一般税收或保险费:经合组织国家公共卫生保健资金来源的比较

Igor Viktorovich Balynin, Vladimir Vadimovich Grishin, Andrei Vasil'evich Ragozin, Aleksandr L'vovich Safonov
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引用次数: 0

摘要

这项研究的主题是比较经合组织国家公共卫生保健的资金来源。提交人详细考虑了实施国家为公民提供免费医疗保障的财政支持来源:来自国家内部收入(主要是一般税收:没有目标联系的强制性付款)和保险费(具有特定目标联系的强制性付款)的转移。提交人根据为落实国家保障向公民提供免费医疗的资金来源所占比例,对经合组织国家进行了分组。特别注意保险和预算财政机制的利弊,为实施国家提供免费医疗的保障提供财政支助。根据研究结果得出的主要结论如下:在现代世界,改善医疗保健系统作为提高公民生活质量的关键因素之一的问题正在积极提出;无论预算财政机制目前在该国使用得多么积极,经合发组织国家公共当局对其的使用都在不断增加;使用预算财政机制,尽管存在缺点,但与保险机制相比有若干优点(主要是由于在雇员人数和工资减少期间的直接影响较小,以及与保险缴款相比,在以一般税收形式管理收入方面的规模经济)。所取得的成果可用于俄罗斯联邦议会、俄罗斯政府、联邦强制性医疗保险基金以及其他国家公共当局在实现医疗保健领域国家政策现代化方面的实际活动。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
General taxes or insurance premiums: a comparison of funding sources for public health care in OECD countries
The subject of the study is a comparison of funding sources for public health care in OECD countries. The authors consider in detail the sources of financial support for the implementation of state guarantees for the provision of free medical care to citizens: transfers from state internal revenues (primarily general taxes: mandatory payments that do not have a target link) and insurance premiums (mandatory payments with a specific target link). The authors grouped the OECD countries depending on the share of sources of financial support for the implementation of state guarantees for the provision of free medical care to citizens. Particular attention is paid to the advantages and disadvantages of insurance and budgetary financial mechanisms for financial support for the implementation of state guarantees for the provision of free medical care. The main conclusions based on the results of the study are as follows: in the modern world, issues of improving the healthcare system as one of the key factors in improving the quality of life of citizens are being actively raised; no matter how actively the budgetary financial mechanism is currently used in the country, its use by public authorities in OECD countries is constantly increasing; the use of the budgetary financial mechanism, despite the existing shortcomings, has a number of advantages compared to the insurance one (primarily, due to the smaller direct impact during periods of reduction in the number of employees and wages, as well as economies of scale in the administration of revenues in the form of general taxes compared to insurance contributions). The results obtained can be used in the practical activities of the Federal Assembly of the Russian Federation, the Government of Russia, the Federal Compulsory Medical Insurance Fund, as well as public authorities from other countries when modernizing the state policy in the field of healthcare.
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