全民医保目标下医疗保障制度底线公平研究
|
摘要
研究目的
在全民医保的背景下，对基本医疗保障制度中的底线公平进行理论探讨，为全民医保目标的实现及可持续发展提供相应的理论支持；通过对城镇职工基本医疗保险、城镇居民基本医疗保险和新型农村合作医疗制度的政策设计与运行效果比较，评价基本医疗保险体系中底线公平的实现情况，分析不公平形成的制度性原因，在典型地区案例分析的基础上，探寻有利于底线公平实现的保护性因素；在理论研究和实证研究的基础上，提出以底线公平为指向的全民医保目标实现策略。
研究方法
引入灾难性家庭卫生支出的概念，测算医保制度底线补偿水平；利用政策过程理论中的夏康斯基模型构建制度分析框架，进行多制度之间的比较，最终对制度的底线公平实现情况进行判断，并对制度差异进行制度性归因。
资料来源：
1．在中外文数据库以及其他相关网站以“全民医保”、“底线公平”、“医疗保险(保障)”、“公平”等词形成检索策略，完成文献检索，同时收集国家出台的三种基本医疗保险政策文件及其配套文件。
2．现场资料收集。包括：
(1)基本医疗保险政策文件
(2)医疗保险管理数据库中参保人病历首页信息
在河南省Z市，收集了2007年12月——2008年3月期间，14家定点医疗机构中的城镇职工医保患者与城镇居民医保患者的住院病历首页信息7354条，对病种进行频数分析后，选择920例冠心病(ICD10编码为125．101)患者信息。
在广东省S市，收集了2008年6月——2008年12月期间，59家定点医疗机构中的综合医保、住院医保与农民工医保混合痔(ICD10编码为184．102)患者住院病历首页信息2104条。同时收集了2008年S市基本医疗保险运行情况统计报表。
3．其它资料来源
(1)2008年中国统计年鉴、2001-2008年国民经济和社会发展统计公报、第三次国家卫生服务调查报告、第四次国家卫生服务调查初步结果(已公布)等。
(2)湖北省劳动与社会保障厅医保处关于三项医保政策比较的课题报告(内部资料)
定量资料分析方法：
对住院费用、个人现金自付费用以及住院天数进行描述性分析(均值、标准差计算)；对不同医保制度下的费用信息和住院天数进行单因素分析(t检验和方差分析)；对不同医保患者的就医机构分布情况进行卡方检验和对应分析。所有数据分析采用SPSS for Windows 12．0专业统计软件处理。
研究结果
1．在底线公平理论研究的基础上，提出了评价基本医疗保险制度底线公平的三方面要求及具体标准：首先，公平参保。有参保权利公平和参保能力公平两方面要求，即一是医保制度将所有人群覆盖；二是个人筹资所占的比例应不超过筹资总水平的50％。其次，医保制度应将提供基本医疗服务中的大病住院医疗保障作为底线目标。第三，医保制度实际补偿水平的底线标准。选择10％作为灾难性家庭卫生支出的临界值，测算出城镇基本医疗保险制度实际补偿比的底线水平是55．22％，农村基本医疗保险制度实际补偿比的底线水平为54．72％。
2．在对城镇职工医保、城镇居民医保和新农合制度进行政策分析与运行效果比较后发现，三种制度在覆盖对象、筹资水平与方式、筹资主体、待遇水平等方面均有差异，且城镇居民医保与新农合较为接近，城镇职工医保与二者的差异明显。具体表现在(1)在制度安排上，三种医保制度覆盖全体人群，但是实际参保率差别较大，城镇职工医保为44．2％，城镇居民医保为12．5％，新农合为91．5％。在筹资责任的分担上，城镇居民医保中的个人筹资负担较重，超过了50％。而城镇职工医保与新农合制度中，用人单位或政府承担主要筹资责任，个人筹资负担较轻。(2)三种制度均对大病住院基本医疗提供保障，而门诊保障在三种制度中并不统一。(3)第四次国家卫生服务调查数据显示，城镇职工医疗保险住院费用补偿比最高(66．2％)，城镇居民基本医疗保险次之(49．2％)，新型农村合作医疗制度较低(34．6％)。
3．在对三种制度差异进行归因分析后发现，(1)制度建立时的社会背景对底线公平实现有重要影响。城镇职工医保的建立背景决定了该制度具有提供较高保障水平的初始目标，有利于底线要求的实现。而新农合与城镇居民医保制度则将从无到有地建立制度作为主要目标，没有对保障水平提出初始目标，因而使得制度之间出现不公平。(2)城乡二元结构阻碍了城镇和农村的医保制度同步同水平发展，是造成底线不公平的原因。(3)制度理念的偏倚是造成底线不公平的另一原因。效率优先的理念被用于指导医疗保障制度，过度强调筹资的责任，以经济水平为前提对人群进行选择或排斥，没有充分体现筹资垂直公平的理念。
4．对S市基本医疗保险体系(综合医保、住院医保和农民工医保制度)进行分析后发现，(1)基本医疗保险体系覆盖率达到94．28％。城镇居民和城镇职工加入同一制度，即综合医保制度。(2)三种医保制度筹资差异显著，用人单位承担了在职和退休人员的主要筹资责任，政府对城镇居民中的弱势群体参保承担主要的筹资责任，而普通城镇居民参保时个人承担主要筹资责任。(3)三种医保制度对住院和门诊均提供保障，综合医保实行个人账户，住院医保和农民工医保实行门诊统筹。(4)卫生服务利用情况不同。单病种分析结果显示，综合医保人员的住院率和平均住院天数均高于其他两种制度；综合医保人员倾向于选择三级医院和专科医院，住院医保人员倾向于选择二级医院，农民工医保人员倾向于选择一级医院。(5)次均住院费用、统筹记账费用，综合医保均高于住院医保和农民工医保，实际补偿水平三者却相差不大，综合医保82．09％，住院医保80．87％，农民工医保73．28％，且均高于城镇基本医疗保险底线补偿水平(55．22％)。农民工医保的筹资补偿效率最高，为483．67，而综合医保的筹资补偿效率为79．53。
研究结论
1．在全民医保目标下，底线公平指的是全体国民都有获得基本医疗保障的权利与能力，并且每个人都能获得一个基准水平的保障，这个基准的保障水平并不因个人所加入制度的差异而有所不同。
2．机会公平对底线公平的实现具有重要意义。参保机会的公平要求人们有平等参保的权利，同时也要有平等参保的能力。静态来看，目前的制度安排已经将城乡不同从业情况的人群考虑在内，实现了全民有保可参。但是如果考虑到人口的流动，则在操作上带来问题，使一些人员难以参保。应参保而未参保的情况在城镇职工医保中表现明显，用人单位是主要的因素。而城乡居民主要依靠政府体现筹资责任，以提高其缴费能力。
3．为了避免医疗费用产生灾难性的后果，具有一定补偿水平的基本医疗保险制度才应被视为是有效的制度。对三种医保制度的目标定位存在一定误区，即过度依赖筹资水平来定位制度的保障水平。新农合制度虽然筹资水平较低，但是农村居民对该制度提出的抗风险的要求并不明显低于城镇医保制度。因而对三种制度保障水平的定位不能简单地按照筹资水平进行排序。
4．城镇职工医保的实际补偿水平达到了底线要求，而城镇居民医保和新农合的补偿水平较低，尚未达到底线要求。认为三种制度的差异是不合理差异，整个体系出现了底线不公平，需要尽快提高城镇居民医保和新农合的保障水平。
5．S市在筹资差异显著的三种制度间实现了较高水平的底线公平。(1)筹资水平对补偿水平的影响并不绝对，客观存在的筹资水平差异并不是制度之间出现底线不公平的必然原因。S市的经验是，在住院医保和农民工医保中制定了强制性的社区首诊政策，通过引导人们基层就医，控制医疗费用不合理支出，提高有限基金的使用效率，从而提高低筹资医保制度的补偿水平。(2)不同制度筹资的差异性客观存在，制度之间保障能力的差异也因此客观存在。为了避免将这种制度性的差异强加于个人，应当在参保环节增加柔性调节机制，即在一定条件下允许人们根据自身情况在不同制度间作出选择，从而维护整个体系的公平。
6．社会环境影响着制度目标与理念的确立。在构建和谐社会的背景下实现全民医保目标，需要明确基本医疗保险制度的定位，重塑公平理念。基本医疗保险制度不仅是一种筹资制度，也是一种社会保障制度，福利与公平是其基本属性。以人群受益的均等性为出发点的底线公平理念是基本医疗保险体系的指导理念。具体包括机会平等、医疗服务利用与医保待遇上的水平公平、筹资上的垂直公平。
7．在理论分析与实证研究的基础上，提出以底线公平为指向的全民医保目标实现策略，包括：
(1)增强医疗保险制度的可及性，提高医疗保险的覆盖率。扩展筹资方式，除政府补助、用人单位与个人分担外，探索慈善救助、帮困基金无息贷款等其他筹资形式；探索弹性缴费机制，平滑时间序列上部分人群的筹资不稳定性；优化简化参保程序，提高制度可及性；加强对用人单位的监督与激励，提高其参保积极性。
(2)淡化个人身份，探索城乡统筹的基本医疗保险制度。在城乡差异不明显的地区，探索城镇居民医保制度和新农合制度的统筹发展模式。在经济发展水平较好的地区，可以进一步探索城镇职工医保与城镇居民医保制度的统筹发展模式。
(3)增强政府责任。包括增强政府对城镇居民和农村居民参保筹资责任，缩小与城镇职工的差距；也包括增强政府在经济、社会等发展中维护社会公正的责任，提高多种公共政策的综合利贫效应，缩小贫富差距，促进社会公正。
(4)构建以底线公平为指向的广泛的医疗保障体系，完善医疗救助制度，发展补充医疗保险和商业医疗保险。
(5)充分发挥医疗保险制度的控费功能，引导人们到基层就诊，减少不合理医疗费用支出，提高基金补偿效率与水平，改善基本医疗保险体系的公平性。
Objectives:
In the context of the universal medical insurance, this study theoreticallydiscusses the baseline equality of the basic medical insurance system, in order toprovide the theoretical support for the realization of the goal of the universal medicalinsurance and its sustainable development; it evaluates the achievement of baselineequality in the basic medical insurance system and analyzes the political influentialfor the formation of inequality by comparing the system designs and operation effectsof the urban workers' basic medical insurance, the social medical insurance for urbanresidents and the new rural cooperative medical system. On the base of case analysisfrom the typical areas, explores the protective factors that contribute to realize thebaseline equality; and then puts forwards the implementation strategies to achieve thegoal of the universal medical insurance directed to baseline equality.
Methods:
The baseline compensation levels of the medical system were measured by usingthe tool of household catastrophic health expenditure; the achievement of baselineequality in the system were evaluated and the institutional reasons due to systemeticdifferences were founded by comparing the multi-systems and using Shar kanskymodel to conduct the institutional analysis framework in the policy process theory.
Data resources
1. Literature retrieval was achieved by using the keywords as "the universalmedical insurance", "baseline equality", "medical insurance (security)" and "equality"in the Chinese Database, foreign language database as well as the other related sites,the three basic medical insurance policy documents and relative supportingdocuments were collected at the same time.
2. Data collection in Z city and S city on site. Including:
(1) Policy documents of the basic medical insurance system
(2) Information on first page of illness cases of the insured people in themanagement database of the medical insurance.
In Z city, information on first page of 7354 hospital records of patients who areeither urban workers or residents was collected in 14 appointed medical institutionsfrom December 2007 to March 2008. After the disease frequency analysis, this studychooses the information of 920 patients who suffer from coronary heart disease (theICD10 code is I25.101).
In S city, patients information on first page of 2104 hospital records werecollected in 59 appointed medical institutions from June 2008 to December2008.These patients suffer from mixed hemorrhoids( the ICD10 code is I84.102) andare urban workers, urban residents or labor workers.
3. Other resources
(1) China Statistical Yearbook (2008), National Economic and SocialDevelopment (2001-2008), Analysis Report of National Health Services Survey in2003 and the initial results of National Health Services Survey in 2008 (published).
(2) The report on the comparison of the three medical insurance systems fromthe Office of Labor and Social Security Insurance Agency in Hubei Province(unpublished).
Data Analysis Methods:
The descriptive analysis (calculated by means and standard deviation) wasconducted to analyze the hospitalization expenses, self-affording fees andhospitalization days; the single factor analysis (t test and ANOVA) was conducted toanalyze the cost information and the hospitalization days in different medicalinsurance systems; the Chi-square test and correspondence analysis were conducted toanalyze the medical distribution of patients in different systems. All the data wasanalyzed by using the professional statistical software of SPSS for Windows 12.0.
Research Outcomes
1. On the base of former research of the baseline equality theory; put forwardthree requirements and the concrete standard which can be used to evaluate thebaseline equality in basic medical security system: at first, equally subscribe toinsurance including both of the equal right and equal capability to subscribe insurance. It means, first, the medical insurance covers universal of people; second, the rate ofpersonal financing should take less the 50% of the total financing. Secondly, themedical insurance system should take the serious illness medical care as the basicgoal in basic medical service provide. Thirdly, the baseline standard of actual medicalcare compensation was caculated. Taken 10% as the critical value of catastrophicfamily pay, educed the baseline of the actual compensation rate is 55.22%, this valuein the rural area is 54.72%.
2.After Comparing the basic medical insurance for urban employee(BMIUE),thebasic medical insurance for urban resident(BMIUR) and new rural cooperativemedical system (NCMS), we educed that the three systems are different in the target,financial levels and ways, the subject of financing ,treatment level ,etc. in the threesystems. Specific performance in (1) in the arrangement of the system, the threesystem capable covered the universal people, but the actual rate of subscribe intoinsurance is different, the BMIUE is 44.2%, BMIUR 12.5%, NCMS is 91.5%.on theresponsibility sharing issue, the burden on the personal financing of BMIUE isalbatross ,more than 50%. Whereas, in BMIUR and NCMS, the employer orgovernment take on the mean responsibility of financing, so the burden on private ismuch easier to take. (2)Three systems all provide the security to the serious illness,but not unity in clinical care. (3)The data from the Forth National Health ServiceSurvey suspect that the highest pay of inpatient is BMIUE(66.2%), second isBMIUR(49.2%), NCMS is the lowest, 34.6%.
3. After the attribution analysis among the three systems, we could educe that, (1)the social background when the system was founded have great affection on thebaseline equality. (2)The dualistic structure of urban and rural blocks the developmentof medical care system in rural and urban area, which is also the reason of thebaseline inequitable. (3)The other reason of baseline inequitable is the bias of systemidea. The value of "efficient first" is used to guide medical care system, overemphasize financing responsibility, but not embody the idea of vertical equity infinancing.
4. After analysing the basic medical insurance system in S city, we can educethat,(1)The coverage rate of basic medical insurance system in S city city reached94.28%. The urban resident and employee attended the same system, integrate medical system. (2)The difference of financing in the three systems is sharply.Employer take on the responsibility of financing for employee (incumbent andretirement) (3) Three systems provide the security to both of clinical and inpatient.Integrate medical insurance use the individual account, Inpatient and farmer workersuse clinical overall planning. (4)There are difference in health service utilize .theresult of DRGs tells that, the inpatient rate and average days of in-hospital of patientcovered by integrate insurance both higher than other two. (5)the averagehospitalization expense and overall planning account expenses of integrate health careis higher than inpatient health care and farmer worker health care ,but actualcompensate level is nearly equally .integrate medical insurance82.09%, inpatientmedical insurance 80.87%,famer worker medical insurance 73.28%,all of them higherthan the baseline compensate level of basic urban medical insurance 55.22%. theefficient of the farmer worker medical insurance is the highest,483.67, same issue onthe integrate medical insurance is 79.53.
Conclusions
1. On the goal of universal medical insurance, baseline equality means, theuniversal people in the country have the right and capability to be enrolled in basicmedical care. Besides, everyone could get a baseline security; the level of thisbaseline would not be different by the variety of people who attend into the system.
2. The opportunity equality plays a great role in the achievement of baselineequality. Equal opportunity of health care subscribe require the people owns the sameright and capability to be enrolled in the health care. From the static aspect, the recentsystem arrangement have already considerate the different situation of the groups,make sure everybody could attend at least one health care. However, if consider thefluidity of the population, it comes the problem in implement.
3. In order to avoid the catastrophic outcomes created from medical expenses,the basic medical care system with certain compensate function is considered as aneffective system. There is a specific misunderstanding among the three systems' goallocation ,that is over depend on the level in financing capability to locate the levelof security of system. It shouldn't taxis the security capability easily based onfinancing level.
4. Actual compensate level of BMIUE have reached the baseline requirement, but the same issue on BMIUR and NCMS are lower, still not reach the baseline. Sothe differences among them are unreasonable, the baseline inequitable emerge in thewhole system, it needs to raise the level of BMIUR and NCMS as soon so possible.
5. S city achieved high level baseline equality among the three systems which arevividly different in financing (1)There is no absolute effect of financing level tocompensate level, the exist financing difference is not the inevitable reason ofbaseline inequality in system. (2)There is discrepancy in financing among differentsystems, so the different support capabilities also exist in these systems. In order toavoid the system discrepancy forcing on private, keep the whole system's equity,choice can be made among different systems according to individual's own situationin some circumstances.
6. The establishment of the concept and goal in the system was effected by thesocial environment. In order to achieve the universal medical care coverage on thebackground of harmony society construction, we should make sure the orientation ofbasic medical insurance system and rebuilt the concept of equality. The basic medicalinsurance system is not only a financing system, but also a social security system. Thefarewell and equality is its basic nature. The baseline equality concept is guideline.Including opportunity fairness on the level of medical service utilize and medical care,so as the vertical equality on financing issue.
7. Based on the theoretical analysis and empirical research, put forward thestrategies for universal medical insurance stand on baseline equality as follows:
(1) Reinforce the accessibility of medical insurance system; raise the coverage ofmedical insurance. Enlarge the methods of financing. Explore the other financingways like charity assistance, no tax loan fund, etc. explore flexible paymentmechanism. Optimize and simplify the process of attending insurance .reinforce thesupervision and motivation to the employer, raise its enthusiasm for attendinginsurance.
(2) To consider individual identity as same. Explore the overall planning systembetween urban and rural .in the area where is no obvious difference between urbanand rural, should explore the overall planning of BMIUR and NCMS. In the goodeconomic development area, should explore the overall planning of BMIUE andBMIUR.
(3) Reinforce the responsibility of government. Including the financingresponsibility for the rural and urban resident, shrink the distance to the urbanemployee. Also including reinforce government responsibility on protect justice ineconomic and society developing.
(4) Construct the universal medical care system which stands on the baselineequality, fulfil the medical assistance system, and develop the supplement medicalinsurance and financial medical insurance.
(5) Completely give play to the expense controller function of medical insurancesystem, lead people to seek medical service in basic medical institutions, decrease theunreasonable medical expense, raise the efficiency and the level of fund compensation,and improve the equality of basic medical insurance system.
在全民医保的背景下，对基本医疗保障制度中的底线公平进行理论探讨，为全民医保目标的实现及可持续发展提供相应的理论支持；通过对城镇职工基本医疗保险、城镇居民基本医疗保险和新型农村合作医疗制度的政策设计与运行效果比较，评价基本医疗保险体系中底线公平的实现情况，分析不公平形成的制度性原因，在典型地区案例分析的基础上，探寻有利于底线公平实现的保护性因素；在理论研究和实证研究的基础上，提出以底线公平为指向的全民医保目标实现策略。
研究方法
引入灾难性家庭卫生支出的概念，测算医保制度底线补偿水平；利用政策过程理论中的夏康斯基模型构建制度分析框架，进行多制度之间的比较，最终对制度的底线公平实现情况进行判断，并对制度差异进行制度性归因。
资料来源：
1．在中外文数据库以及其他相关网站以“全民医保”、“底线公平”、“医疗保险(保障)”、“公平”等词形成检索策略，完成文献检索，同时收集国家出台的三种基本医疗保险政策文件及其配套文件。
2．现场资料收集。包括：
(1)基本医疗保险政策文件
(2)医疗保险管理数据库中参保人病历首页信息
在河南省Z市，收集了2007年12月——2008年3月期间，14家定点医疗机构中的城镇职工医保患者与城镇居民医保患者的住院病历首页信息7354条，对病种进行频数分析后，选择920例冠心病(ICD10编码为125．101)患者信息。
在广东省S市，收集了2008年6月——2008年12月期间，59家定点医疗机构中的综合医保、住院医保与农民工医保混合痔(ICD10编码为184．102)患者住院病历首页信息2104条。同时收集了2008年S市基本医疗保险运行情况统计报表。
3．其它资料来源
(1)2008年中国统计年鉴、2001-2008年国民经济和社会发展统计公报、第三次国家卫生服务调查报告、第四次国家卫生服务调查初步结果(已公布)等。
(2)湖北省劳动与社会保障厅医保处关于三项医保政策比较的课题报告(内部资料)
定量资料分析方法：
对住院费用、个人现金自付费用以及住院天数进行描述性分析(均值、标准差计算)；对不同医保制度下的费用信息和住院天数进行单因素分析(t检验和方差分析)；对不同医保患者的就医机构分布情况进行卡方检验和对应分析。所有数据分析采用SPSS for Windows 12．0专业统计软件处理。
研究结果
1．在底线公平理论研究的基础上，提出了评价基本医疗保险制度底线公平的三方面要求及具体标准：首先，公平参保。有参保权利公平和参保能力公平两方面要求，即一是医保制度将所有人群覆盖；二是个人筹资所占的比例应不超过筹资总水平的50％。其次，医保制度应将提供基本医疗服务中的大病住院医疗保障作为底线目标。第三，医保制度实际补偿水平的底线标准。选择10％作为灾难性家庭卫生支出的临界值，测算出城镇基本医疗保险制度实际补偿比的底线水平是55．22％，农村基本医疗保险制度实际补偿比的底线水平为54．72％。
2．在对城镇职工医保、城镇居民医保和新农合制度进行政策分析与运行效果比较后发现，三种制度在覆盖对象、筹资水平与方式、筹资主体、待遇水平等方面均有差异，且城镇居民医保与新农合较为接近，城镇职工医保与二者的差异明显。具体表现在(1)在制度安排上，三种医保制度覆盖全体人群，但是实际参保率差别较大，城镇职工医保为44．2％，城镇居民医保为12．5％，新农合为91．5％。在筹资责任的分担上，城镇居民医保中的个人筹资负担较重，超过了50％。而城镇职工医保与新农合制度中，用人单位或政府承担主要筹资责任，个人筹资负担较轻。(2)三种制度均对大病住院基本医疗提供保障，而门诊保障在三种制度中并不统一。(3)第四次国家卫生服务调查数据显示，城镇职工医疗保险住院费用补偿比最高(66．2％)，城镇居民基本医疗保险次之(49．2％)，新型农村合作医疗制度较低(34．6％)。
3．在对三种制度差异进行归因分析后发现，(1)制度建立时的社会背景对底线公平实现有重要影响。城镇职工医保的建立背景决定了该制度具有提供较高保障水平的初始目标，有利于底线要求的实现。而新农合与城镇居民医保制度则将从无到有地建立制度作为主要目标，没有对保障水平提出初始目标，因而使得制度之间出现不公平。(2)城乡二元结构阻碍了城镇和农村的医保制度同步同水平发展，是造成底线不公平的原因。(3)制度理念的偏倚是造成底线不公平的另一原因。效率优先的理念被用于指导医疗保障制度，过度强调筹资的责任，以经济水平为前提对人群进行选择或排斥，没有充分体现筹资垂直公平的理念。
4．对S市基本医疗保险体系(综合医保、住院医保和农民工医保制度)进行分析后发现，(1)基本医疗保险体系覆盖率达到94．28％。城镇居民和城镇职工加入同一制度，即综合医保制度。(2)三种医保制度筹资差异显著，用人单位承担了在职和退休人员的主要筹资责任，政府对城镇居民中的弱势群体参保承担主要的筹资责任，而普通城镇居民参保时个人承担主要筹资责任。(3)三种医保制度对住院和门诊均提供保障，综合医保实行个人账户，住院医保和农民工医保实行门诊统筹。(4)卫生服务利用情况不同。单病种分析结果显示，综合医保人员的住院率和平均住院天数均高于其他两种制度；综合医保人员倾向于选择三级医院和专科医院，住院医保人员倾向于选择二级医院，农民工医保人员倾向于选择一级医院。(5)次均住院费用、统筹记账费用，综合医保均高于住院医保和农民工医保，实际补偿水平三者却相差不大，综合医保82．09％，住院医保80．87％，农民工医保73．28％，且均高于城镇基本医疗保险底线补偿水平(55．22％)。农民工医保的筹资补偿效率最高，为483．67，而综合医保的筹资补偿效率为79．53。
研究结论
1．在全民医保目标下，底线公平指的是全体国民都有获得基本医疗保障的权利与能力，并且每个人都能获得一个基准水平的保障，这个基准的保障水平并不因个人所加入制度的差异而有所不同。
2．机会公平对底线公平的实现具有重要意义。参保机会的公平要求人们有平等参保的权利，同时也要有平等参保的能力。静态来看，目前的制度安排已经将城乡不同从业情况的人群考虑在内，实现了全民有保可参。但是如果考虑到人口的流动，则在操作上带来问题，使一些人员难以参保。应参保而未参保的情况在城镇职工医保中表现明显，用人单位是主要的因素。而城乡居民主要依靠政府体现筹资责任，以提高其缴费能力。
3．为了避免医疗费用产生灾难性的后果，具有一定补偿水平的基本医疗保险制度才应被视为是有效的制度。对三种医保制度的目标定位存在一定误区，即过度依赖筹资水平来定位制度的保障水平。新农合制度虽然筹资水平较低，但是农村居民对该制度提出的抗风险的要求并不明显低于城镇医保制度。因而对三种制度保障水平的定位不能简单地按照筹资水平进行排序。
4．城镇职工医保的实际补偿水平达到了底线要求，而城镇居民医保和新农合的补偿水平较低，尚未达到底线要求。认为三种制度的差异是不合理差异，整个体系出现了底线不公平，需要尽快提高城镇居民医保和新农合的保障水平。
5．S市在筹资差异显著的三种制度间实现了较高水平的底线公平。(1)筹资水平对补偿水平的影响并不绝对，客观存在的筹资水平差异并不是制度之间出现底线不公平的必然原因。S市的经验是，在住院医保和农民工医保中制定了强制性的社区首诊政策，通过引导人们基层就医，控制医疗费用不合理支出，提高有限基金的使用效率，从而提高低筹资医保制度的补偿水平。(2)不同制度筹资的差异性客观存在，制度之间保障能力的差异也因此客观存在。为了避免将这种制度性的差异强加于个人，应当在参保环节增加柔性调节机制，即在一定条件下允许人们根据自身情况在不同制度间作出选择，从而维护整个体系的公平。
6．社会环境影响着制度目标与理念的确立。在构建和谐社会的背景下实现全民医保目标，需要明确基本医疗保险制度的定位，重塑公平理念。基本医疗保险制度不仅是一种筹资制度，也是一种社会保障制度，福利与公平是其基本属性。以人群受益的均等性为出发点的底线公平理念是基本医疗保险体系的指导理念。具体包括机会平等、医疗服务利用与医保待遇上的水平公平、筹资上的垂直公平。
7．在理论分析与实证研究的基础上，提出以底线公平为指向的全民医保目标实现策略，包括：
(1)增强医疗保险制度的可及性，提高医疗保险的覆盖率。扩展筹资方式，除政府补助、用人单位与个人分担外，探索慈善救助、帮困基金无息贷款等其他筹资形式；探索弹性缴费机制，平滑时间序列上部分人群的筹资不稳定性；优化简化参保程序，提高制度可及性；加强对用人单位的监督与激励，提高其参保积极性。
(2)淡化个人身份，探索城乡统筹的基本医疗保险制度。在城乡差异不明显的地区，探索城镇居民医保制度和新农合制度的统筹发展模式。在经济发展水平较好的地区，可以进一步探索城镇职工医保与城镇居民医保制度的统筹发展模式。
(3)增强政府责任。包括增强政府对城镇居民和农村居民参保筹资责任，缩小与城镇职工的差距；也包括增强政府在经济、社会等发展中维护社会公正的责任，提高多种公共政策的综合利贫效应，缩小贫富差距，促进社会公正。
(4)构建以底线公平为指向的广泛的医疗保障体系，完善医疗救助制度，发展补充医疗保险和商业医疗保险。
(5)充分发挥医疗保险制度的控费功能，引导人们到基层就诊，减少不合理医疗费用支出，提高基金补偿效率与水平，改善基本医疗保险体系的公平性。
Objectives:
In the context of the universal medical insurance, this study theoreticallydiscusses the baseline equality of the basic medical insurance system, in order toprovide the theoretical support for the realization of the goal of the universal medicalinsurance and its sustainable development; it evaluates the achievement of baselineequality in the basic medical insurance system and analyzes the political influentialfor the formation of inequality by comparing the system designs and operation effectsof the urban workers' basic medical insurance, the social medical insurance for urbanresidents and the new rural cooperative medical system. On the base of case analysisfrom the typical areas, explores the protective factors that contribute to realize thebaseline equality; and then puts forwards the implementation strategies to achieve thegoal of the universal medical insurance directed to baseline equality.
Methods:
The baseline compensation levels of the medical system were measured by usingthe tool of household catastrophic health expenditure; the achievement of baselineequality in the system were evaluated and the institutional reasons due to systemeticdifferences were founded by comparing the multi-systems and using Shar kanskymodel to conduct the institutional analysis framework in the policy process theory.
Data resources
1. Literature retrieval was achieved by using the keywords as "the universalmedical insurance", "baseline equality", "medical insurance (security)" and "equality"in the Chinese Database, foreign language database as well as the other related sites,the three basic medical insurance policy documents and relative supportingdocuments were collected at the same time.
2. Data collection in Z city and S city on site. Including:
(1) Policy documents of the basic medical insurance system
(2) Information on first page of illness cases of the insured people in themanagement database of the medical insurance.
In Z city, information on first page of 7354 hospital records of patients who areeither urban workers or residents was collected in 14 appointed medical institutionsfrom December 2007 to March 2008. After the disease frequency analysis, this studychooses the information of 920 patients who suffer from coronary heart disease (theICD10 code is I25.101).
In S city, patients information on first page of 2104 hospital records werecollected in 59 appointed medical institutions from June 2008 to December2008.These patients suffer from mixed hemorrhoids( the ICD10 code is I84.102) andare urban workers, urban residents or labor workers.
3. Other resources
(1) China Statistical Yearbook (2008), National Economic and SocialDevelopment (2001-2008), Analysis Report of National Health Services Survey in2003 and the initial results of National Health Services Survey in 2008 (published).
(2) The report on the comparison of the three medical insurance systems fromthe Office of Labor and Social Security Insurance Agency in Hubei Province(unpublished).
Data Analysis Methods:
The descriptive analysis (calculated by means and standard deviation) wasconducted to analyze the hospitalization expenses, self-affording fees andhospitalization days; the single factor analysis (t test and ANOVA) was conducted toanalyze the cost information and the hospitalization days in different medicalinsurance systems; the Chi-square test and correspondence analysis were conducted toanalyze the medical distribution of patients in different systems. All the data wasanalyzed by using the professional statistical software of SPSS for Windows 12.0.
Research Outcomes
1. On the base of former research of the baseline equality theory; put forwardthree requirements and the concrete standard which can be used to evaluate thebaseline equality in basic medical security system: at first, equally subscribe toinsurance including both of the equal right and equal capability to subscribe insurance. It means, first, the medical insurance covers universal of people; second, the rate ofpersonal financing should take less the 50% of the total financing. Secondly, themedical insurance system should take the serious illness medical care as the basicgoal in basic medical service provide. Thirdly, the baseline standard of actual medicalcare compensation was caculated. Taken 10% as the critical value of catastrophicfamily pay, educed the baseline of the actual compensation rate is 55.22%, this valuein the rural area is 54.72%.
2.After Comparing the basic medical insurance for urban employee(BMIUE),thebasic medical insurance for urban resident(BMIUR) and new rural cooperativemedical system (NCMS), we educed that the three systems are different in the target,financial levels and ways, the subject of financing ,treatment level ,etc. in the threesystems. Specific performance in (1) in the arrangement of the system, the threesystem capable covered the universal people, but the actual rate of subscribe intoinsurance is different, the BMIUE is 44.2%, BMIUR 12.5%, NCMS is 91.5%.on theresponsibility sharing issue, the burden on the personal financing of BMIUE isalbatross ,more than 50%. Whereas, in BMIUR and NCMS, the employer orgovernment take on the mean responsibility of financing, so the burden on private ismuch easier to take. (2)Three systems all provide the security to the serious illness,but not unity in clinical care. (3)The data from the Forth National Health ServiceSurvey suspect that the highest pay of inpatient is BMIUE(66.2%), second isBMIUR(49.2%), NCMS is the lowest, 34.6%.
3. After the attribution analysis among the three systems, we could educe that, (1)the social background when the system was founded have great affection on thebaseline equality. (2)The dualistic structure of urban and rural blocks the developmentof medical care system in rural and urban area, which is also the reason of thebaseline inequitable. (3)The other reason of baseline inequitable is the bias of systemidea. The value of "efficient first" is used to guide medical care system, overemphasize financing responsibility, but not embody the idea of vertical equity infinancing.
4. After analysing the basic medical insurance system in S city, we can educethat,(1)The coverage rate of basic medical insurance system in S city city reached94.28%. The urban resident and employee attended the same system, integrate medical system. (2)The difference of financing in the three systems is sharply.Employer take on the responsibility of financing for employee (incumbent andretirement) (3) Three systems provide the security to both of clinical and inpatient.Integrate medical insurance use the individual account, Inpatient and farmer workersuse clinical overall planning. (4)There are difference in health service utilize .theresult of DRGs tells that, the inpatient rate and average days of in-hospital of patientcovered by integrate insurance both higher than other two. (5)the averagehospitalization expense and overall planning account expenses of integrate health careis higher than inpatient health care and farmer worker health care ,but actualcompensate level is nearly equally .integrate medical insurance82.09%, inpatientmedical insurance 80.87%,famer worker medical insurance 73.28%,all of them higherthan the baseline compensate level of basic urban medical insurance 55.22%. theefficient of the farmer worker medical insurance is the highest,483.67, same issue onthe integrate medical insurance is 79.53.
Conclusions
1. On the goal of universal medical insurance, baseline equality means, theuniversal people in the country have the right and capability to be enrolled in basicmedical care. Besides, everyone could get a baseline security; the level of thisbaseline would not be different by the variety of people who attend into the system.
2. The opportunity equality plays a great role in the achievement of baselineequality. Equal opportunity of health care subscribe require the people owns the sameright and capability to be enrolled in the health care. From the static aspect, the recentsystem arrangement have already considerate the different situation of the groups,make sure everybody could attend at least one health care. However, if consider thefluidity of the population, it comes the problem in implement.
3. In order to avoid the catastrophic outcomes created from medical expenses,the basic medical care system with certain compensate function is considered as aneffective system. There is a specific misunderstanding among the three systems' goallocation ,that is over depend on the level in financing capability to locate the levelof security of system. It shouldn't taxis the security capability easily based onfinancing level.
4. Actual compensate level of BMIUE have reached the baseline requirement, but the same issue on BMIUR and NCMS are lower, still not reach the baseline. Sothe differences among them are unreasonable, the baseline inequitable emerge in thewhole system, it needs to raise the level of BMIUR and NCMS as soon so possible.
5. S city achieved high level baseline equality among the three systems which arevividly different in financing (1)There is no absolute effect of financing level tocompensate level, the exist financing difference is not the inevitable reason ofbaseline inequality in system. (2)There is discrepancy in financing among differentsystems, so the different support capabilities also exist in these systems. In order toavoid the system discrepancy forcing on private, keep the whole system's equity,choice can be made among different systems according to individual's own situationin some circumstances.
6. The establishment of the concept and goal in the system was effected by thesocial environment. In order to achieve the universal medical care coverage on thebackground of harmony society construction, we should make sure the orientation ofbasic medical insurance system and rebuilt the concept of equality. The basic medicalinsurance system is not only a financing system, but also a social security system. Thefarewell and equality is its basic nature. The baseline equality concept is guideline.Including opportunity fairness on the level of medical service utilize and medical care,so as the vertical equality on financing issue.
7. Based on the theoretical analysis and empirical research, put forward thestrategies for universal medical insurance stand on baseline equality as follows:
(1) Reinforce the accessibility of medical insurance system; raise the coverage ofmedical insurance. Enlarge the methods of financing. Explore the other financingways like charity assistance, no tax loan fund, etc. explore flexible paymentmechanism. Optimize and simplify the process of attending insurance .reinforce thesupervision and motivation to the employer, raise its enthusiasm for attendinginsurance.
(2) To consider individual identity as same. Explore the overall planning systembetween urban and rural .in the area where is no obvious difference between urbanand rural, should explore the overall planning of BMIUR and NCMS. In the goodeconomic development area, should explore the overall planning of BMIUE andBMIUR.
(3) Reinforce the responsibility of government. Including the financingresponsibility for the rural and urban resident, shrink the distance to the urbanemployee. Also including reinforce government responsibility on protect justice ineconomic and society developing.
(4) Construct the universal medical care system which stands on the baselineequality, fulfil the medical assistance system, and develop the supplement medicalinsurance and financial medical insurance.
(5) Completely give play to the expense controller function of medical insurancesystem, lead people to seek medical service in basic medical institutions, decrease theunreasonable medical expense, raise the efficiency and the level of fund compensation,and improve the equality of basic medical insurance system.
引文
1. Sen A. 2001.10 These on Globalization. Global Viewpoint, July 12. Available on line at http://www.digitalnpq.org/global_services/global%20viewpoint/07-12-01.html.
2．世界银行2006年世界发展报告公平与发展
3．联合国发起世界社会公正日 倡导实现社会公正 http://news.jcrb.com/jxsw/200902/t20090211_135635.html
4．联合国开发计划署驻华代表处等．人类发展报告2005追求公平的人类发展．北京：中国对外翻译出版公司，2005
5．Timothy Evans，Margaret Whitehead，et al．挑战健康不公平--从理念到行动．牛津：牛津大学出版社．2003
6. Whitehead M., Diderichsen F. 1997. International evidence on social inequalities in health. In: Drever F., Whitehead M. (eds), Health Inequalities-Decennial Supplement. DS Series No. 15. Office for National Statistics. London: The Stationery Office, pp. 45-69.
7. Van de Water H., Boshuizen H., Perenboom R. 1996. Health expectancy in the Netherlands 1983-1990. European Journal of Public Health 6:21-28.
8. Valkonen T., Sihvonen A.P., Lahelma E.1997. Health expectancy by level of education in Finland. Social Science and Medicine 44:801-808.
9. UNICEF.1999. The Progress of Nations 1999. New York: UNICEF.
10. Pritchett L, Summers LH. Wealthier is healthier. Journal of Human Resources.1996.31 (4): 841-868
11. World Bank. World development report 2000/2001: attacking poverty. New York: Oxford University Press, 2000
12. Bloom D, Sashs J. Geography, demography and economic growth in Africa. Brookings Papers on Economic Activity, 1998, 2:207-273
13．世界卫生组织．2000年世界卫生报告卫生系统：改进业绩．北京：人民卫生出版社．2000
14．国务院发展研究中心课题组．对中国医疗卫生体制改革的评价与建议(概要与重点)．中国发展评论中文版第7卷增刊1期：1-14
15．卫生部统计信息中心．中国卫生服务调查研究：第三次国家卫生服务调查分析报告．北京：中国协和医科大学出版社，2004
16. Sen A. 1999. Development as Freedom. New York: Alfred A. Knopf.
17. Kuh D., Power C., Blane D., Bartley M. 1997. Social pathways between childhood and adult health. In: Kuh D., Ben-Shlomo Y. (eds), A Life Course Approach to Chronic Disease Epidemiology. Oxford: Oxford University Press. pp. 169-198.
18．孟庆国，胡鞍钢．消除健康贫困应成为农村卫生改革与发展的优先战略．中国卫生资源，2000，3(6)：245-248
19. Christiansen T. 1993. Equity in the finance and delivery of health care in Denmark. In: van
Doorslaer E., Wagstaff A., Rutten F.(eds), Equity in the Finance and Delivery of Health Care: An International Perspective. New York: Oxford University Press, pp. 101-115.
20. Nolan B., Turbat B. 1993. Cost Recovery in Public Health Services in Sub-Saharan Africa. Mimeograph. Washington, DC: Economic Development Institute, Human Resources Division, World Bank.
21. Wagstaff A., van Doorslaer E. 1993. Equity in the finance of health care: methods and finding. In: van Doorslaer E., Wagstaff A., Rutten F.(eds), Equity in the Finance and Delivery of Health Care: An International Perspective. New York: Oxford University Press, pp. 20-49.
22. Waddington C., Enyimayew K.A. 1990. A price to pay, part 2: the impact of user charges in the Volta region of Ghana. International Journal of Health Planning and Management 5:287-312.
23. Gertler P., van der Gaag J. 1990. The Willingness to Pay for Medical Care. Baltimore: John Hopkins University Press.
24. Culyer A.J. 1989. Cost containment in Europe. Health Care Financing Review Suppl 21-22.
25. Alailama P., Mohideen F. 1984. Health sector expenditure flows in Sri Lanka. World Health Statistical Quarterly 37(4):403-420.
26. Grosh M. 1995. Toward quantifying the trade-off: administrative costs and incidence of targeted programs in Latin America. In: van de Walle D., Nead K.. (eds), Public Spending and the Poor. Theory and Evidence. Baltimore: The Johns Hopkins University Press for the World Bank, pp. 450-458.
27．赵郁馨，张毓辉，唐景霞等．卫生服务利用公平性案例研究．中国卫生经济．2005，24(7)：5-7
28．任苒，金凤．新型农村合作医疗实施后卫生服务可及性和医疗负担的公平性研究．中国卫生经济，2007，26(1)：27-31
29. Liu Y.L., Hsial W.C., Li Q., Liu X.Z., Ren M.H. 1995. Transformation of China's rural health care financing. Social Science Medicine 41(8):1085-1093.
30．黄玉玲．构建更具社会公平的全民健康保障制度．卫生经济研究，2006(2)：45
31. Ma J., Lu MS., Quan HD.. From A National, Centrally Planned Health System To A System Based On The Market: Lessons From China. Health Affairs , 2008, 27(4): 937-947.
32．张太海，董炳光，申曙光等．城镇职工基本医疗保险制度运行质量评价初论．中国卫生事业管理，2004，20(7)：410-413
33．王欢，苏锦英，闫磊磊等．底线公平视角下城镇居民基本医疗保险制度与新型农村合作医疗制度的比较．医学与社会，2009，22(1)：3-5
34．唐代兴．公正伦理与制度道德．北京：人民出版社，2003
35．周辅成选编．西方伦理学名著选辑(上卷)．上海：商务印书馆，1964
36．侯剑平，邱长溶．健康公平理论研究综述．经济学动态，2006(7)：97-102．
37. Whitehead M.1992.The concepts and principles of equity and health. International Journal of Health Services.22(3):429-445
38. Barry B.1990[1965].Political Argument.Berkeley:University of California Press
39. Yuanli Liu, William C. Hsiao,Karen Eggleston.Equity in health and health care: the Chinese experience. Social Science & Medicine 49:1349-1356
40. Culyer A., Wagstaff A.1993 Equity and equality in health and health care. Journal of Health Economics 12:431-457
41. Wagstaff A., Doorslaer E.V. 1993. Equity in the finance and delivery of health cars: concepts and definitions. In:Doorslaer, E.V. (Ed.), Equity in the Finance and Delivery of Health Care an International Perspective. Oxford University Press, Oxford.
42.Hurst J.W. 1985. Financing Health Services in the United States. London: King Edward's Hospital Fund.
43.Hurst J.W. 1991.Reforming Health care in seven European nations. Health Affairs 10(3):7-21
44.Mill, J.S., 1861, Utilitarianism (22nd edn.), Bobbs-Merill, Indianapolis.
45.Olsen J.A. 1997. Theories of justice and their implications for priority setting in health care. Journal of Health Economics 16:625-639.
46.Willians B. 1973. A critique of utilitarianism. In: Smart J.J.C., Williams B. (eds), Utilitarianism; For and Against. Cambridge: Cambridge University Press, pp. 75-150.
47.Sen A.1980. Equality of What? In: McMurrin S. (eds), The Tanner Lectures in Human Value, vol 1, Salt Lake City: University of Utah Press, pp. 195-220.
48.Veatch R.M. 1991. Justice and the right to health care: an egalitarian account. In: Bole T.J., Bondeson W.B.(eds), Rights to Health Care. Dordrecht: Kluwer, pp. 83-102.
49.Le Grand J. 1982. The Strategy of Equality. London: Allen and Unwin.
50.Roemer J. 1980. Equality of Opportunity. Cambridge, Mass: Harvard University Press.
51.Sen A.1985. Commodities and Capabilities. Amsterdam: North Holland.
52.Sen A.1993.Capability and well-being. In: Nussbaum M.C., Sen A. (eds), Quality of Life. Oxford: Clarendon, pp. 30-53.
53.Rawls J. 1971. ATheory of Justice. Cambridge: Harvard University Press.
54.Gakidou E.E., Murray C.J.L., Frenk J. 1999. Defining and measuring health inequality. Bulletin of the World Health Organization 78(l):42-54.
55.Bommier A., Steckov G 2002. Defining Health Inequality: Why Rawls Succeeds Where Social Welfare Theory Fails. Journal of Health Economics 21(3):497-513.
56.Rawls J. 1993a. Political Liberalism. New York: Columbia University Press.
57.Rawls J. 1993b. The law of people. In: Shute S., Hurly S. (eds), On Human Rights: The Oxford Amnesty Lectures. New York: Basic Books, pp. 41-82.
58.Wagstaff A., Doorslaer E.V. 2004. Overall versus socioeconomic health inequality. Health Ecnonmics 13: 297-301.
59.Kakwani N., Wagstaff A.,Doorslaer E.V. 1997. Socioeconomic inequality in health: Measurement, computation and statistical inference. Journal of Economics 77:87-103.
60.Doorslaer E.V.,Jones A.M. 2004. Income-related inequality in health an health care in the European Union. Health Economics 13:605-608.
61.Humphries K.H., Doorslaer E.V. 2000. Income-related health inequality in Canada. Social Science & Medicine 50:663-971.
62.Diderichsen F., Hallqvist J. 1998. Social inequalities in health: some methodological considerations for the study of social position and social context. In: Arve-Pares B.(ed) Inequality in Health-A Swedish Perspective. Stockholm: Swedish Council for Social Research, pp. 25-39.
63.景天魁.大力推进与国情相适应的社会保障制度建设——构建底线公平的福利模式.理 论前沿，2007(18)：5-9
64．景天魁．底线公平与社会保障的柔性调节．社会学研究，2004(6)：32-40
65．景天魁．三十年民生发展之追问：经济发展、社会公正、底线公平——由民生研究之一斑窥民生发展之全豹．理论前沿，2008(14)：5-9
66．景天魁．“底线公平”的社会保障体系．中国社会保障，2008(1)：40-42
67. Wagstaff A.,M. Lindelow, G. Jun, et al. Extending health insurance to the rural population: An impact evaluation of China's New Cooperative Medical Scheme. World bank: WPS4150, 2007
68．保罗·A·萨巴蒂尔编．政策过程理论．北京：生活·读书·新知三联书店，2004
69. Carrin, G. et al. 2001. The Impact of the Degree of Risk - Sharing in Health Financing on Health System Attainment. HNP Discussion Paper. Washington,DC: The world Bank.
70．贡森．财政应该支持建立全民基本医疗保障制度．市场与人口分析，2006(5)：34-38．
71．顾昕．全民医保的制度选择至关重要．中国社会保障，2007(1)：26-27
72．刘继同，陈育德．“一个制度、多种标准”与全民性基本医疗保险制度框架．人文杂志，2006(3)：133—140
73．叶赛敏．建立全民基本医疗保障制度的思考．卫生经济研究，2006(10)：48
74．朱俊生．重塑全民医保制度的建构理念．市场与人口分析，2006(5)：38-40
75．网络资料，从全民医保到福利普惠．http://edu.beelink.com.cn/20070304/2241884.shtml
76．World Bank．2005．Spending Wisely：Buying Health Services for the Poor．
77．贾少鑫．论“底线伦理”的特征和构建．首都师范大学学报：社会科学版，2007，(6)：131—134
78．胡宜安．论弱势群体的道德底线．伦理学研究，2006，(3)：38-42
79．胡宜安．论弱势群体与底线公平．特区经济，2004(9)：87-89
80．[美]马斯洛原著，成明编译．马斯洛人本哲学[M]．北京：九州出版社，2003
81．李风圣，吴云亭．公平与效率——制度分析．北京：经济科学出版社，1995
82．[美]布莱恩·巴里著，孙晓春译．正义诸理论．长春：吉林人民出版社，2004
83．杨玲．美国、瑞典社会保障制度比较研究．武汉：武汉大学出版社，2006
84．彭华民，顾金土．底线公平理论的学术价值．光明日报，2009-04-28
85．吴传俭，梅强，周绿林等．社会医疗保险公平性与政府保险政策建议研究．中国卫生经济，24(4)：24-26
86．刘平．我国城镇职工基本医疗保险公平性研究．武汉大学硕士论文，2005
87．吴爱平．保险人群医疗服务利用公平性研究南通市职工医疗保险实证．复旦大学博士论文．2004
88. World Bank. 2006. World development report 2006: Equity and Development. World Bank.
89．景天魁．底线公平必须做到的公平．河南日报，2007-05-23
90．何新根．医疗卫生服务特性与改革路径．浙江经济，2006(10)：22-23
91．梁鸿，王云竹．公共财政政策框架下基本医疗服务体系的构建．中国卫生经济，2005(24)：8—11
92．马丽平，吴奇飞．公立医院改革模式的同顾与反思——兼论公立医院套用国企改革模式的理论缺陷．中国卫生经济，2006，25(2)：16-19
93 梁鸿，朱莹，赵德金．我国现行基本医疗服务界定的弊端及其重新界定的方法与政策．中 国卫生经济，2005，24：7-10
94．梁鸿，孙晓明．发展社区卫生服务理论与政策的聚焦．社区卫生保健．2005．4(1)：1-7
95．杨永梅．我国基本医疗卫生服务均等化问题研究．哈尔滨商业大学学报：社会科学版，2009(2)：96-99
96．饶克勤．国际医疗卫生体制改革与中国．北京：中国协和医科大学出版社，2007
97．封进，秦蓓．中国农村医疗消费行为变化及其政策含义．世界经济文汇，2006(1)：76-88
98．谭湘渝，樊国昌．新型农村合作医疗保险制度补偿模式研究——兼与质疑“大病统筹”模式者商榷．经济体制改革，2007(4)：152-155
99．穆怀中．社会保障适度水平研究．经济研究，1997(2)：56-63
100．于保荣，高静，宫习飞等．中低收入国家不同医疗保障制度设计对抵御疾病经济风险的作用研究．中国循证医学杂志，2008，8(10)：833-841
101. Hammer J.S., Berman P. 1995. Ends and means in public health policy in developing countries. Health Policy 32(3): 29-45
102．张亮，憨魁．疾病家庭相对经济风险分析．中国农村卫生事业管理．1998．18(2)：8-9．新型农村合作医疗试点县农民疾病经济风险分析
103．彭芳，陈迎春，徐锡武等．湖北省新型农村合作医疗试点县农民疾病经济风险分析．中国卫生经济，2004，23(7)：34-36
104. Jonathan Morduch. Between The State and The Market: Can Informal Insurance Patch The Safety Net? .The World Bank Research Observer, 1999, 14 (2) : 187-207
105. Wagstaff A. Poverty and health sector inequalities. Bulletin of the World Health Organization, 2002, 80 (2):97-105
106．马敬东．中国西部农村贫困家庭健康风险模型与风险管理研究．华中科技大学博士论文．2007
107. Narayan D., Chambers R., Shah M., Petesch P. 1999. Global Synthesis: Consultations with the Poor. Prepared for the Global Synthesis Workshop, September 22-23, 1999. Poverty Group, PREM, World Bank. Washington, DC: World Bank.
108. Xu K, Evans EB, Kawabata K et al. Household catastrophic health expenditure: a multicountry analysis. The Lancet, 2003, 362:111-117
109. Wyszewianski I. Families with catastrophic health care expenditures. Health Service Research, 1986, 21 (6) : 17-34
110. Berki SE. A look at catastrophic medical expenses and the poor. Health Affairs, 1986, 5: 139-145
111．陶四海，赵郁馨，万泉等．灾难性卫生支出分析方法研究．中国卫生经济，2004，23(4)：9-11
112. K Xu, D Evans, G Carrin, A Aguilar, P Musgrove, T Evans. (2007). Protecting Households From Catastrophic Health Spending. Health Affairs, 26, no.4 (2007): 972-983.
113. Strong K., Mathers C., Leeder S., et al. Preventing chronic diseases: how many lives can we save? Lancet, 2005, 366(10):1578-1582
114．尹爱田，刘永强，王垚等．农村慢性病病人家庭的疾病经济风险分析．卫生经济研究， 2006(12)：14-16
115．张学杰．经济收入与健康存量相关关系的数量模型分析．医学与社会 2001，14(1)：1-3
116．[日]青木昌彦著，周黎安译．比较制度分析．上海：上海远东出版社，2001
117．[英]伯特兰·罗素著，张师竹译．社会改造原理[M]．上海：上海人民出版社，2001
118．王颖．中国城镇医疗保障制度研究．西南财经大学硕士论文，2007
119．肖寓桐．我国城镇医疗保障制度研究．新疆财经大学硕士论文，2007
120．景天魁等．社会公正理论与政策．北京：社会科学文献出版社，2004
121．杨新民．二元医疗保险问题研究．厦门大学博士论文，2005
122．吴鹏森．“民工潮”形成原因的社会结构分析．中国农村经济，1997(6)：12-14
123．吴鹏森．农民丁社会保障的理念创新与发展思路．中国社会学网站http://www.sociology.cass.net.cn/shxw/shgz/shgz55/t20090312_20789.htm
124．郑功成．社会保障学：理念、制度、实践与思辨．上海：商务印书馆，2004
125．方菲．从极端到理性的回归-中国社会保障理念的嬗变及其道路选择．长白学刊，2008(4)：58-61
126．[德]科佩尔·S·平森，范德一译．德国近现代史．北京，商务印书馆，1987
127．王德录等．人权宣言．北京：求实出版社，1998
128．贡森．财政应该支持建立全民基本医疗保障制度．市场与人口分析，2006(5)：34-38
129．方菲．从极端到理性的回归-中国社会保障理念的嬗变及其道路选择．长自学刊，2008(4)：58-61
130．景天魁．中国社会保障的理念基础．吉林大学社会科学学报，2003(3)：60-64
131．刘同芗．当代中国社会保障理念的嬗变与启示．山东社会科学，2007(10)：28-32
132．欧水生，沈华亮．深圳市职工医疗保险医疗费用结算办法的探索．中国卫生事业管理，2000，16(8)：470-471，490
133．李再强，林枫．国外社区首诊制度简介．中国卫生经济，2006，25(2)：76-77．
134．周端明．社会保障的新理念中国农民扶持性社会保障体制．经济学家，2006(5)
135．皮埃尔·勒鲁．论平等．上海：商务印书馆，1996
136．宋林飞．从“风险社会”走向和谐社会．江海学刊，2007(4)：12-18
137．考斯塔·埃斯平，安德森郑秉文译．福利资本主义的三个世界．北京：法律出版社，2003
138．阿瑟·奥肯．平等与效率．北京：华夏出版社，1999
139．吴红宇．农村劳动力流动的发展趋势．农民日报，2006-02-25
140．世界银行．2020年的中国：新世纪的发展挑战．北京：中国财政经济出版社，1997
141．张永丽，黄祖辉．中国农村劳动力流动研究述评．中国农村观察，2008(1)：69-79
142．蔡昉．中国经济面临的转折及其对改革和发展的挑战．中国社会科学，2007(3)
143．梁雄军、林云、邵丹萍．农村劳动力二次流动的特点、问题与对策——对浙、闽、津三地外来务工者的调查．中国社会科学，2007(3)
144．鲁全，武文莉．公平、平等与共享：城乡统筹社会保障制度建设的基本理念 长白学刊，2008(4)：62-64
145．赵永生，郝佳，李鹏等．构建城乡统筹的社会医疗保障体系初探．卫生经济研究，2008(9)：45-46
146．郑功成．社会保障学．上海：商务印书馆，2000
147．杨团．二元社会保障结构的问题与整合趋势．中国社会学网 http://www.sociology.cass.net.cn/shxw/shzc/t20040206 1921.htm
148．孟天广．社会分层与政治态度层化——改革以来社会变迁的效应(对1990-2001年的分析)．北京大学研究生学志，2008(4)
149．李培林、李强等．中国社会分层．北京：社会科学文献出版社，2004
150．李友梅、孙立平、沈原主编．当代中国社会分层：理论与实证．北京：社会科学文献出版社，2006
151．戴卫东．社会学视角下的中国社会保障问题．中国社会学网 http://www.sociology.cass.net.cn/shxw/shzc/t20081008_18855.htm
152．数据来源于网络新闻．《瞭望》：中国居民收入差距已超过合理限度http://news.qq.com/a/20080221/001272.htm
153. Beck ,Ulrich. Risk Society: Towards a New Modernity. London :Sage ,1992
154．宋林飞．现代社会学．上海：上海人民出版社，1987
155．符策慧．舞钢模式：全民医保的现实主义路径．中国医疗前沿，2006(5)：35-38
156．赵永生，郝佳，李鹏等．构建城乡统筹的社会医疗保障体系初探．卫生经济研究，2008(9)：45-46
157．中国社会保障发展报告(2007)No．3．转型中的卫生服务与医疗保障北京：社会科学文献出版社，2007
158. Saltman R.,Figureras J.(eds).1997.European Health Sector Reform:Analysis of Current Strategies. World Health Organiazation Regional Publications, European series No.72.Copenhagen:WHO.
159．马敬东，张亮．“病有所医”面临的挑战：中国健康保障系统发展的三个失衡．中国卫生经济，2009，28(4)：5-6
160．网络新闻，26万人减免千万医疗费，惠民医疗为民省下4．6亿http://unn.people.com.cn/GB/22220/69675/69677/5277402.html
161. Yip W., Mahal A.. The Health Care Systems Of China And India:Performance And Future Challenges. Health Affairs, 2008, 27(4):921-932
162. K. J. Arrow. Uncertainty and the welfare economics of medical care. The American Economic Review, 1963, (5): 141-149.
163．郭士征．我国农民工社会保障的现状评估、问题及其改进．“2007年和谐社会构建与社会保障国际论坛”国际学术研讨会
1. Sen A. 2001.10 These on Globalization. Global Viewpoint, July 12.http://www.digitalnpq.org/global_services/global%20viewpoint/07-12-01.html.
2．Timothy Evans，Margaret Whitehead，et al．挑战健康不公平--从理念到行动．牛津：牛津大学出版社．2003
3．唐代兴．公正伦理与制度道德．北京：人民出版社，2003
4．周辅成．西方伦理学名著选辑上卷．北京：商务印书馆，1996
5. Whitehead M., Diderichsen F. 1997. International evidence on social inequalities in health. In:Drever F., Whitehead M. (eds), Health Inequalities-Decennial Supplement. DS Series No. 15.Office for National Statistics. London: The Stationery Office, pp. 45-69.
6 Van de Water H., Boshuizen H.,Perenhoom R_.1996. Health expectancy in the Netherlands 1983-1990. European Journal of Public Health 6:21-28.
7 Valkonen T., Sihvonen A.P., Lahelma E.1997. Health expectancy by level of education in Finland. Social Science and Medicine 44:801-808.
8 UNICEE 1999. The Progress of Nations 1999. New York: UNICEE
9 Pritchett L, Summers LH. Wealthier is healthier. Journal of Human Resources. 1996.31 (4): 841-868
10 World Bank. World development report 2000/2001: attacking poverty. New York: Oxford University Press, 2000
11 Bloom D, Sashs J. Geography, demography and economic growth in Africa. Brookings Papers on Economic Activity, 1998, 2:207-295
12 Whitehead M.1992.The concepts and principles of equity and health. International Journal of Health Services.22(3):429-445
13 Barry B.1990[1965].Political Argument.Berkeley:University of California Press
14 Yuanli Liu, William C. Hsiao,Karen Eggleston.Equity in health and health care: the Chinese experience. Social Science & Medicine 49:1349-1356
15 侯剑平，邱长溶．健康公平理论研究综述．经济学动态，2006(7)：97—102．
16 汉升，胡善联．我国卫生资源分布公平性研究．中国卫生事业管理，1994(2)：105
17 Culyer A., Wagstaff A.1993 Equity and equality in health and health care. Journal of Health Economics 12:431-457
18 Wagstaff A., Doorslaer E.V. 1993. Equity in the finance and delivery of health care: concepts and definitions. In:Doorslaer, E.V. (Ed.), Equity in the Finance and Delivery of Health Care an International Perspective. Oxford University Press, Oxford.
19 Hurst J.W. 1985. Financing Health Services in the United States. London: King Edward's Hospital Fund.
20 Hurst J.W. 1991.Reforming Health care in seven European nations. Health Affairs 10(3):7-21
21 Mill, J.S., 1861, Utilitarianism (22rid edn.), Bobbs-Merill, Indianapolis.
22 Olsen J.A. 1997. Theories of justice and their implications for priority setting in health care. Journal of Health Economics, 16: 625-639.
23 Willians B. 1973. A critique of utilitarianism. In: Smart J.J.C., Williams B. (eds), Utilitarianism; For and Against. Cambridge: Cambridge University Press, pp. 75-150.
24 Sen A.1980. Equality of What? In: McMurrin S. (eds), The Tanner Lectures in Human Value, vol 1, Salt Lake City: University of Utah Press, pp. 195-220.
25 Veatch R.M. 1991. Justice and the right to health care: an egalitarian account. In: Bole T.J., Bondeson W.B.(eds), Rights to Health Care. Dordrecht: Kluwer, pp. 83-102.
26 Le Grand J. 1982. The Strategy of Equality. London: Allen and Unwin.
27 Olsen J.A. 1997. Theories of justice and their implications for priority setting in health care. Journal of Health Economics 16:625-639.
28 Roemer J. 1980. Equality of Opportunity. Cambridge, Mass: Harvard University Press.
29 Sen A.1985. Commodities and Capabilities. Amsterdam: North Holland.
30 Sen A.1993.Capability and well-being. In: Nussbaum M.C., Sen A. (eds), Quality of Life. Oxford: Clarendon, pp. 30-53.
31 Sen A. 1999. Development as Freedom. New York: Alfred A. Knopf.
32 Rawls J. 1971. A Theory of Justice. Cambridge: Harvard University Press.
33 Gakidou E.E., Murray C.J.L., Frenk J. 1999. Defining and measuring health inequality. Bulletin of the World Health Organization 78(1):42-54.
34 Bommier A., Steckov G. 2002. Defining Health Inequality: Why Rawls Succeeds Where Social Welfare Theory Fails. Journal of Health Economics 21(3):497-513.
35 Rawls J. 1993b. The law of people. In: Shute S., Hurly S. (eds), On Human Rights: The Oxford Amnesty Lectures. New York: Basic Books, pp. 41-82.
36 Rawls J. 1993a. Political Liberalism. New York: Columbia University Press.
37 Wagstaff A., Doorslaer E.V. 2004. Overall versus socioeconomic health inequality. Health Ecnonmics 13: 297-301.
38 Kakwani N., Wagstaff A.,Doorslaer E.V. 1997. Socioeconomic inequality in health: Measurement, computation and statistical inference. Journal of Economics 77:87-103.
39 Doorslaer E.V.,Jones A.M. 2004. Income-related inequality in health and health care in the European Union. Health Economics 13:605-608.
40 Humphries K.H., Doorslaer E.V. 2000. Income-related health inequality in Canada. Social Science & Medicine 50:663-971.
41 Gakidou E.E., Murray C.J.L., Frenk J. 1999. Defining and measuring health inequality. Bulletin of the World Health Organization 78(1):42-54.
42 Anand S., Hanson K. 1998. DALYs: efficiency versus equity. World Development 26(2):307-310.
43 陈家应，龚幼龙，严非．卫生保健与健康公平性研究进展．《国外医学》卫生经济分册，2000，17(4)：153-158
44 刘丽杭，王新良．健康公平——概念、影响因素与政策．医学与哲学．2004，25(6)：2-4
45 李敏．对健康公平性及其影响因素的研究．中国卫生事业管理，2005(9)：516-519
46 吴静，李竹，叶荣伟等．甘肃榆中地区健康公平性及其相对变化．中国公共卫生，2003，19(2)：225-227
47 Wagstaff A., Paci P., Doorslaer E.V.1991. On the measurement of inequalities in the health. Social Science and Medicine 33:545-577.
48 Mackenbach J.P., Kunst A.E. 1997. Measuring the magnitude of socioeconomic inequalities in health. Social Science and Medicine 44:757-771
49 Diderichsen F., Hallqvist J. 1998. Social inequalities in health: some methodological considerations for the study of social position and social context. In: Arve-Par(?)s B.(ed) Inequality in Health-A Swedish Perspective. Stockholm: Swedish Council for Social Research, pp. 25-39.
50 冯占春，侯泽蓉，代会侠等．我国城乡卫生费用的公平性研究．中华医院管理．2006，22(10)：660-661
51 李斌．卫生筹资公平性研究进展．中国卫生经济，2004，23(2)：15-18
52 万泉，赵郁馨，方豪．卫生筹资的垂直公平和累进性研究．中国卫生经济，2003，22(3)：4—6
53 Christiansen T. 1993. Equity in the finance and delivery of health care in Denmark. In: van Doorslaer E., Wagstaff A., Rutten F. (eds), Equity in the Finance and Delivery of Health Care: An International Perspective. New York: Oxford University Press, pp. 101-115.
54 Nolan B., Turbat B. 1993. Cost Recovery in Public Health Services in Sub-Saharan Africa. Mimeograph. Washington, DC: Economic Development Institute, Human Resources Division, World Bank.
55 Wagstaff A., van Doorslaer E. 1993. Equity in the finance of health care: methods and finding. In: van Doorslaer E., Wagstaff A., Rutten F. (eds), Equity in the Finance and Delivery of Health Care: An International Perspective. New York: Oxford University Press, pp. 20-49.
56 Waddington C., Enyimayew K.A. 1990. A price to pay, part 2: the impact of user charges in the Volta region of Ghana. International Journal of Health Planning and Management 5:287-312.
57 Gertler P., van der Gaag J. 1990. The Willingness to Pay for Medical Care. Baltimore: John Hopkins University Press.
58 Culyer A.J. 1989. Cost containment in Europe. Health Care Financing Review 21-22.
59 Alailama P., Mohideen F.1984. Health sector expenditure flows in Sri Lanka. World Health Statistical Quarterly 37(4):403-420.
60 Grosh M. 1995. Toward quantifying the trade-off: administrative costs and incidence of targeted programs in Latin America. In: van de Walle D., Nead K.. (eds), Public Spending and the Poor. Theory and Evidence. Baltimore: The Johns Hopkins University Press for the World Bank, pp. 450-458.
61 赵郁馨，张毓辉，唐景霞等．卫生服务利用公平性案例研究．中国卫生经济．2005，24(7)：5-7
62 Liu Y.L., Hsial W.C., Li O., Liu X.Z., Ren M.H. 1995. Transformation of China's rural health care financing. Social Science Medicine 41(8):1085-1093.
63 朱卫东．我国医疗保障制度改革的公平性与效率性探讨．北京行政学院学报，2006(1)：57-60．
64 刘玉恩．我国医疗保障公平性研究．中国初级卫生保健，2007(7)：3-5．
65 徐凯赞，欧阳亮辉．我国社会保障制度的公平性思考．宁夏社会科学，2004(2)：62-64．
66 黄玉玲．浅谈构建更具社会公平的全民健康保障制度的思考．中国卫生事业管理，2006(3)：152．
67 胡金伟，冯振翼，李伟．山东省某县新型农村合作医疗受益公平性研究．中华医院管理，2007，23(3)：183-185
68 王卫忠．实施新型农村合作医疗前后农村居民卫生服务利用公平性比较研究．中国卫生事业管理，2008，236(2)：111-113
69 任苒，金凤．新型农村合作医疗实施后卫生服务可及性和医疗负担的公平性研究．中国卫生经济，2007，26(1)：27-31
70 陈家应，舒宝刚，于浩等．职工医疗保险改革对卫生服务公平性的影响．中国卫生资源，2001，4(4)：109-111
71 徐巍巍，刘国恩．中国城镇职工医疗保险个人帐户对公平性的影响：基于镇江试点改革的研究．世界经济文汇，2006，(1)：67-74
72 刘国恩，蔡仁华，熊先军等．中国城市医疗保险体制改革：论成本分担的公平性．经济学，2003，2(2)：435—452
2．世界银行2006年世界发展报告公平与发展
3．联合国发起世界社会公正日 倡导实现社会公正 http://news.jcrb.com/jxsw/200902/t20090211_135635.html
4．联合国开发计划署驻华代表处等．人类发展报告2005追求公平的人类发展．北京：中国对外翻译出版公司，2005
5．Timothy Evans，Margaret Whitehead，et al．挑战健康不公平--从理念到行动．牛津：牛津大学出版社．2003
6. Whitehead M., Diderichsen F. 1997. International evidence on social inequalities in health. In: Drever F., Whitehead M. (eds), Health Inequalities-Decennial Supplement. DS Series No. 15. Office for National Statistics. London: The Stationery Office, pp. 45-69.
7. Van de Water H., Boshuizen H., Perenboom R. 1996. Health expectancy in the Netherlands 1983-1990. European Journal of Public Health 6:21-28.
8. Valkonen T., Sihvonen A.P., Lahelma E.1997. Health expectancy by level of education in Finland. Social Science and Medicine 44:801-808.
9. UNICEF.1999. The Progress of Nations 1999. New York: UNICEF.
10. Pritchett L, Summers LH. Wealthier is healthier. Journal of Human Resources.1996.31 (4): 841-868
11. World Bank. World development report 2000/2001: attacking poverty. New York: Oxford University Press, 2000
12. Bloom D, Sashs J. Geography, demography and economic growth in Africa. Brookings Papers on Economic Activity, 1998, 2:207-273
13．世界卫生组织．2000年世界卫生报告卫生系统：改进业绩．北京：人民卫生出版社．2000
14．国务院发展研究中心课题组．对中国医疗卫生体制改革的评价与建议(概要与重点)．中国发展评论中文版第7卷增刊1期：1-14
15．卫生部统计信息中心．中国卫生服务调查研究：第三次国家卫生服务调查分析报告．北京：中国协和医科大学出版社，2004
16. Sen A. 1999. Development as Freedom. New York: Alfred A. Knopf.
17. Kuh D., Power C., Blane D., Bartley M. 1997. Social pathways between childhood and adult health. In: Kuh D., Ben-Shlomo Y. (eds), A Life Course Approach to Chronic Disease Epidemiology. Oxford: Oxford University Press. pp. 169-198.
18．孟庆国，胡鞍钢．消除健康贫困应成为农村卫生改革与发展的优先战略．中国卫生资源，2000，3(6)：245-248
19. Christiansen T. 1993. Equity in the finance and delivery of health care in Denmark. In: van
Doorslaer E., Wagstaff A., Rutten F.(eds), Equity in the Finance and Delivery of Health Care: An International Perspective. New York: Oxford University Press, pp. 101-115.
20. Nolan B., Turbat B. 1993. Cost Recovery in Public Health Services in Sub-Saharan Africa. Mimeograph. Washington, DC: Economic Development Institute, Human Resources Division, World Bank.
21. Wagstaff A., van Doorslaer E. 1993. Equity in the finance of health care: methods and finding. In: van Doorslaer E., Wagstaff A., Rutten F.(eds), Equity in the Finance and Delivery of Health Care: An International Perspective. New York: Oxford University Press, pp. 20-49.
22. Waddington C., Enyimayew K.A. 1990. A price to pay, part 2: the impact of user charges in the Volta region of Ghana. International Journal of Health Planning and Management 5:287-312.
23. Gertler P., van der Gaag J. 1990. The Willingness to Pay for Medical Care. Baltimore: John Hopkins University Press.
24. Culyer A.J. 1989. Cost containment in Europe. Health Care Financing Review Suppl 21-22.
25. Alailama P., Mohideen F. 1984. Health sector expenditure flows in Sri Lanka. World Health Statistical Quarterly 37(4):403-420.
26. Grosh M. 1995. Toward quantifying the trade-off: administrative costs and incidence of targeted programs in Latin America. In: van de Walle D., Nead K.. (eds), Public Spending and the Poor. Theory and Evidence. Baltimore: The Johns Hopkins University Press for the World Bank, pp. 450-458.
27．赵郁馨，张毓辉，唐景霞等．卫生服务利用公平性案例研究．中国卫生经济．2005，24(7)：5-7
28．任苒，金凤．新型农村合作医疗实施后卫生服务可及性和医疗负担的公平性研究．中国卫生经济，2007，26(1)：27-31
29. Liu Y.L., Hsial W.C., Li Q., Liu X.Z., Ren M.H. 1995. Transformation of China's rural health care financing. Social Science Medicine 41(8):1085-1093.
30．黄玉玲．构建更具社会公平的全民健康保障制度．卫生经济研究，2006(2)：45
31. Ma J., Lu MS., Quan HD.. From A National, Centrally Planned Health System To A System Based On The Market: Lessons From China. Health Affairs , 2008, 27(4): 937-947.
32．张太海，董炳光，申曙光等．城镇职工基本医疗保险制度运行质量评价初论．中国卫生事业管理，2004，20(7)：410-413
33．王欢，苏锦英，闫磊磊等．底线公平视角下城镇居民基本医疗保险制度与新型农村合作医疗制度的比较．医学与社会，2009，22(1)：3-5
34．唐代兴．公正伦理与制度道德．北京：人民出版社，2003
35．周辅成选编．西方伦理学名著选辑(上卷)．上海：商务印书馆，1964
36．侯剑平，邱长溶．健康公平理论研究综述．经济学动态，2006(7)：97-102．
37. Whitehead M.1992.The concepts and principles of equity and health. International Journal of Health Services.22(3):429-445
38. Barry B.1990[1965].Political Argument.Berkeley:University of California Press
39. Yuanli Liu, William C. Hsiao,Karen Eggleston.Equity in health and health care: the Chinese experience. Social Science & Medicine 49:1349-1356
40. Culyer A., Wagstaff A.1993 Equity and equality in health and health care. Journal of Health Economics 12:431-457
41. Wagstaff A., Doorslaer E.V. 1993. Equity in the finance and delivery of health cars: concepts and definitions. In:Doorslaer, E.V. (Ed.), Equity in the Finance and Delivery of Health Care an International Perspective. Oxford University Press, Oxford.
42.Hurst J.W. 1985. Financing Health Services in the United States. London: King Edward's Hospital Fund.
43.Hurst J.W. 1991.Reforming Health care in seven European nations. Health Affairs 10(3):7-21
44.Mill, J.S., 1861, Utilitarianism (22nd edn.), Bobbs-Merill, Indianapolis.
45.Olsen J.A. 1997. Theories of justice and their implications for priority setting in health care. Journal of Health Economics 16:625-639.
46.Willians B. 1973. A critique of utilitarianism. In: Smart J.J.C., Williams B. (eds), Utilitarianism; For and Against. Cambridge: Cambridge University Press, pp. 75-150.
47.Sen A.1980. Equality of What? In: McMurrin S. (eds), The Tanner Lectures in Human Value, vol 1, Salt Lake City: University of Utah Press, pp. 195-220.
48.Veatch R.M. 1991. Justice and the right to health care: an egalitarian account. In: Bole T.J., Bondeson W.B.(eds), Rights to Health Care. Dordrecht: Kluwer, pp. 83-102.
49.Le Grand J. 1982. The Strategy of Equality. London: Allen and Unwin.
50.Roemer J. 1980. Equality of Opportunity. Cambridge, Mass: Harvard University Press.
51.Sen A.1985. Commodities and Capabilities. Amsterdam: North Holland.
52.Sen A.1993.Capability and well-being. In: Nussbaum M.C., Sen A. (eds), Quality of Life. Oxford: Clarendon, pp. 30-53.
53.Rawls J. 1971. ATheory of Justice. Cambridge: Harvard University Press.
54.Gakidou E.E., Murray C.J.L., Frenk J. 1999. Defining and measuring health inequality. Bulletin of the World Health Organization 78(l):42-54.
55.Bommier A., Steckov G 2002. Defining Health Inequality: Why Rawls Succeeds Where Social Welfare Theory Fails. Journal of Health Economics 21(3):497-513.
56.Rawls J. 1993a. Political Liberalism. New York: Columbia University Press.
57.Rawls J. 1993b. The law of people. In: Shute S., Hurly S. (eds), On Human Rights: The Oxford Amnesty Lectures. New York: Basic Books, pp. 41-82.
58.Wagstaff A., Doorslaer E.V. 2004. Overall versus socioeconomic health inequality. Health Ecnonmics 13: 297-301.
59.Kakwani N., Wagstaff A.,Doorslaer E.V. 1997. Socioeconomic inequality in health: Measurement, computation and statistical inference. Journal of Economics 77:87-103.
60.Doorslaer E.V.,Jones A.M. 2004. Income-related inequality in health an health care in the European Union. Health Economics 13:605-608.
61.Humphries K.H., Doorslaer E.V. 2000. Income-related health inequality in Canada. Social Science & Medicine 50:663-971.
62.Diderichsen F., Hallqvist J. 1998. Social inequalities in health: some methodological considerations for the study of social position and social context. In: Arve-Pares B.(ed) Inequality in Health-A Swedish Perspective. Stockholm: Swedish Council for Social Research, pp. 25-39.
63.景天魁.大力推进与国情相适应的社会保障制度建设——构建底线公平的福利模式.理 论前沿，2007(18)：5-9
64．景天魁．底线公平与社会保障的柔性调节．社会学研究，2004(6)：32-40
65．景天魁．三十年民生发展之追问：经济发展、社会公正、底线公平——由民生研究之一斑窥民生发展之全豹．理论前沿，2008(14)：5-9
66．景天魁．“底线公平”的社会保障体系．中国社会保障，2008(1)：40-42
67. Wagstaff A.,M. Lindelow, G. Jun, et al. Extending health insurance to the rural population: An impact evaluation of China's New Cooperative Medical Scheme. World bank: WPS4150, 2007
68．保罗·A·萨巴蒂尔编．政策过程理论．北京：生活·读书·新知三联书店，2004
69. Carrin, G. et al. 2001. The Impact of the Degree of Risk - Sharing in Health Financing on Health System Attainment. HNP Discussion Paper. Washington,DC: The world Bank.
70．贡森．财政应该支持建立全民基本医疗保障制度．市场与人口分析，2006(5)：34-38．
71．顾昕．全民医保的制度选择至关重要．中国社会保障，2007(1)：26-27
72．刘继同，陈育德．“一个制度、多种标准”与全民性基本医疗保险制度框架．人文杂志，2006(3)：133—140
73．叶赛敏．建立全民基本医疗保障制度的思考．卫生经济研究，2006(10)：48
74．朱俊生．重塑全民医保制度的建构理念．市场与人口分析，2006(5)：38-40
75．网络资料，从全民医保到福利普惠．http://edu.beelink.com.cn/20070304/2241884.shtml
76．World Bank．2005．Spending Wisely：Buying Health Services for the Poor．
77．贾少鑫．论“底线伦理”的特征和构建．首都师范大学学报：社会科学版，2007，(6)：131—134
78．胡宜安．论弱势群体的道德底线．伦理学研究，2006，(3)：38-42
79．胡宜安．论弱势群体与底线公平．特区经济，2004(9)：87-89
80．[美]马斯洛原著，成明编译．马斯洛人本哲学[M]．北京：九州出版社，2003
81．李风圣，吴云亭．公平与效率——制度分析．北京：经济科学出版社，1995
82．[美]布莱恩·巴里著，孙晓春译．正义诸理论．长春：吉林人民出版社，2004
83．杨玲．美国、瑞典社会保障制度比较研究．武汉：武汉大学出版社，2006
84．彭华民，顾金土．底线公平理论的学术价值．光明日报，2009-04-28
85．吴传俭，梅强，周绿林等．社会医疗保险公平性与政府保险政策建议研究．中国卫生经济，24(4)：24-26
86．刘平．我国城镇职工基本医疗保险公平性研究．武汉大学硕士论文，2005
87．吴爱平．保险人群医疗服务利用公平性研究南通市职工医疗保险实证．复旦大学博士论文．2004
88. World Bank. 2006. World development report 2006: Equity and Development. World Bank.
89．景天魁．底线公平必须做到的公平．河南日报，2007-05-23
90．何新根．医疗卫生服务特性与改革路径．浙江经济，2006(10)：22-23
91．梁鸿，王云竹．公共财政政策框架下基本医疗服务体系的构建．中国卫生经济，2005(24)：8—11
92．马丽平，吴奇飞．公立医院改革模式的同顾与反思——兼论公立医院套用国企改革模式的理论缺陷．中国卫生经济，2006，25(2)：16-19
93 梁鸿，朱莹，赵德金．我国现行基本医疗服务界定的弊端及其重新界定的方法与政策．中 国卫生经济，2005，24：7-10
94．梁鸿，孙晓明．发展社区卫生服务理论与政策的聚焦．社区卫生保健．2005．4(1)：1-7
95．杨永梅．我国基本医疗卫生服务均等化问题研究．哈尔滨商业大学学报：社会科学版，2009(2)：96-99
96．饶克勤．国际医疗卫生体制改革与中国．北京：中国协和医科大学出版社，2007
97．封进，秦蓓．中国农村医疗消费行为变化及其政策含义．世界经济文汇，2006(1)：76-88
98．谭湘渝，樊国昌．新型农村合作医疗保险制度补偿模式研究——兼与质疑“大病统筹”模式者商榷．经济体制改革，2007(4)：152-155
99．穆怀中．社会保障适度水平研究．经济研究，1997(2)：56-63
100．于保荣，高静，宫习飞等．中低收入国家不同医疗保障制度设计对抵御疾病经济风险的作用研究．中国循证医学杂志，2008，8(10)：833-841
101. Hammer J.S., Berman P. 1995. Ends and means in public health policy in developing countries. Health Policy 32(3): 29-45
102．张亮，憨魁．疾病家庭相对经济风险分析．中国农村卫生事业管理．1998．18(2)：8-9．新型农村合作医疗试点县农民疾病经济风险分析
103．彭芳，陈迎春，徐锡武等．湖北省新型农村合作医疗试点县农民疾病经济风险分析．中国卫生经济，2004，23(7)：34-36
104. Jonathan Morduch. Between The State and The Market: Can Informal Insurance Patch The Safety Net? .The World Bank Research Observer, 1999, 14 (2) : 187-207
105. Wagstaff A. Poverty and health sector inequalities. Bulletin of the World Health Organization, 2002, 80 (2):97-105
106．马敬东．中国西部农村贫困家庭健康风险模型与风险管理研究．华中科技大学博士论文．2007
107. Narayan D., Chambers R., Shah M., Petesch P. 1999. Global Synthesis: Consultations with the Poor. Prepared for the Global Synthesis Workshop, September 22-23, 1999. Poverty Group, PREM, World Bank. Washington, DC: World Bank.
108. Xu K, Evans EB, Kawabata K et al. Household catastrophic health expenditure: a multicountry analysis. The Lancet, 2003, 362:111-117
109. Wyszewianski I. Families with catastrophic health care expenditures. Health Service Research, 1986, 21 (6) : 17-34
110. Berki SE. A look at catastrophic medical expenses and the poor. Health Affairs, 1986, 5: 139-145
111．陶四海，赵郁馨，万泉等．灾难性卫生支出分析方法研究．中国卫生经济，2004，23(4)：9-11
112. K Xu, D Evans, G Carrin, A Aguilar, P Musgrove, T Evans. (2007). Protecting Households From Catastrophic Health Spending. Health Affairs, 26, no.4 (2007): 972-983.
113. Strong K., Mathers C., Leeder S., et al. Preventing chronic diseases: how many lives can we save? Lancet, 2005, 366(10):1578-1582
114．尹爱田，刘永强，王垚等．农村慢性病病人家庭的疾病经济风险分析．卫生经济研究， 2006(12)：14-16
115．张学杰．经济收入与健康存量相关关系的数量模型分析．医学与社会 2001，14(1)：1-3
116．[日]青木昌彦著，周黎安译．比较制度分析．上海：上海远东出版社，2001
117．[英]伯特兰·罗素著，张师竹译．社会改造原理[M]．上海：上海人民出版社，2001
118．王颖．中国城镇医疗保障制度研究．西南财经大学硕士论文，2007
119．肖寓桐．我国城镇医疗保障制度研究．新疆财经大学硕士论文，2007
120．景天魁等．社会公正理论与政策．北京：社会科学文献出版社，2004
121．杨新民．二元医疗保险问题研究．厦门大学博士论文，2005
122．吴鹏森．“民工潮”形成原因的社会结构分析．中国农村经济，1997(6)：12-14
123．吴鹏森．农民丁社会保障的理念创新与发展思路．中国社会学网站http://www.sociology.cass.net.cn/shxw/shgz/shgz55/t20090312_20789.htm
124．郑功成．社会保障学：理念、制度、实践与思辨．上海：商务印书馆，2004
125．方菲．从极端到理性的回归-中国社会保障理念的嬗变及其道路选择．长白学刊，2008(4)：58-61
126．[德]科佩尔·S·平森，范德一译．德国近现代史．北京，商务印书馆，1987
127．王德录等．人权宣言．北京：求实出版社，1998
128．贡森．财政应该支持建立全民基本医疗保障制度．市场与人口分析，2006(5)：34-38
129．方菲．从极端到理性的回归-中国社会保障理念的嬗变及其道路选择．长自学刊，2008(4)：58-61
130．景天魁．中国社会保障的理念基础．吉林大学社会科学学报，2003(3)：60-64
131．刘同芗．当代中国社会保障理念的嬗变与启示．山东社会科学，2007(10)：28-32
132．欧水生，沈华亮．深圳市职工医疗保险医疗费用结算办法的探索．中国卫生事业管理，2000，16(8)：470-471，490
133．李再强，林枫．国外社区首诊制度简介．中国卫生经济，2006，25(2)：76-77．
134．周端明．社会保障的新理念中国农民扶持性社会保障体制．经济学家，2006(5)
135．皮埃尔·勒鲁．论平等．上海：商务印书馆，1996
136．宋林飞．从“风险社会”走向和谐社会．江海学刊，2007(4)：12-18
137．考斯塔·埃斯平，安德森郑秉文译．福利资本主义的三个世界．北京：法律出版社，2003
138．阿瑟·奥肯．平等与效率．北京：华夏出版社，1999
139．吴红宇．农村劳动力流动的发展趋势．农民日报，2006-02-25
140．世界银行．2020年的中国：新世纪的发展挑战．北京：中国财政经济出版社，1997
141．张永丽，黄祖辉．中国农村劳动力流动研究述评．中国农村观察，2008(1)：69-79
142．蔡昉．中国经济面临的转折及其对改革和发展的挑战．中国社会科学，2007(3)
143．梁雄军、林云、邵丹萍．农村劳动力二次流动的特点、问题与对策——对浙、闽、津三地外来务工者的调查．中国社会科学，2007(3)
144．鲁全，武文莉．公平、平等与共享：城乡统筹社会保障制度建设的基本理念 长白学刊，2008(4)：62-64
145．赵永生，郝佳，李鹏等．构建城乡统筹的社会医疗保障体系初探．卫生经济研究，2008(9)：45-46
146．郑功成．社会保障学．上海：商务印书馆，2000
147．杨团．二元社会保障结构的问题与整合趋势．中国社会学网 http://www.sociology.cass.net.cn/shxw/shzc/t20040206 1921.htm
148．孟天广．社会分层与政治态度层化——改革以来社会变迁的效应(对1990-2001年的分析)．北京大学研究生学志，2008(4)
149．李培林、李强等．中国社会分层．北京：社会科学文献出版社，2004
150．李友梅、孙立平、沈原主编．当代中国社会分层：理论与实证．北京：社会科学文献出版社，2006
151．戴卫东．社会学视角下的中国社会保障问题．中国社会学网 http://www.sociology.cass.net.cn/shxw/shzc/t20081008_18855.htm
152．数据来源于网络新闻．《瞭望》：中国居民收入差距已超过合理限度http://news.qq.com/a/20080221/001272.htm
153. Beck ,Ulrich. Risk Society: Towards a New Modernity. London :Sage ,1992
154．宋林飞．现代社会学．上海：上海人民出版社，1987
155．符策慧．舞钢模式：全民医保的现实主义路径．中国医疗前沿，2006(5)：35-38
156．赵永生，郝佳，李鹏等．构建城乡统筹的社会医疗保障体系初探．卫生经济研究，2008(9)：45-46
157．中国社会保障发展报告(2007)No．3．转型中的卫生服务与医疗保障北京：社会科学文献出版社，2007
158. Saltman R.,Figureras J.(eds).1997.European Health Sector Reform:Analysis of Current Strategies. World Health Organiazation Regional Publications, European series No.72.Copenhagen:WHO.
159．马敬东，张亮．“病有所医”面临的挑战：中国健康保障系统发展的三个失衡．中国卫生经济，2009，28(4)：5-6
160．网络新闻，26万人减免千万医疗费，惠民医疗为民省下4．6亿http://unn.people.com.cn/GB/22220/69675/69677/5277402.html
161. Yip W., Mahal A.. The Health Care Systems Of China And India:Performance And Future Challenges. Health Affairs, 2008, 27(4):921-932
162. K. J. Arrow. Uncertainty and the welfare economics of medical care. The American Economic Review, 1963, (5): 141-149.
163．郭士征．我国农民工社会保障的现状评估、问题及其改进．“2007年和谐社会构建与社会保障国际论坛”国际学术研讨会
1. Sen A. 2001.10 These on Globalization. Global Viewpoint, July 12.http://www.digitalnpq.org/global_services/global%20viewpoint/07-12-01.html.
2．Timothy Evans，Margaret Whitehead，et al．挑战健康不公平--从理念到行动．牛津：牛津大学出版社．2003
3．唐代兴．公正伦理与制度道德．北京：人民出版社，2003
4．周辅成．西方伦理学名著选辑上卷．北京：商务印书馆，1996
5. Whitehead M., Diderichsen F. 1997. International evidence on social inequalities in health. In:Drever F., Whitehead M. (eds), Health Inequalities-Decennial Supplement. DS Series No. 15.Office for National Statistics. London: The Stationery Office, pp. 45-69.
6 Van de Water H., Boshuizen H.,Perenhoom R_.1996. Health expectancy in the Netherlands 1983-1990. European Journal of Public Health 6:21-28.
7 Valkonen T., Sihvonen A.P., Lahelma E.1997. Health expectancy by level of education in Finland. Social Science and Medicine 44:801-808.
8 UNICEE 1999. The Progress of Nations 1999. New York: UNICEE
9 Pritchett L, Summers LH. Wealthier is healthier. Journal of Human Resources. 1996.31 (4): 841-868
10 World Bank. World development report 2000/2001: attacking poverty. New York: Oxford University Press, 2000
11 Bloom D, Sashs J. Geography, demography and economic growth in Africa. Brookings Papers on Economic Activity, 1998, 2:207-295
12 Whitehead M.1992.The concepts and principles of equity and health. International Journal of Health Services.22(3):429-445
13 Barry B.1990[1965].Political Argument.Berkeley:University of California Press
14 Yuanli Liu, William C. Hsiao,Karen Eggleston.Equity in health and health care: the Chinese experience. Social Science & Medicine 49:1349-1356
15 侯剑平，邱长溶．健康公平理论研究综述．经济学动态，2006(7)：97—102．
16 汉升，胡善联．我国卫生资源分布公平性研究．中国卫生事业管理，1994(2)：105
17 Culyer A., Wagstaff A.1993 Equity and equality in health and health care. Journal of Health Economics 12:431-457
18 Wagstaff A., Doorslaer E.V. 1993. Equity in the finance and delivery of health care: concepts and definitions. In:Doorslaer, E.V. (Ed.), Equity in the Finance and Delivery of Health Care an International Perspective. Oxford University Press, Oxford.
19 Hurst J.W. 1985. Financing Health Services in the United States. London: King Edward's Hospital Fund.
20 Hurst J.W. 1991.Reforming Health care in seven European nations. Health Affairs 10(3):7-21
21 Mill, J.S., 1861, Utilitarianism (22rid edn.), Bobbs-Merill, Indianapolis.
22 Olsen J.A. 1997. Theories of justice and their implications for priority setting in health care. Journal of Health Economics, 16: 625-639.
23 Willians B. 1973. A critique of utilitarianism. In: Smart J.J.C., Williams B. (eds), Utilitarianism; For and Against. Cambridge: Cambridge University Press, pp. 75-150.
24 Sen A.1980. Equality of What? In: McMurrin S. (eds), The Tanner Lectures in Human Value, vol 1, Salt Lake City: University of Utah Press, pp. 195-220.
25 Veatch R.M. 1991. Justice and the right to health care: an egalitarian account. In: Bole T.J., Bondeson W.B.(eds), Rights to Health Care. Dordrecht: Kluwer, pp. 83-102.
26 Le Grand J. 1982. The Strategy of Equality. London: Allen and Unwin.
27 Olsen J.A. 1997. Theories of justice and their implications for priority setting in health care. Journal of Health Economics 16:625-639.
28 Roemer J. 1980. Equality of Opportunity. Cambridge, Mass: Harvard University Press.
29 Sen A.1985. Commodities and Capabilities. Amsterdam: North Holland.
30 Sen A.1993.Capability and well-being. In: Nussbaum M.C., Sen A. (eds), Quality of Life. Oxford: Clarendon, pp. 30-53.
31 Sen A. 1999. Development as Freedom. New York: Alfred A. Knopf.
32 Rawls J. 1971. A Theory of Justice. Cambridge: Harvard University Press.
33 Gakidou E.E., Murray C.J.L., Frenk J. 1999. Defining and measuring health inequality. Bulletin of the World Health Organization 78(1):42-54.
34 Bommier A., Steckov G. 2002. Defining Health Inequality: Why Rawls Succeeds Where Social Welfare Theory Fails. Journal of Health Economics 21(3):497-513.
35 Rawls J. 1993b. The law of people. In: Shute S., Hurly S. (eds), On Human Rights: The Oxford Amnesty Lectures. New York: Basic Books, pp. 41-82.
36 Rawls J. 1993a. Political Liberalism. New York: Columbia University Press.
37 Wagstaff A., Doorslaer E.V. 2004. Overall versus socioeconomic health inequality. Health Ecnonmics 13: 297-301.
38 Kakwani N., Wagstaff A.,Doorslaer E.V. 1997. Socioeconomic inequality in health: Measurement, computation and statistical inference. Journal of Economics 77:87-103.
39 Doorslaer E.V.,Jones A.M. 2004. Income-related inequality in health and health care in the European Union. Health Economics 13:605-608.
40 Humphries K.H., Doorslaer E.V. 2000. Income-related health inequality in Canada. Social Science & Medicine 50:663-971.
41 Gakidou E.E., Murray C.J.L., Frenk J. 1999. Defining and measuring health inequality. Bulletin of the World Health Organization 78(1):42-54.
42 Anand S., Hanson K. 1998. DALYs: efficiency versus equity. World Development 26(2):307-310.
43 陈家应，龚幼龙，严非．卫生保健与健康公平性研究进展．《国外医学》卫生经济分册，2000，17(4)：153-158
44 刘丽杭，王新良．健康公平——概念、影响因素与政策．医学与哲学．2004，25(6)：2-4
45 李敏．对健康公平性及其影响因素的研究．中国卫生事业管理，2005(9)：516-519
46 吴静，李竹，叶荣伟等．甘肃榆中地区健康公平性及其相对变化．中国公共卫生，2003，19(2)：225-227
47 Wagstaff A., Paci P., Doorslaer E.V.1991. On the measurement of inequalities in the health. Social Science and Medicine 33:545-577.
48 Mackenbach J.P., Kunst A.E. 1997. Measuring the magnitude of socioeconomic inequalities in health. Social Science and Medicine 44:757-771
49 Diderichsen F., Hallqvist J. 1998. Social inequalities in health: some methodological considerations for the study of social position and social context. In: Arve-Par(?)s B.(ed) Inequality in Health-A Swedish Perspective. Stockholm: Swedish Council for Social Research, pp. 25-39.
50 冯占春，侯泽蓉，代会侠等．我国城乡卫生费用的公平性研究．中华医院管理．2006，22(10)：660-661
51 李斌．卫生筹资公平性研究进展．中国卫生经济，2004，23(2)：15-18
52 万泉，赵郁馨，方豪．卫生筹资的垂直公平和累进性研究．中国卫生经济，2003，22(3)：4—6
53 Christiansen T. 1993. Equity in the finance and delivery of health care in Denmark. In: van Doorslaer E., Wagstaff A., Rutten F. (eds), Equity in the Finance and Delivery of Health Care: An International Perspective. New York: Oxford University Press, pp. 101-115.
54 Nolan B., Turbat B. 1993. Cost Recovery in Public Health Services in Sub-Saharan Africa. Mimeograph. Washington, DC: Economic Development Institute, Human Resources Division, World Bank.
55 Wagstaff A., van Doorslaer E. 1993. Equity in the finance of health care: methods and finding. In: van Doorslaer E., Wagstaff A., Rutten F. (eds), Equity in the Finance and Delivery of Health Care: An International Perspective. New York: Oxford University Press, pp. 20-49.
56 Waddington C., Enyimayew K.A. 1990. A price to pay, part 2: the impact of user charges in the Volta region of Ghana. International Journal of Health Planning and Management 5:287-312.
57 Gertler P., van der Gaag J. 1990. The Willingness to Pay for Medical Care. Baltimore: John Hopkins University Press.
58 Culyer A.J. 1989. Cost containment in Europe. Health Care Financing Review 21-22.
59 Alailama P., Mohideen F.1984. Health sector expenditure flows in Sri Lanka. World Health Statistical Quarterly 37(4):403-420.
60 Grosh M. 1995. Toward quantifying the trade-off: administrative costs and incidence of targeted programs in Latin America. In: van de Walle D., Nead K.. (eds), Public Spending and the Poor. Theory and Evidence. Baltimore: The Johns Hopkins University Press for the World Bank, pp. 450-458.
61 赵郁馨，张毓辉，唐景霞等．卫生服务利用公平性案例研究．中国卫生经济．2005，24(7)：5-7
62 Liu Y.L., Hsial W.C., Li O., Liu X.Z., Ren M.H. 1995. Transformation of China's rural health care financing. Social Science Medicine 41(8):1085-1093.
63 朱卫东．我国医疗保障制度改革的公平性与效率性探讨．北京行政学院学报，2006(1)：57-60．
64 刘玉恩．我国医疗保障公平性研究．中国初级卫生保健，2007(7)：3-5．
65 徐凯赞，欧阳亮辉．我国社会保障制度的公平性思考．宁夏社会科学，2004(2)：62-64．
66 黄玉玲．浅谈构建更具社会公平的全民健康保障制度的思考．中国卫生事业管理，2006(3)：152．
67 胡金伟，冯振翼，李伟．山东省某县新型农村合作医疗受益公平性研究．中华医院管理，2007，23(3)：183-185
68 王卫忠．实施新型农村合作医疗前后农村居民卫生服务利用公平性比较研究．中国卫生事业管理，2008，236(2)：111-113
69 任苒，金凤．新型农村合作医疗实施后卫生服务可及性和医疗负担的公平性研究．中国卫生经济，2007，26(1)：27-31
70 陈家应，舒宝刚，于浩等．职工医疗保险改革对卫生服务公平性的影响．中国卫生资源，2001，4(4)：109-111
71 徐巍巍，刘国恩．中国城镇职工医疗保险个人帐户对公平性的影响：基于镇江试点改革的研究．世界经济文汇，2006，(1)：67-74
72 刘国恩，蔡仁华，熊先军等．中国城市医疗保险体制改革：论成本分担的公平性．经济学，2003，2(2)：435—452