摘要
当前我国医疗保障基金的举报制度,存在举报人门槛较低、奖励和保护举报人方法单一和举报人所处的法律关系界定不清楚等问题,可以借鉴美国在医疗保障基金监管领域内的“吹哨人”立法,将举报人限定为内部举报人,通过完善的奖励和保护制度,破解其举报时的伦理困境和后顾之忧,与行政监管形成合力,确保内部举报人为公共利益而对有确凿证据的违法违规使用医疗保障基金的行为而勇于举报、敢于举报,从而有效维护我国医疗保障基金的安全。
There are some problems in China's national and local level of health insurance supervision fund reporting system,such as non-requirement for whistleblowers,single reward and protect mechanism,undefined legal relation of whistle blowers.Referential experience can be learned from the United States in the field of health insurance fund supervision:the"whistleblower"legislation.The whistleblowers are required to be internal whistleblowers.Their ethical dilemma and worries are handled by sound reward and protect mechanism.Internal whistleblowers will have the courage to report for the public interest against the illegal use of health insurance funds with solid evidence,and effectively maintain the safety of China's medical insurance fund.
作者
孟彦辰
MENG Yanchen(College of Medical Humanities,Capital Medical University,Beijing 100069,China)
出处
《医学与哲学》
北大核心
2022年第14期43-47,59,共6页
Medicine and Philosophy
基金
2020年首都医科大学国家医疗保障研究院开放性课题(YB2020B07)。
关键词
医疗保障基金监管
举报
吹哨人
health insurance fund supervision
whistle blowing
whistleblower
