Reasonable Setting The Treatment Of Basic Employees Medical Insurance

After years of being reformed, our health care system has achieved some success. Since theproblems like “difficult and expensive to cure disease” and”the more disease people cure,the poorer they will be “still exist. China begins the second health care reform,on the basisof our first time health care reform being regarded unsucessful. We hope to find out thecharacteristics of medical spending in line with the laws of medical services, through theway of empirical studies using our historical Medicare data.We study the treatment of basic medical insurance which includes " pooled funds " and "personal accounts "by using the Medicare data of Kunshan Jiangsu province. First, we usethe four part model to estimate and predict the lifetime medical expenditures, then weanalysis the characteristics of lifelong medical expenditure, and set the established model toestimate the lifetime health expenditure medical insurance medical treatment under differentelasticity. The study found, lifelong medical expenditure has two obvious characteristics:personal account balance plays a positive role in smoothing health risk, in most of themedical expenditure focus after the age of60, and the ratio is about50%. For the medicalexpenditure elasticity of medical treatment: we found that the proportion which has beenpaid by the SRP funds in peoples’ lifetime medical expenditures is very sensitive to theindividual copayment percentage of inpatient expenditures. We also estimate the elasticityof two factors (general SRP funds and catastrophic disease funds) in SRP funds and twofactors (personal account and cash) in personal payments. We found that the treatment ofmedical insurance will affect the proportion paid by the general SRP funds and theproportion paid by the catastrophic disease funds the most. Based on empirical results,policy makers can achieve its policy objectives by adjusting the appropriate medicalinsurance treatment.So we put forward policy Suggestions: from the perspective of reducing the burden ofgovernment, the government need to effectively control the overall pay ratio and reasonableadjust the radio of the individual pay to the hospitalization medical expenses, it will be themost effective; form the reducing the burden, the perspective to solve the poor problembecause of illness, can appropriately raise outpatient health care treatment and hospitalmedical expenses top line. Furthermore it will not let a larger increase in the fiscal burdenand ginseng protect personnel to obviously feel the risk bearing role of health insurance.