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新生代农民工基本医疗保险制度可分为初创、发展与危机并存、整合与完善三个发展阶段。户籍制度、土地产权制度、就业制度、收入分配制度作为宏观因素影响与制约医保制度的发展。参保资格、缴费年限、缴费基数、报销门槛、统筹层次等医疗保险制度设计层面存在缺陷,阻碍新生代农民工享受均等医保待遇。医疗服务机构、用工单位、新生代农民工个人的行为策略微观作用于医保有效需求。需求预期、需求能力、心理机制相互作用下,新生代农民工医保需求悖论产生。为解决这一难题,需充分发挥政府主导作用;针对新生代农民工个性特点制定和完善基本医疗保险制度;多方合作,灵活运用柔性管理方式,理性解决医保难题。
The new generation of migrant workers basic medical insurance system can be divided into start-up, development and crisis coexist, integration and improvement of the three stages of development. Household registration system, land ownership system, employment system, income distribution system as a macroeconomic factors affect and restrict the development of health insurance system. Insured insurance, payment years, payment base, reimbursement threshold, the overall level of medical insurance system design flaws, hinder the new generation of migrant workers to enjoy equal medical treatment. Medical service agencies, labor units, the new generation of migrant workers behavior of individuals acting micro-health insurance effective demand. Under the interaction of demand expectation, demand ability and psychological mechanism, the paradox of health care needs of new generation migrant workers arises. In order to solve this problem, it is necessary to give full play to the leading role of the government; to formulate and perfect the basic medical insurance system according to the personality characteristics of the new generation of migrant workers; to cooperate flexibly and flexibly with flexible management methods to rationally solve the medical insurance problems.