Study On The Sustainable Development Of Medical Insurance For Urban And Rural Residents-

Healthy,stable and sustainable health insurance system can give participants a sense of security.Since the urban and rural residents health insurance system has been in operation in Songyang County,Lishui City,Zhejiang Province for more than ten years,many problems have gradually emerged,threatening the sustainable operation of its medical insurance fund.This paper mainly analyses the problems existing in fund income,fund expenditure and government supervision of Songyang county government in the process of implementing the sustainable operation of urban and rural residents medical insurance through case studies,and puts forward suggestions.It mainly draws the following two points of view:(1)The inadequate supervision of government departments has resulted in the outpatient service of medical institutions,the increase of hospitalization expenses year by year,and the growth rate is obviously too fast,resulting in the forced adjustment of the medical insurance fund: increasing collection efforts,increasing personal burden,increasing financial pressure,and the annual deficit of the medical insurance coordinated fund.In addition,the government lacks correct guidance on the medical treatment behavior of the insured,which leads to the blind medical treatment of the insured and weakens the effect of medical insurance.In this regard,the government needs to strengthen the supervision of medical institutions,increase the guidance of medical behavior of insured objects,control the growth of medical expenses reasonably,create a healthy environment for the operation of medical treatment and medical insurance of insured objects,and guarantee the sustainable operation of medical insurance funds at the source.(2)The health insurance policy formulated by the government is not perfect enough.The lack of risk-sharing mechanism for commercial insurance companies in policy-making makes the operational risks of commercial insurance companies bear only by themselves,weakens their enthusiasm to participate in urban and rural residents medical insurance,and poses a threat to the stability of the operational mechanism of medical insurance;secondly,in such a situation,the pressure of urban and rural medical insurance funds is so great.Next,it is not a stable and sustainable way to raise funds from urban and rural health insurance funds.It is difficult to maintain the sustainable operation of medical insurance.It is necessary to broaden other financing channels on the basis of the original financing path.Furthermore,the reimbursement standard isdetermined by the per capita disposable income.The insurance personnel use a unified starting standard,but the starting standard of 20000 has exceeded the family’s bearing range for the difficult groups,so the setting of the starting standard needs to be more detailed,and the starting standard for the difficult groups should be reduced.Above all,we can see that there are big problems in the supervision and policy of government agencies,which affect the sustainable development of medical insurance for urban and rural residents in Songyang County.The innovation of this paper lies in the close connection with the reality,the use of examples to illustrate the phenomenon and draw conclusions.The author chooses a more comprehensive research object,the various links of urban and rural residents medical insurance,to analyze the existing problems in detail,and to put forward practical solutions according to the actual situation of Songyang County,with a view to urban and rural residence.Suggestions for the sustainable development of the Civil Medical Insurance Fund.