摘要
社会保险欺诈直接危及基金安全,为实现社会保险基金有序运行,必须深入推进反欺诈工作。社会保险反欺诈的制度设计应充分尊重民意,唯此反欺诈工作方能获得公众的广泛认同和深度参与。社会保险反欺诈公众认知问卷调查结果显示,约80%的公众听说过社会保险欺诈。在一般认知方面,公众认为基本医疗保险领域的欺诈行为最为多见;社会保险欺诈在待遇支付与领取阶段更为集中;主要的欺诈实施主体为自然人和社会保险服务机构及其工作人员。在欺诈行为可责罚性认知方面,公众认为对于社会保险欺诈应当予以惩罚,且普遍不认同轻罚。在公众参与反欺诈方面,超过4/5的受访者不了解当地社会保险反欺诈规范性文件;约73%的受访者愿意举报社会保险欺诈行为。基于以上研究发现,制定统一的社会保险反欺诈法、加大公众举报欺诈的奖励力度、完备举报人保护制度、进一步扩大社会保险覆盖范围等策略的综合运用能够有效促进社会保险反欺诈目标的实现。
Social insurance fraud poses a threat to the security of social funds.In order to realize the orderly operation of social insurance funds,we should further promote anti-fraud work.When designing the anti-fraud system in social insurance,we need to respect public opinion.Only in this way can the anti-fraud work be widely recognized and actively participated by the public.According to the results of the public awareness questionnaire on social insurance fraud,about 80%of the public have heard of social insurance fraud.In terms of general awareness,the public thinks that fraud in basic medical insurance is the most common.Social insurance fraud is more concentrated in payment and collection stage,and the main subjects of fraud are natural persons,social insurance agencies and their staff.In terms of the punishment of fraud,the public thinks that social insurance fraud should be punished,and generally does not agree with light punishment.In terms of public participation in anti-fraud,more than 80 percent respondents have no idea of local anti-fraud documents in social insurance.About 73 percent of respondents are willing to report social security fraud.Based on the above findings,the comprehensive application of strategies such as the formulation of an anti-fraud law,increasing the reward for the public to report fraud,improving whistle-blower protection system,further expanding the coverage of social insurance can effectively help realize the goal of anti-fraud in social insurance.
作者
王素芬
WANG Su-fen(Law School of Liaoning University,Shenyang,Liaoning,110036)
出处
《深圳大学学报（人文社会科学版）》
CSSCI
北大核心
2021年第2期84-94,共11页
Journal of Shenzhen University：Humanities & Social Sciences
基金
国家社科基金一般项目“社会保险反欺诈立法研究”(13BFX141)
辽宁省教育厅一般项目“医疗保险可持续运行的法制保障研究”(LJC201921)
关键词
社会保险
反欺诈
公众认知
社会保险基金
反欺诈策略
social insurance
anti-fraud
public cognition
social insurance funds
anti-fraud strategy
