文档介绍：分类号学校代码!Q5垒2 密级学号2Q12Q2Q2Q!Q墨新型农村合作医疗制度运行的伦理反思 Eth ca ref ect ORS on the new rur a coope rat ve med ca system runn ng 湖南师范大学学位评定委员会办公室--0一五年五月万方数据摘要新型农村合作医疗(简称新农合)是我国医疗保障体系的“三驾马车"(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)之一,是保障农民生命健康权的重要举措。新农合与伦理道德存在密切关系:第一,伦理道德催生了新农合,并为新农合地顺利实施提供了良好的道德环境;第二,新农合以社会和谐、公平公正和农民的幸福安康为伦理目标,在实施过程中促进了个人道德和社会道德的发展,体现了以人为本、互助共济的伦理精神。然而,新农合在运行实施过程中也存在不少伦理问题,这些问题有其自身独特原因和危害,具体表现如下:第一,不公平问题。由于经济发展的不平衡、制度本身的不完善,导致新农合运行中存在外部地域的不公平和参合农民内部的不公平,这对农民的逆向选择和农村两级分化有一定负面影响。第二,政府道德责任缺失问题。由于政府对新农合定性定位的价值偏离和专职人员的缺失,导致对新农合地监督不到位,这对新农合的保障水平和农民生命健康权的实现有一定负面影响。第三,道德风险。由于第三方支付机制和按服务项目付费的后付制,导致参合农民的过度医疗消费、定点医疗机构的过度医疗供给和医患合谋的道德风险,这对公平与效率的平衡和医疗卫生领域道德水平的提升有一定负面影响。解决新农合运行中存在的伦理问题可以采取如下对策:第一,明确新农合的伦理价值取向即健康平等和人道主义;坚持基本的伦理原则,即公平与效率相结合的原则和责任原则。第二,培养农民的道德万方数据主体性,即承认农民的道德主体地位、激发农民的主体意识和培养农民的主体能力。第三,强化政府道德责任,政府应不断完善新农合制度、推动新农合法治建设、加强宣传力度和建立高素质的医护队伍。第四,统筹城乡医疗保障体系,迈向全民医保,真正实现社会公平。关键词:新农合;伦理;反思;运行万方数据 ABSTRACT The new rural cooperative medical system(referred to as NCMS)is one of the troika’S health care is an important measure to protect farmers’right to] is aclose relationship between the NCMS and ,ethics spawned NCMS,and provide a good environment for the smooth implementation ,the goal ofNCMS isthe social harmony,fair and well— promotes personal moral and social moral development. There are many ethical issues in the imp]ementation process performance iS as ,the issue to imbalances ofeconomic development andthe imperfect system,NCMS has external and internal unfair. This has an negative impact on the adverse selection and polarization of ,the government lack of moral to deviation ofthe government’S value and lacking offul卜time staff,special oversight of the NCMS is not has a negat ire impact on security level and the right to ,Moral to third—party payment mechanism and after the payment system,there exist farmers’over h