The Effect Of Commercial Medical Insurance Under Conditions Of Social Basic Medical Insurance ——From The Perspective Of Medical Expenditure

With the continuous upgrading of medical services and the development of the social medical security system,the people’s demand for medical and health service protection has also increased significantly,which has led to a continuous increase in the medical expenses that the people have to pay when they fall ill,and compared to the past,the people increasingly feel that the basic social medical insurance is not enough to protect them and the burden of medical expenses is heavier.Therefore,in order for the people to have a better and healthier life,the State is constantly improving the basic social health insurance system,while paying attention to the development of commercial health insurance in the social security system,and has issued a number of policy recommendations to promote the development of commercial health insurance,such as "Several Opinions on Accelerating Commercial Health Insurance".According to the data of 2021 Statistical Yearbook,the premium income of commercial health insurance in China in 2020 was as high as 871.27 billion yuan.Commercial health insurance is developing in a benign direction,and even though it has not developed for as long as basic social health insurance,it has been rapidly accepted by the market,and commercial health insurance,which accounts for a large proportion of commercial health insurance,has also attracted much attention.Most of the existing studies have argued theoretically that commercial health insurance can complement social health insurance to improve the protection system,but there are fewer studies that quantify the role of commercial health insurance in the context of basic social health insurance from medical expenditure data.To what extent does commercial health insurance play a positive role in outpatient and inpatient health care expenditure under basic social health insurance? This is the central question explored in this paper.The study of the impact of commercial health insurance on health care expenditure under basic social health insurance will not only enrich the theoretical knowledge of commercial health insurance,but also provide a theoretical basis for the purchase of commercial health insurance,which has certain practical significance.This paper,through extensive literature reading and collation,combines the theory of expected utility function and the influence mechanism of medical insurance on medical expenditure,divides medical expenditure into two parts: outpatient medical expenditure and inpatient medical expenditure to construct an expected utility model of medical insurance,and empirically analyses the role of commercial medical insurance under the condition of social basic medical insurance,so as to put forward policy recommendations.The empirical results show that: firstly,the purchase of commercial medical insurance by individuals with basic social medical insurance will have a catalytic effect on outpatient medical expenditure and inpatient medical expenditure,which means that the purchase of commercial medical insurance under the condition of having basic social medical insurance will increase individuals’ demand for medical services,leading to an increase in the overall demand for medical services,mainly releasing those who used to pay for medical services because of the low reimbursement rate of medical insurance and The demand for medical services is mainly released for those patients who had given up receiving treatment because of the low reimbursement rate of medical insurance and their financial situation to pay for higher medical costs.Secondly,for respondents who participate in both commercial medical insurance and basic social medical insurance,their expected utility is performed well in the outpatient and inpatient treatment components,and respondents who participate in both commercial medical insurance and basic social medical insurance have higher utility expectations compared to those who participate in basic social medical insurance only,so with basic social medical insurance,residents have the necessity of commercial health insurance.Thirdly,when decision makers have a clear understanding of their own health conditions,such as whether they need more frequent inpatient treatment or more frequent outpatient treatment,and have the financial ability to afford commercial medical insurance,purchasing commercial medical insurance can max expected utility,i.e.mini the financial burden caused by medical expenses.Based on the empirical results,this paper proposes that the government should provide policy support for commercial health insurance,insurance companies should improve the level and targeting of their products,and society should promote the advantages of having commercial health insurance.