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2009153POPULATION&DEVELOPMENTVol.15No.32009339(,100070):39,,:;;:F8401684:A:1674-1668(2009)03-0017-10ComparativeInstitutionalAnalysisofUrbanResidentsMedicalInsuranceBasedon9ExperimentalSchemesof3ProvincesintheEast,MiddleandWestofChinaZHUJun2sheng(SchoolofLaborEconomics,CapitalUniversityofBusinessandEconomics,Beijing100070,China)Abstract:ThispaperanalyzestheUrbanResidentsBasicMedicalInsuranceSystem(URB2MIS)inninecitiesofthreeprovincesfromnineaspects,andevaluatestheirperformances.ThestudyshowsthatURBMISdesignmuststicktotheprincipleofcombinationofunifiedsystemframeworkwithdecentralizationofdecision-makingtoorganicallyintegratethenaturalevolu2tionofthesystemwithsubjectivedesign.Keywords:urbanresidents;medicalInsurance;comparativeinstitutionalanalysis.120074,,()(),,(),,,,:2009-01-17;:2009-04-10:(07ASH008);(07BaJG14);(SZ200710038016);(SM200910038012)3:(1976),,,,,,:7120093,,,,20072779,,39,,,,,,2392.1,(),,,,,,,:2.1.1?,,,,,,2007,29350,12024,41%;7891,27%(10%);32%[1],,32%42%,,,,,,2007,13420,(29350)4517%,,,,79,118,127,84,72[2],,,,(),40(1890-1930)7%60%,,35-37(1930-19651967),96%,10%50%,47(1883-1930),,88%,58[3](81:)[4],,,,,,,2.1.2?,,,,,,,,,,,,,,,,,[5],,,,,,,,,,,,,,,,;,,;2.22.2.19,:,,,,,,,2.2.2,,,,,,,,91200932.2.3,:400,140,400;:100,130,70;:100,90,70,:900,300,400;:420,240,140;:250,280,200,,,,2.32.3.1,,,,,,,,,,9()(,60),(Solidarity),,2.3.2,,,,,,,,,,,,,,,,,,,,,,,,,,,,2.3.320,,,5;60,30,,,02:,,,,,,(),,,,,,,;,(Medicaid),,:P=100-45S2N250FPF83,P;NS,55%;,50%;,83%,2.3.4,,,,,50%;,()4;,3.2,4.8,,,,,2.49,,,,,,,(Capitation),,30(),,,,,,[6-9],,(),(priori2tysetting),,,2.59,:,1220093,,,,,:,,3,34,,,,3;,5,15610,,,,,,,,,,,2.6,[10],,,[11],,WHO,40%,,MedishieldMedis2ave,,,1990Medishield,,[12],,,,[13],(FPGC),,[14-16],,,,,,[17],,,2.7,,,,,,,,,,,:,922:,,,,,,,,,,,,[18-19](),,,,,,,,[20],,,,,,,,,,,()[21],,,,,,,,,,(contracting),;,,,2.8,,,,,,,,,,,,,,,,,,2.92.9.1,,,,3220093,,,,,,,,5%,,,,,,,,,,,,2.9.2,[22],,,,,,,,,,,,,(LICS),,,,,;,,,,,,,,,:,,,,:,,,,,,,,,,42:,,,,,339,,,,,,,,,,,,,,,,,,,,,,,,,:[1].2007[J/OL].[2][3][4]GuyCarrinandChrisJames.Socialhealthinsur2ance:Keyfactorsaffectingthetransitiontowardsuniversalcover2age.InternationalSocialSecurityReview,Vol.58,1/2005.[5].[M].:.2008.[6]PannarunothaiS.,PatmasiriwatD.,SrithamrongsawatS.U2niversalhealthcoverageinThailand:ideasforreformandpolicystruggling.HealthPolicy,2004,68(1):17-30.[7]TangcharoensathienV.,WibulpholprasertS.,Nitayaram2phongS.Knowledgebasedchangestohealthsystems:theThaiexperienceinpolicydevelopment.BulletinoftheWorldHealthOrganization,2004,82(10):750-756.[8]TangcharoensathienV.,TantivessS.,TeerawattananonY.,AuamkulN.,JongudoumsukP.UniversalCoverageandItsIm2pactonReproductiveHealthServicesinThailand.ReproductiveHealthMatters,2002,10(20):59-69.[9]SuraratdechaC.,SaithanuS.,TangcharoensathienV.Isu2niversalcoverageasolutionfordisparitiesinhealthcare?:Find2ingsfromthreelow-incomeprovincesofThailand.HealthPoli2cy,2005,73(3):272-284.[10]XuK.,EvansD.B.,KawabataK.,ZeramdiniR.,KlavusJ.,MurrayC.J.L.Householdcatastrophichealthexpenditure:amulticountryanalysis.Elsevier,2003:111-117.VanDammeW.,MeessenB.,PorI.,KoberK.Catastrophichealthexpendi2ture.Elsevier,2003:996-996.[11]KawabataK.,XuK.,CarrinG.Preventingimpoverishmentthroughprotectionagainstcatastrophichealthexpenditure.SciE2LOPublicHealth,2002:612-612.[12]BarrM.D.MedicalSavingsAccountsinSingapore:ACrit2icalInquiry.,2001,26:709-726.[13]ChengT.TaiwansNewNationalHealthInsurancePro2gram:GenesisandExperienceSoFar.HealthAffairs,2003,22:61-76.52,,.[M].:,1999.20093[14]FrenkJ.,Gonzalez-PierE.,Gomez-DantesO.,LezanaM.A.,KnaulF.M.Comprehensivereformtoimprovehealthsys2temperformanceinMexico.Lancet,2006,368(9546):1524-1534.[15]KnaulF.M.,Arreola-OrnelasH.,Mendez-CarniadoO.,Bryson-CahnC.,BarofskyJ.,MaguireR.,MirandaM.,SesmaS.Evidenceisgoodforyourhealthsystem:policyreformtoremedycatastrophicandimpoverishinghealthspendinginMexico.Lancet,2006,368(9549):1828-1841.[16]KnaulF.M.,FrenkJ.HealthinsuranceinMexico:achie2vinguniversalcoveragethroughstructuralreform.HealthAffairs(ProjectHope),2005,24(6):1467-1476.[17]DrorD.M.,PrekerA.S.SocialRe-Insurance:ANewApproachtoSustainCommunityHealthFinancing.InternationalLabourOrganization,2002.[18]Zeckhauser,Richard&Keeler,Emmett,1970.AnotherTypeofRiskAversion,Econometrica,EconometricSociety,vol.38(5),pages661-665.[19][20][21]KornaiJ,EgglestonK.Welfare,Choice,andSolidarityinTransition:ReformingthehealthsectorinEasternEurope.Cambridge:CambridgeUniversityPress,2001.[22],,,.:[J].,2007,(5).:B¾rnighausen,T.;Sauerborn,R.2002.Onehundredandeight2eenyearsoftheGermanhealthinsurancesystem:Arethereanylessonsformiddle-andlow-incomecountries?,inSo2cialScienceandMedicine,Vol.54,No.10.Carrin,G.;James,C.2004.Evaluatingsocialhealthinsurance:Keydesignfeaturesinthetransitionperiod(HealthFinancingPolicyIssuePaper).Geneva,WorldHealthOrganization,De2partmentofHealthSystemFinancing,ExpenditureandRe2sourceAllocation(PER).Cutler,D.M.2002.Equality,efficiencyandmarketfundamen2tals:Thedynamicsofinternationalmed