Studies On Balance Of Payments Under Full-covered Social Health Insurance Of China

With the continuous development of social and economic progress, improving the social medical insurance system has become an important symbol of social civilization and progress, which not only improves the health level of the overall people, but also promotes the well-off society and builds a harmonious society.It explores the realization of social health insurance under full-covered systems concept and policy design from the view of the social point. It cites an instance of Dalian, puts up the studies on the balance of full-coverage mode, which bases on the specific situation statistics and data analysis.Firstly, comparing the medical insurance operation mode between domestic and abroad countries, finds that the weaknesses of our medical insurance system compared with foreign advanced system, and draws lessons from the foreign experience. At the same time,it conceives the full-covered health insurance mode, which bases on the analysis of the current situation and formation reasons, and designs multidimensional systems which covering the urban workers, minors and in college students, migrant workers and landless peasants, in order to achieve universal health insurance coverage.Secondly, it studies the income and expenditure status of the current health insurance fund based on the design of the universal health insurance coverage. In summing up the balance situation over the years, compares the differences among Beijing, Shanghai, Wuxi, Zhenjiang and Dalian, obtains the major factors of the balance of the fund payments, which includes policy, management agency and the population aging, and comes up the countermeasures of overcoming the negative factors and achieving a balanced budget.Finally, cites the instance of Dalian, uses the mathematical modeling approach to construct the whole balance of health insurance coverage patterns. It finds that Dalian current rate of medical insurance fund balance is 23.65% which far higher than the national requirement of 15%, excessive medical insurance fund balance results in a serious waste of social resources. It combines with the policy factors and settlement factors which leading to the fundamental imbalance, and researches the relativity between the collection amount of medical insurance fund and the payments of medical expenses, sorts out the balance of medical insurance fund. It designs the medical insurance fund balance model which covers a wide range of insured people and reduces the surplus fund to ease the burden on residents of medical expenses, achieves the balance of medical insurance fund. It introduces the concept of "capacity factor", achieves the break-even results by adjusting the variables.By literature analysis and mathematical modeling, it carries on the research of medical insurance system for China's full-covered model and medical insurance fund balance issues.In the design of health insurance system under full-covered which according with our national conditions, at the same time, completes the model of medical insurance system undered full-covered, which provides a solution to the current imbalance between revenue and expenditure of medical insurance fund, relieves the overweight insured health care costs, provides a theoretical basis and analysis tools for further studies on the social medical insurance.