The Economic Operational Pattern And Simulation Analysis Of Social Health Insurance

Social health insurance was regarded as one of the most difficult and complicated components in the social security system because of the highly uncertain diseases and other factors artificially imposed. Since social health insurance has great role in the relief of social conflicts and protection of labor force, all governments in the world has placed great importance in social health insurance. However, it has become a seriously stubborn illness owing to the escalation of health cost and health reform has become an inevitable trend in health insurance systems in the world.The Chinese social security system has been established and improved through continuous health insurance system reform. The paper first reviewed the process of health insurance system reform in China, summarized the main achievements and existent problems in it. This research project was targeted to study the economic regular patterns and the influencing factors by means of quantitative methods, to design and develop corresponding program packages using simulation technology. The final product can be used to improve the level of scientific decision-making and management in the administration of health insurance.The major synopsis and results were summarized as the following: From the published statistics and data in the official website, it was shown that the elasticity of health care with respect to income is 1.24; the proportion of the government has been steadily decreased year by year in the health expenditure and personal expenditure has increased greatly in recent years, which means that the cost control of the government has shrunk and such a situation weakened the health cost control. Meanwhile, there is great unfairness in health consumption since high-income group pay a less proportion in health care and the poor burdened more than the rich. Therefore, the poor should be favored in the policy making.There exists prevailing information asymmetry in the health care market. Possessing special knowledge, health care providers were considered as the authoritative by consumers. By constructing a welfare economic model, it was proved that health cost cannot be controlled effectively only through raising co-payment or deductibles and it may lead to insufficient health care demand. It put forward that the provider's advantage in health care should be exploited fully and explicit incentive should be given to the provider in order to manage the health cost successfully.According to data from the reform experimental city, it analyzed the economic pattern of raise and allocation of health insurance funds. It also built econometric models by means of personal data of 20,000 employed insures for the past continuous five years. Key factors influencing health cost were identified. It concluded that the health care insurance consumption has close relationship with the insurance policy and therefore, health insurance system is the key determinant for health care consumption pattern.A program package has been developed with simulation technology. This package can provide better accurate short-term forecast under the fluctuation of insurance policy. It can help the administration institutes analyze the potential influence of the policy change. It helps to reduce decision-making errors and therefore has significant application values.The paper has studied the economic pattern of social health insurance in depth from both macro and micro levels. It built not only theoretical model but also carried out positive analysis with real data, and also developed a program package. It provided scientific basis for the management of health cost. It has great theoretical and application values in improving the level of management and decision-making for the health insurance administration institutes.