Comparative Study Of International Medical Security Systems And Policy Options For China

Aiming at the medical security systems in typical countries and following the line of model study, this dissertation applies the economic theories to analyze the origin, establishment and development of the medical security systems and on this basis puts forwards policy options for China' s medical security system reform.Based on the research of the medical security systems in seventeen typical countries, this dissertation concludes that all systems are composed of the following five models, namely social medical aid, social medical insurance, national health services, market-oriented medical insurance and individual saving medical security. These five models could be further divided into three types, i. e. public benefit type (including social medical aid model and national health services model), insurance type (including social medical insurance model and market oriented medical insurance model) and self-security type (individual saving medical security). It further argues that medical security systems of all countries are derived from different combinations of these five models. This abstract categorization method emphasizes key points and characteristics making the complicated relationship between medical security schemes and medical security systems in various countries clearer to facilitate comparative analysis of systems in different medical security systems. Based upon case study of typical countries, this dissertation describes, in detail, the historical development, basic policies and key characters of the five models and thoroughly analyzes each, it also categorizes them into different models based on those common characteristics of different systems and the differences of similar systems and analyzes them comparatively.In addition, this dissertation studies important topics such as changing concepts of health, aging, rapid development of medical technology and economic globalization that countries around the world are facing, analyzes the impact of these factors on medical security systems. It also examines how various countries are addressing these issues at the policy level. This dissertation maintains that the basic trend for all countries in developing their medical security systems is the application of several models to build medical security systems with multiple levels and multiple forms. To build a social medical insurance system as the basic system of medical security systems is a common choice for most countries. The trend is to combine the medical security system with preventive healthcare and public health services to transition from the stage of curing diseases to a higher stage of maintaining goodhealth. It is a successful experience shared by most of the countries studied to strengthen government responsibility while using market mechanism to increase the effectiveness of the medical aspect of their social security systems.This dissertation draws four basic conclusions based on the study of building and developing medical security systems in other countries. First, the establishment and development of medical security system must have solid theoretical base to serve as guidance. It must have a clear long-term development goal and it should be implemented unswervingly then. Second, it must follow the principle of maximizing cost effectiveness to choose models of medical security system and to set priority of the system. Third, medical security should be combined with public health that focuses on health prevention to fully utilize limited health resources for the best results. Fourth, the establishment and promotion of medical security system should be in consistent with development of economy and level of income as well as the state financial ability. It should follow the principle of step-by-step implementation, within capability and gradual improvement.As a practice of combining theoretical study with actual reality, this dissertation, based upon deep analysis of our country' s actual situation and application of historical experiences of both China and countries...