丹尼斯C·缪勒．公共选择理论．中国社会科学出版社．1999．4
21．斯蒂格利茨．经济学． 中国人民大学出版社．1997．
22．何其芳，范伟编著．工伤保险和劳动权益维护．中国人事出版社．2004．
23．周元洪主编．工伤保险生育保险．机械工业出版社，2004．
24．莫湘益编著．工伤事故认定与法律处理．湖南人民出版社，2003．
25．王盛东主编．事故处理与工伤保险．中国石化出版社，2002．
26．乌日图主编．医疗工伤生育保险．中国劳动社会保障出版社，2001．
27．葛蔓主编．工伤保险改革与实践．中国人事出版社，2000．
28．孙树菡主编．工伤保险．中国人民大学出版社，2000．
29．黄秀梅，陈挺编著．工伤的认定与赔偿．南京出版社，2000．
30．张剑如．关于工伤保险的理论思考．劳动安全与健康．2003．10
31．王文．工伤保险实行差别费率和费率浮动的设想．中国劳动．2003．2
32．莫湘益．工伤认定范围探索．北京市劳动管理干部学院学报．2004．2．
33．吕琳．工伤保险与民事赔偿适用关系研究．法商研究．2003．3．
34．刘祖德，何华刚．我国工伤保险制度的改革和实践．法商研究．2003．3．
35．张礼文，晋延溪，潘立全．河北省企业工伤保险改革探索．劳动杂志．2002．7．
36．徐康平主编．劳动工伤事故保险与损害赔偿．人民法院出版社．2002．1．
1. Janet currie, Jonthan Guber. Unemployment insurance and medical treatment: the equalizing impact of the Medicaid expansions. Journal of public Economics 82(2001)63—89.
2. Robert Genetski. Administration cost and the relative efficiency of public and private social security systems. March 9,1999,SSP, NO. 15.
3. Osker Gans. The economics of social security in developing country: positive and normative considerations. Economics. Vol54.1996.
4. Dilnot, Anderw, Kay, John, and Morris, Nick The Reform of social Security Oxford University press. 1984),
5. Hchman, Harold, and Rdgers, James Pareto Optimal Distribution. American Eonamic Review. 59\4.1969.542-557.
6. Gollier, C.,and M. S. Kimball. New methods in the classical economics of uncertainty: Comparing risks. Discussion paper. University of Michigan. 1997.
7. Gormam, W. M. The structure of the utility function. Review of Economic Studies. vol 35.1968.367-90.
8. Raviv, A.The design of an optimal insurance policy. American Economic Review. Vol.69.1979.84-96.
9. Dean, Hartley, 1995, Social Security and Social Control, Routledge, London.
10. Kotlikoff, Laurence J., Testing the Theory of social Securit yand Life Cycle Accumulation Economical Review69.
11. David de Meza and David C.Webb. Advantageous Selection in insurance markets. The RAND Journal of Economics. Vol32. No2. summer 2001.249—262.
2．邓大松主编．社会保障若干重大问题研究．海天出版社．2000．
3．邓大松主编．保险经营与管理．中国金融出版社．1999．
4．李珍主编．社会保障理论．中国劳动社会保障出版社．2001．
5．李珍．社会保障制度与经济发展．武汉大学出版社．1998．
6．王东进主编．中国社会保障制度的改革与发展．法律出版社．2001．
7．穆怀中主编．社会保障概论．辽宁大学出版社．2000．
8．郑功成著．社会保障学．商务印书馆．2000．
9．丛树海著．社会保障经济理论．上海三联书店．1996．
10．林义主编．社会保险基金管理．中国劳动社会保障出版社．2001．
11．孙树菡主编．工伤保险．中国人民大学出版社．2000．
12．唐霁松．工伤保险解答．改革出版社．1995．8．
13．张礼文，贾振江岸编．工伤保险权益维护．中国劳动社会保障出版社．2000．
14．周元洪主编．工伤保险生育保险．机械工业出版社．2004．
15．王盛东主编．事故处理与工伤保险．中国石化出版社．2004．
16．杨立范主编．企业职工工伤保险与医疗保险实务全书．中国环境科学出版社．1996．
17．侯文若著．社会保障理论与实践．中国劳动出版社．1991．
18．赵曼．社会保障制度结构与运行分析．中国计划出版社．1997．
19．卡尔·H．博尔奇．保险经济学．商务印书馆．1999．5
20．丹尼斯C·缪勒．公共选择理论．中国社会科学出版社．1999．4
21．斯蒂格利茨．经济学． 中国人民大学出版社．1997．
22．何其芳，范伟编著．工伤保险和劳动权益维护．中国人事出版社．2004．
23．周元洪主编．工伤保险生育保险．机械工业出版社，2004．
24．莫湘益编著．工伤事故认定与法律处理．湖南人民出版社，2003．
25．王盛东主编．事故处理与工伤保险．中国石化出版社，2002．
26．乌日图主编．医疗工伤生育保险．中国劳动社会保障出版社，2001．
27．葛蔓主编．工伤保险改革与实践．中国人事出版社，2000．
28．孙树菡主编．工伤保险．中国人民大学出版社，2000．
29．黄秀梅，陈挺编著．工伤的认定与赔偿．南京出版社，2000．
30．张剑如．关于工伤保险的理论思考．劳动安全与健康．2003．10
31．王文．工伤保险实行差别费率和费率浮动的设想．中国劳动．2003．2
32．莫湘益．工伤认定范围探索．北京市劳动管理干部学院学报．2004．2．
33．吕琳．工伤保险与民事赔偿适用关系研究．法商研究．2003．3．
34．刘祖德，何华刚．我国工伤保险制度的改革和实践．法商研究．2003．3．
35．张礼文，晋延溪，潘立全．河北省企业工伤保险改革探索．劳动杂志．2002．7．
36．徐康平主编．劳动工伤事故保险与损害赔偿．人民法院出版社．2002．1．
1. Janet currie, Jonthan Guber. Unemployment insurance and medical treatment: the equalizing impact of the Medicaid expansions. Journal of public Economics 82(2001)63—89.
2. Robert Genetski. Administration cost and the relative efficiency of public and private social security systems. March 9,1999,SSP, NO. 15.
3. Osker Gans. The economics of social security in developing country: positive and normative considerations. Economics. Vol54.1996.
4. Dilnot, Anderw, Kay, John, and Morris, Nick The Reform of social Security Oxford University press. 1984),
5. Hchman, Harold, and Rdgers, James Pareto Optimal Distribution. American Eonamic Review. 59\4.1969.542-557.
6. Gollier, C.,and M. S. Kimball. New methods in the classical economics of uncertainty: Comparing risks. Discussion paper. University of Michigan. 1997.
7. Gormam, W. M. The structure of the utility function. Review of Economic Studies. vol 35.1968.367-90.
8. Raviv, A.The design of an optimal insurance policy. American Economic Review. Vol.69.1979.84-96.
9. Dean, Hartley, 1995, Social Security and Social Control, Routledge, London.
10. Kotlikoff, Laurence J., Testing the Theory of social Securit yand Life Cycle Accumulation Economical Review69.
11. David de Meza and David C.Webb. Advantageous Selection in insurance markets. The RAND Journal of Economics. Vol32. No2. summer 2001.249—262.