生育保险制度在国家通过立法的条件下，为怀孕和分娩等生育因素而中断工 作的城镇女性职工，由国家和社会对其提供必要的医疗保健服务、生育津贴以及 生育产假，帮助她们恢复继续从事劳动的能力，对早日重返劳动岗位具有重要意 义。目前，有些省市已经出台灵活就业人员参加城镇职工医疗保险就可同等享受 生育保险待遇，如果进一步扩展将生育保险并入医疗保险，就可以依托医疗保险 的认可度和覆盖率，为广大非城镇职工育龄妇女提供灵活的生育保障。同时，在 生育保险的制度的运行中也暴露一些问题，生育保险制度的覆盖范围狭窄，主要 对象是城镇职工以及事业单位，缺乏公平性；法律法规不健全，强制力弱造成一 些企业逃避缴费的现象，使劳动者享受不到应有的待遇；此外，生育保险基金的 结余过多，增值保值问题突出；待遇保障水平偏低等。 本文主要从公平视角构建并入医疗保险制度的生育保险制度，利用医疗保险 的高覆盖率等优势，将生育保险并入医疗保险，建立一种个人、企业单位和政府 共同分担责任，以财政支持为主要筹资渠道的生育保障制度，不同人群可以自由 选择适合自己的生育保险。 首先，主要分析介绍我国的生育制度以及生育保险制度沿革，通过我国生育 保险发展现状从中找出存在的问题加以分析，找出问题原因。同时，比较国外生 育保险制度，归纳国外可借鉴的经验。 其次，分析我国生育保险并入医疗保险的必要性，主要从生育保险与医疗保 险的关联性，对生育保险并入医疗保险的意义进行阐述。 然后，对我国并入医疗保险的生育保险制度的财政支持可行性进行分析。结 合我国目前的生育政策及生育率水平，运用logistics模型对生育待遇领取次数 进行测算，结合现有生育保险的个人生育补贴平均数，计算出未来十年生育保险 基金补贴总额。对财政收入进行灰色预测后，得出生育保险基金的支出占财政收 入的比例，并对所占比例进行分析。 最后，依据全文内容进行总结，提出扩大生育保险的覆盖范围，加强生育保 险基金的管理以及增值保值，提高生育保险基金的社会统筹层次，提高生育支付 待遇水平等对策与建议。 关键词:生育保险；医疗保险；生育津贴；公平性；可行性ABSTRACT ABSTRACT Maternity insurance system in the country through legislation conditions for pregnancy and childbirth and other reproductive factors and interrupt the work of urban female workers, the state and society for its provision of necessary medical care, maternity benefits and maternity leave, helping them to continue to engage in recovery the ability to work on an early return to the labor positions of great significance. Currently, some provinces have introduced flexible employment to participate in medical insurance for urban workers can enjoy the same maternity insurance benefits, maternity insurance if further extension will be incorporated into the medical insurance, medical insurance you can rely on recognition and coverage for the majority of non-urban Women of childbearing age workers to provide flexible maternity protection. Meanwhile, in the run maternity insurance system has also exposed some problems: the coverage of maternity insurance system is narrow, the main target is the urban workers and institutions, lack of fairness; inadequate laws and regulations, enforcement is weak cause some companies to evade payment phenomenon, so that workers do not enjoy proper treatment; in addition, excessive maternity insurance fund balance, value preservation issues outstanding; the low level of protection and other benefits. This paper mainly built from Fairness medical insurance system incorporated maternity insurance system, the use of high medical insurance coverage and other advantages, will be incorporated into the health insurance maternity insurance, the establishment of a personal, business units and shared responsibility of the government to financial support to maternity protection system main sources of financing, different people can freely choose their own maternity insurance. First, we need to analyze the reproductive system and the introduction of maternity insurance system evolution, through the development of China's current situation maternity insurance to find out the problems to be analyzed to identify cause of the problem. Meanwhile, more foreign birth insurance system, induction can learn from foreign experience. Secondly, the necessity of maternity insurance incorporated into health insurance, mainly from the maternity insurance and medical insurance association, incorporated in medical insurance for maternity insurance elaborate meaning. Then, on the feasibility of financial support incorporated health insurance maternity insurance system for analysis. Combined with the current level of China's fertility policy and fertility, using logistics model number of times to receive生育保险并入医疗保险的可行性研究 treatment on fertility estimates, combined with personal growth average subsidy existing maternity insurance, the total amount of the subsidy is calculated maternity insurance fund over the next decade. After fiscal revenues prediction, draw maternity insurance fund expenditure accounted for the proportion of revenue, and the proportion of analysis. Finally, according to the full text summarized proposed to expand the coverage of maternity insurance, maternity insurance fund to strengthen the management and value preservation, improve the overall level of social maternity insurance fund to improve the level of fertility treatment and other payment countermeasures and suggestions. Key words: maternity insurance;medical insurance;maternity allowance;fairness;f easibility目录 目录 第一章 绪论............................................. 1 第一节 选题背景与意义 ..........................................1 一、选题背景.................................................1 二、研究意义.................................................4 第二节 国内外研究现状 ..........................................4 一、国内相关文献综述.........................................5 二、国外相关文献综述.........................................7 三、对国内外文献评述.........................................7 第三节 研究思路、方法和可能的创新与不足 ........................8 一、研究思路.................................................8 二、研究方法.................................................9 三、创新点和存在不足........................................10 第二章 相关概念界定与理论基础.......................... 11 第一节 相关概念的界定 .........................................11 一、生育保险制度............................................11 二、医疗保险制度............................................12 第二节 理论基础 ................................................12 一、公平正义理论............................................13 二、公共产品理论............................................13 三、生存权和发展权理论......................................14 第三章 国内外生育保险制度.............................. 16 第一节 国内生育政策及保险制度 .................................16 一、生育政策及保险制度发展..................................16 二、生育保险制度施行现状....................................18 三、生育保险制度存在的问题..................................22 第二节 国外生育保险制度 .......................................24 一、生育保险制度的发展......................................24 二、国外生育保险制度介绍....................................24生育保险并入医疗保险的可行性研究 三、国外生育保险制度经验借鉴................................26 第四章 生育保险并入医疗保险的必要性.................... 28 第一节 生育保险和医疗保险的关联性 .............................28 一、参保对象重叠............................................28 二、报销项目交叉............................................28 三、报销模式相似............................................28 第二节 生育保险并入医疗保险的意义 .............................29 一、提高生育保险的覆盖率....................................29 二、充分利用基本医疗保险资源................................29 三、合理利用生育保险基金....................................31 四、提高保险制度管理效率....................................32 五、减轻企业社会保险缴费负担................................32 第五章 生育保险并入医疗保险的可行性.................... 33 第一节 每年生育保险待遇领取次数测算 ...........................33 一、模型及数据介绍..........................................33 二、生育保险待遇领取次数预测................................34 第二节 生育保险基金支出测算分析 ...............................35 一、人均生育补贴分析........................................35 二、未来十年生育补贴总额计算................................37 第三节 生育保险补贴额的财政支持分析 ............................37 一、未来十年财政收入水平预测................................37 二、生育保险基金补贴支出占财政收入比例......................42 第六章 结论与对策建议.................................. 44 第一节 结论 ...................................................44 第二节 对策建议 ...............................................44 一、扩大生育保险覆盖范围....................................44 二、提高生育保险待遇标准....................................45 三、加强对保险基金的管理....................................46 四、推动生育保险法制建设....................................47