【摘要】：醫(yī)療保險是為補償參保者因疾病風險造成的經(jīng)濟損失而建立的一項社會保險制度，，醫(yī)療保險基金為保障參保者的基本醫(yī)療、由用人單位和個人繳費而籌集建立的專項基金。社會保險法規(guī)定：社會保險經(jīng)辦機構負責醫(yī)療保險基金的籌集、管理和支付，并要建立健全預決算制度、財務會計制度和內部審計制度；醫(yī)療保險經(jīng)辦機構應當定期向社會公布醫(yī)療保險基金情況、醫(yī)療保險基金的收入、支出、結余和收益情況；國務院財政部門、社會保險行政部門、審計機關對社會保障基金的收支、管理和投資運營情況實施監(jiān)督。但在實際運行中，醫(yī)療保險基金的管理和運營過程中暴露出許多問題，如醫(yī)療保險基金被騙取、擠占和挪用，醫(yī)療保險基金信息披露不充分、運營信息不透明等，直接影響醫(yī)療保險制度改革的進度和社會的和諧穩(wěn)定。 本文先對福利經(jīng)濟學的平等與效率理論、委托代理理論和博弈理論進行分析，確立了文章的理論基礎；其次采用問卷調查的方法分析了醫(yī)療保險基金財務會計信息披露的主體、目標、會計核算基礎、信息質量特征等；同時采用博弈分析的方法確立了醫(yī)療保險經(jīng)辦機構和參保者、政府監(jiān)管部門、民間監(jiān)管機構和注冊會計師納什均衡的決策行為，在此基礎上構建了以資產(chǎn)負債表、收支表和現(xiàn)金流量表為主體財務會計信息披露體系；最后提出建立多層次的財務會計信息披露體系、全方位的監(jiān)管體系和完善醫(yī)療保險信息系統(tǒng)的政策建議。文章的創(chuàng)新之處主要有兩點：一是在規(guī)范研究的同時輔以問卷調查，提高了規(guī)范研究的科學性和可靠性；二是構建了以醫(yī)療保險基金資產(chǎn)負債表、收支表和現(xiàn)金流量表為主的醫(yī)療保險基金財務會計信息披露體系。
[Abstract]:Medical insurance is a social insurance system established to compensate the insured for the economic loss caused by the disease risk. The medical insurance fund is a special fund raised by employers and individuals to protect the basic medical care of the insured. The Social Insurance Law stipulates that the social insurance agencies are responsible for the collection, management and payment of medical insurance funds, and shall establish and improve the system of pre-accounting, financial accounting and internal audit; The medical insurance agency shall regularly announce to the public the status of the medical insurance fund, the income, expenditure, balance and income of the medical insurance fund; The financial department of the State Council, the administrative department of social insurance and the auditing institution shall exercise supervision over the income and expenditure, administration and investment operation of the social security fund. However, in the actual operation, many problems have been exposed in the management and operation of the medical insurance fund, such as the medical insurance fund being defrauded, embezzled and misappropriated, the information disclosure of the medical insurance fund is not sufficient, the operation information is not transparent, and so on. Directly affect the progress of medical insurance system reform and social harmony and stability. This paper first analyzes the equality and efficiency theory of welfare economics, principal-agent theory and game theory, and establishes the theoretical basis of the article; Secondly, the main body, target, accounting basis and information quality characteristics of financial accounting information disclosure of medical insurance fund are analyzed by questionnaire. At the same time, the game analysis method is used to establish the balanced decision-making behavior of medical insurance agencies and insurance providers, government regulators, private regulators and certified public accountants. On this basis, the balance sheet is constructed. Income and expenditure statement and cash flow statement are the main financial accounting information disclosure system; Finally, it puts forward the establishment of a multi-level financial and accounting information disclosure system, a comprehensive regulatory system and policy recommendations to improve the medical insurance information system. There are two main innovations in this paper: one is to improve the scientific nature and reliability of normative research by means of questionnaire survey in addition to normative research; Secondly, the financial and accounting information disclosure system of medical insurance fund is constructed, which is mainly composed of balance sheet, income and expenditure statement and cash flow statement.
【學位授予單位】：湖南大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：F840.4

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