Health Insurance Law Research

Health insurance, related to other insurance coverage, such as Marine insurance, fire insurance, property insurance, unemployment insurance and life insurance, is a new insurance fields whether in China or in the United States and its history is short. The development of the law and regulation about health insurance, compared to the law of insurance, is not long. In the USA, the history of insurance law is about 100 years, but in China, the emergence of health insurance is only 60 years. Until 2006, the relatively complete definitaion of health insurance in the legal standard just appeared after the promulgation of Healthe Insurance Management Regulation.Adapt to the development of health insurance business and the related legal construction of the health insurance in the chinese academic circle, the time of the legal research to health insurance is not long. Not only the quantity of related achievements is small, but also the content of the achievements is nearly all belong to the whole social security. This article chose health insurance and its legislation as the research object, reviewed the experience of American of which the construction of the law of health insurance is led the world, combined the legal construction practice in Chinese health insurance system design recent years, analyzed the trajectory, contents, features, experience and lesson in the legislation program of health insurance, so as to promote our health insurance (medical insurance) reform and legal construction.In this paper, there are five chapters except the introduction and conclusion.The Introduction involved to the historical writing background, the reason why today the health insurance have becoming the front of countries legislation (in the western developed countries, the valu of health insurance has accounted for more than one-third gross value of the insurance market), and the relationship between the health insurance and social development, the improvement of people’s living standard, the concerns of social health, the functions of governmental transformation so on. Then the Introduction analyzed sino-american research achievements and significance related to law of health insurance law under academia, especially Chinese economics, social security. The article discusses about the field by use of analysis tools and methods, and puts forward some opinions and ideas their own innovation, and the paper itself still exist some shortage.The first chapter is Health Insurance Theoretical Basis. This chapter of the sino-us academia use of insurance, health insurance, health insurance act annotates the basic concept, this paper discusses that the U.S. health insurance legal system can be established thoughts origin and theoretical basis, and points out that the focus on healthy, the pursuit of happiness, advocating, emphasizing together, requirements of mutual reflect fairness, efficiency, and advocate intervention, outstanding ideas, such as the welfare of American health insurance on the formation and development of the legal system has great influence, the United States as a pluralistic country for immigration, in forming and establish health insurance law system, also shows a striking characteristics of a variety of theoretical originThe second chapter is th Formation and Development of Law of Health Insurance. Expounds the us-china health insurance and legislative origin, development and evolution process, one of the American history to some, the relatively long experience bumpy and frustration and more more, of course, groped to more abundant experience also a bit. Through the systematic review of the two countries health insurance legal development history, we can find grasp to several characteristics, such as American health insurance law the origin, development, evolution, mature, with a very strong spontaneity, scattered sex and diversity; Also with a strong progressive, that the United States of America’s health insurance business and legislation is a gradual progress for a long period of time, is increasingly perfect process; American health insurance legal system developing, maturing, is also a federal government strengthen intervention dynamics, universal health insurance reform deepening, people increasingly accept universal health insurance concept and plan the process; Whether the United States, or China, in health law construction, there is still a lot more work to do. Especially in China, in many fields are still blank. So, by comparing the two countries health insurance legal history and characteristics, we can find some with regularity of the elements, such as method of social, historical, method of law of the conservatism of the progressive, method, etc.The third chapter is the Design of Law System of American Health Insurance. Discussing the current U.S. health insurance legal framework system, namely in the United States, its basis established health insurance health insurance, main down a federal and state government funded medical insurance care plan (Medicare), medical treatment insurance assistance program (Medicaid), state children’s health insurance program, soldiers and indians as a special group health insurance plan, and by private health insurance companies carry out plan, such as medical health insurance maintenance organization (HMOs) plans, medical insurance can choose provider organization (PPOs) plans, medical insurance pay plan according to the service project PFFs), etc. (In private health insurance plan, insurance companies and business owners by business cooperation for employee "employers (the) buy health insurance" most developed in America, occupy the whole health insurance business above 60%. This chapter analyzed these health insurance plan formation, system content, character, effects and the existing problems, this paper expounds the American academia on these plans and modified the evaluation opinions, and explores the implementation of system and academia to China improved opinions for reference.The fourth chapter is the Design of Law System of China Health Insurance. Discussing the new chinese sixty years especially since the reform and opening of China health insurance system design and analysis of the legislative process, in this process has established three major health insurance system:the primary medical treatment of the town worker health insurance, urban residents’ basic health insurance and new rural cooperative medical system under the framework of medical treatment insurance, and of the ascendant our emerging commercial health insurance, the paper compares detailed. The author analyzes the above-mentioned health insurance system in the current operating practice, achievements, to carry forward the whole China’s social security contributions, and cause of the difficulties in legal system construction, especially on issues. The author puts forward, only accelerate in the field of Chinese health insurance the legislative process, perfect the laws and regulations, to strengthen existing health insurance career achievements of some deep, and to overcome the difficult problem.The fifth chapter, Health Insurance and Some Legal Reform Thinking, reviews the early 20th century America since the start of the medical insurance system reform process, focused on the after 1990’s Clinton and Obama both the President’s universal health insurance reform movement, analyzed the failure and President Clinton reform reasons for the failure of the reform, Obama presidential success and successful reason, elaborated the decision American health insurance legal system development and evolution of the social and historical background, the article discusses the reform of plays a crucial role in the success or failure of the major international events, reform plan design, as well as content reform objectives and plans content disjointed, the American economy is in recession and recovery reform, influence of the reform process of error, as well as any in the concrete operation on the reform of difficulty, the opposition (opposition and against each of medical interest groups) power is sufficient to powerful, various social strata, and the attitude of treating American medical special religious cultural traditions and values, etc, the author thought that health insurance reform, and the construction of legal system of health insurance, not only is a medical or legal things, but a social movement, involving the whole country and all walks of life and all classes and every family business, if legislation without these aspects of skill to agree or interest coordination and balance basically the same words, reform or the system construction will the lip, route to failure. Since China in 2009, has entered a new round of medical treatment to ensure a system to reform, and in this respect, the experience of America deserves our attention and reference for special.Epilogue part, mainly expounds the two countries, especially China, health insurance law, some existing problems and Suggestions to solve these problems and countermeasures. Although, these Suggestions and countermeasures just a student’s view, may not be completely conforms to China’s reality, but after all, nearly three years after the author of the time to think about income, a Chinese insurance industry and law might have a little reference reference value.