Firstly , reviews and analyses the evolution and present situation of the medical care insurance of cities and towns workers ; secondly , analyses the objectivity which restricts the medical care insurance reform , and then finds a solution to breakthrough the bottleneck of social medical care insurance reform ; thirdly , analyses the evolution of medical care insurance reform of western countries objectively , so that we can make a strong argumentation why we should learn their successful experience to perfect our medical care insurance ; last , makes a serious investigation towards some major problems which needs to be solved during our present medical care insurance reform , such as perfect the system , enlarge the coverage of insurance in a high speed , promotes the medical and medicine administration system at the same time sets up a human ? oriented concept called “ equality priority and efficiency ” the thesis sticks to the basic principle of dialectical and historical materialism in investigation method , tries to adopt a series of methods , includes the followings : scientific abstraction , statistics , the combination of international comparison and internal analysis , etc . the thesis has already made some achievements after making a thorough study about the obstacle and policy of our national medical care insurance reform 第三部分內(nèi)容,客觀分析了西方國家醫(yī)療保險改革的路徑,并就我國城鎮(zhèn)職工醫(yī)療保險所應(yīng)借鑒的有益經(jīng)驗(yàn)進(jìn)行了論證。第四部分內(nèi)容,對我國現(xiàn)階段城鎮(zhèn)職工醫(yī)療保險改革實(shí)踐中需要解決的幾個主要問題,比如完善制度設(shè)計(jì)、快速推進(jìn)保險的覆蓋面、切實(shí)推行醫(yī)療醫(yī)藥管理體制的同步改革、樹立“公平優(yōu)先兼顧效率”的人本理念等問題,進(jìn)行了認(rèn)真的研究,提出了解決這些問題的途徑。本論文在研究方法上,堅(jiān)持了辨證唯物論和歷史唯物論相結(jié)合的基本原則,采用了科學(xué)抽象法、統(tǒng)計(jì)法、國際比較與國情分析相結(jié)合等諸多的方法。