上海市生育保险保障水平研究

发布时间：2018-09-10 18:40

【摘要】：生育保险是对劳动女性因生育子女而暂时中断劳动时给予生活保障和物质帮助的社会保险制度。作为暂停工作的女性和新生儿的重要生活支撑,生育保险保障水平直接关系到女性及新生儿的生活状况、人口的健康水平和家庭的养育压力,对新生人口质量、医改成果共享和生育意愿的释放都有重要影响。随着上海市将外来从业人员纳入生育保险参保范围和提高生育医疗费补贴水平,上海市生育保险保障水平得到提升。作为生育负担重、生育率低、生育保险发展较早的特大城市,目前上海市生育保险保障水平究竟如何,能否满足生育女性及其家庭的需求?生育保险保障水平调整的动态机制是否形成,是否与社会经济发展等相同步?这些都是需要探究和解答的问题。本文首先通过政策梳理和文献回顾,明确上海市生育保险保障水平的发展历程和现状;其次,通过问卷调查发现目前上海市生育保险对生育人群的保障情况及问题;第三,结合学界成果和本文研究内容,确定反映上海市生育保险保障水平的指标体系,并对上海市生育保险保障水平进行较全面的测算;最后,通过访谈分析对上海市生育保险保障水平背后存在的原因进行探究,在此之上得出相关建议。本文主要研究结论有:上海市生育保险覆盖水平偏低,2005年以来常年徘徊在62%左右的水平,未随着社会经济发展而显著增长,覆盖范围较为有限,但社会成员主观参保意愿高;同时,生育保险覆盖率相对水平、覆盖人数增速和覆盖率增速水平在各险种中都处于较低位置,发展速度低于其他险种;上海市生育津贴绝对水平呈不断增长趋势,2007年来从业女性生育津贴年均增幅10.64%,全体女性年均增幅10.37%;相对水平方面,最低生育津贴生育津贴水平难以满足产妇及新生儿的基本生活需求,对正常生活需求的保障程度更偏低;生育津贴增速多低于居民人均消费水平、社会平均工资等指标的增速,与社会经济发展的同步性待加强;上海市生育医疗费补贴标准自2004年来多年未调整,补贴标准偏低、科学的动态调整机制不健全;生育医疗费补贴对生育女性的保障水平多在40%-50%之间,整体保障水平偏低,个体生育医疗花费负担较大;生育保险参保的监督力度不强,用人单位参保意识差,待遇标准确定和调整机制不健全等是上海市生育保险保障水平现存问题的主要原因。基于此,本文建议:落实生育保险参保的监督机制,加快生育保险并入医疗保险的实施步伐;建立与居民消费水平、社会平均工资等相适应的生育津贴调整机制;建立与生育医疗费用相适宜的补贴标准调整机制。
[Abstract]:Maternity insurance is a social insurance system that provides life security and material assistance to working women when they temporarily interrupt their work because of giving birth to their children. As an important living support for women and newborns who are suspended from work, the level of maternity insurance security is directly related to the living conditions of women and newborns, the health level of the population and the pressure of family rearing, and the quality of the newborn population. The sharing of medical reform results and the release of fertility will have important effects. With the introduction of foreign employees into the scope of maternity insurance in Shanghai and the improvement of the subsidy level of maternity medical expenses, the level of maternity insurance in Shanghai has been improved. As a megalopolis with heavy fertility burden, low fertility rate and early development of birth insurance, what is the current level of maternity insurance protection in Shanghai, and whether it can meet the needs of fertile women and their families? Is the dynamic mechanism of the level adjustment of maternity insurance formed, and is it in step with the social and economic development? These are questions that need to be explored and answered. First of all, through the review of policy and literature review, this paper clarifies the development process and status quo of the level of maternity insurance in Shanghai; secondly, through the questionnaire survey, we find the current situation and problems of the protection of fertility insurance to the fertility population in Shanghai; third, Combined with the academic achievements and the research content of this paper, the index system reflecting the level of maternity insurance security in Shanghai is determined, and the level of maternity insurance security in Shanghai is measured more comprehensively. Finally, Through interview and analysis, the author explores the reasons behind the level of maternity insurance in Shanghai, and draws some relevant suggestions. The main conclusions of this paper are as follows: the coverage level of fertility insurance in Shanghai is on the low side, which has hovered around 62% since 2005, and has not increased significantly with the development of social economy, and the coverage scope is relatively limited, but the subjective willingness of social members to participate in insurance is high; At the same time, the relative level of fertility insurance coverage, the growth rate of population coverage and coverage rate are in a relatively low position in all kinds of insurance, and the development speed is lower than that of other types of insurance. The absolute level of maternity allowance in Shanghai has been increasing continuously. Since 2007, the average annual increase of maternity allowance for employed women has been 10.64, and the average annual average increase for all women is 10.37. The minimum maternity allowance level is difficult to meet the basic living needs of mothers and newborns, and the degree of support for normal living needs is even lower. The growth rate of maternity allowances is mostly lower than that of the per capita consumption level of residents and the growth rate of average social wages and other indicators. The standard of subsidy for reproductive medical expenses in Shanghai has not been adjusted for many years since 2004, the standard of subsidy is on the low side, and the scientific dynamic adjustment mechanism is not perfect. The guarantee level of maternity medical fee subsidy for female fertility is between 40% and 50%, the overall level of guarantee is low, the burden of individual reproductive medical treatment is large, the supervision of birth insurance to participate in insurance is not strong, and the employer's consciousness of participating in insurance is poor. The determination and adjustment mechanism of treatment standard are the main reasons for the existing problems in the level of maternity insurance in Shanghai. Based on this, this paper suggests: to implement the supervision mechanism of maternity insurance, to accelerate the implementation of the integration of birth insurance into medical insurance, to establish a mechanism of adjustment of maternity allowance, which is suitable for residents' consumption level, social average wage, and so on; Establish appropriate subsidy standard adjustment mechanism for reproductive medical expenses.
【学位授予单位】：华东师范大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：F842.617

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