以国有、集体企业为基础建立和发展起来的我国劳动保障系统,随着经济全球化、市场化,城镇职工的就业形式和结构都相应发生着变化。经济结构调整后国有、集体企业的离岗、下岗或失业者,与个体从业人员、自由职业者、农民工等形成了灵活就业群体。这一群体活跃在国民经济和社会生活的各个领域,他们的劳动时间、收入报酬、工作场地、劳动关系等,与传统的、建立在工业化和现代工厂制度基础上的主流就业方式有所区别。比如劳动关系非正规化(没有正规的劳动合同、存在多重劳动关系、没有劳动关系权利义务相对等)、劳动报酬差异性大(有固定报酬形式、计时工资、计件工资等)、劳动时间、场地、用人机制灵活等。因此建立或者接续、管理好这一群体的基本医疗保障,成为城镇职工参加基本医疗保障一个难题,也是不可回避的需要解决的课题。 The labor security system in our country, established and developed on the basis of state-owned and collective enterprises, has undergone corresponding changes in the form and structure of employment for urban workers as the economy becomes globalized and marketized. After the readjustment of economic structure, state-owned and collective enterprises have formed flexible employment groups such as leaving their posts, laid-off workers or unemployed persons, and individual employees, freelancers and migrant workers. This group is active in all fields of national economy and social life. Their labor time, income, work place and labor relations are different from those of the traditional forms of employment based on the industrialized and modern factory systems. Such as irregular labor relations (no formal labor contracts, multiple labor relations, no relative rights and obligations of labor relations, etc.), large differences in labor remuneration (such as fixed remuneration, hourly wages, piece rates, etc.), working hours, venues , Flexible employment mechanism. Therefore, to establish or continue and manage the basic medical insurance for this group has become a difficult problem for urban workers to participate in basic medical insurance and an unavoidable problem to be solved.