中文摘要：

医保筹资中,如果最差＂类型＂里个体的健康行为水平,与全社会健康行为的平均水平相比,二者之差在临界范围内,那么,在设计筹资机制时应充分考虑＂个体责任＂;反之,如果二者之差超过临界值,则不应考虑＂个体责任＂,因为这时个体不良行为受＂环境＂影响很大,该责任应由社会承担。以烟民为例的实证研究表明,中国应采取后一种筹资机制。

英文摘要：

This paper proposes an ideal concept of payment for basic medical insurance under the framew ork of Roemer’s equality of opportunity. This paper suggests that individual responsibility should be taken full account of w hen designing the basic medical insurance financing if the gap of health behaviors betw een the disadvantage type and the average is smaller than the threshold. On the other hand,if the gap is larger than the threshold,the payment should be identical in one type,because the differences of health behaviors are due to circumstance. The empirical evidence from smokers show s that the latter is suitable for China.