Research On The Impact Of Private Health Insurance On The Expenditure Of Public Medical Insurance Funds

As an important part of the multi-level medical security system,since the new medical reform in 2009,the Party Central Committee and the State Council have repeatedly issued documents to encourage and support the development of commercial health insurance.In regional practice,the medical security management departments in different regions show great differences in supporting the development of commercial health insurance,among which,some regions are worried that the development of commercial health insurance will increase the expenditure of the basic medical insurance fund and damage the sustainable operation of the basic medical insurance fund,so they adopt a conservative attitude of not supporting and not opposing the development of commercial health insurance,which is not conducive to the construction and development of commercial health insurance and multi-level medical security system.Will the development of commercial health insurance affect the expenditure of the basic medical insurance fund? If so,what is the mechanism of its impact?This study first clarifies the research direction and ideas through literature review and theoretical analysis,and puts forward the research hypothesis that the impact effect of commercial health insurance on the expenditure of basic medical insurance fund may be promoted,inhibited or not significantly affected.Secondly,based on the panel data of 31 provincial-level administrative units in China for a total of 8 years from 2012 to 2019,the insurance density of commercial health insurance was set as the explanatory variable,and the per capita annual expenditure of the basic medical insurance fund for urban employees was set as the explanatory variable,and the generalized moment estimation(systematic GMM)model was used for regression,and the instrumental variable method was used to test the endogenous problem,and it was found that the increase of the insurance density of commercial health insurance in China would have a restraining effect on the expenditure of the basic medical insurance fund.And this inhibition effect will be stronger in areas with higher insurance density.Finally,based on the development status and policy orientation of commercial health insurance,as well as the development experience of two commercial health insurance products,Zhuhai "Great Love Without Borders" and Kunming "Spring City Huimin Insurance",feasible measures to support the development of commercial health insurance are summarized.Based on the above,this study draws the following conclusions and recommendations:(1)The development of commercial health insurance in China is conducive to alleviating the expenditure pressure of the basic medical insurance fund.The impact mechanism is that patients who apply for commercial health insurance are more inclined to use medical services outside the basic medical insurance list,which in turn reduces the consumption of drugs with substitution relationships in the basic medical insurance catalogue,and reduces the expenditure of the basic medical insurance fund.(2)The higher the development level of commercial health insurance,the stronger the above impact effect.The difference in the impact effect may be related to the coverage and level of coverage of commercial health insurance products.It is recommended that local governments encourage and support the development of commercial health insurance,especially participate in and guide the development of customized commercial health insurance in cities;It is recommended that commercial health insurance companies focus on the protection of their products on pharmaceutical items outside the basic medical insurance catalog,and take the initiative to improve the inclusiveness of urban customized commercial health insurance.