| With the further advancement of the "Healthy China" strategy,in the new era,it is required to further promote the structural reform of the supply side of China’s commercial health insurance,enhance commercial health insurance to meet the increasingly diversified health insurance needs,and realize the transition from commercial health insurance industry to large health service industry.However,at this stage,there are still many shortcomings in China’s commercial health insurance market,which cannot meet the urgent needs of the "Healthy China" strategic layout.Specifically,on the one hand,the consumer and the entire society’s demand for commercial health insurance has undergone a fundamental change,and new demands have been made on the service capabilities and service quality of commercial health insurance.First,in the context of population aging and national health,individual consumers’ demand for commercial health insurance services is becoming more diverse.Second,in the key historical market of China ’s overall improvement in quality and efficiency,it is improving the welfare of residents,In carrying out poverty alleviation and other work,the whole society has high hopes for commercial health insurance,and put forward new requirements for commercial health insurance from the perspective of social needs.On the other hand,China’s commercial health insurance market still faces many other problems,such as the low degree of marketization of product pricing,structural imbalances in the supply main body,weak product coordination capabilities,and lack of some guarantee functions.At the same time,China is in a critical period of reform and development,and the new tasks and problems it faces are lacking both practical reference and systematic theoretical guidance.Commercial health insurance,as an important part of the construction of China’s large health industry,how to improve the service capacity and service quality of commercial health insurance,and play the role of supplementary insurance,has become an important issue that needs urgent discussion.The purpose of this article is to explore the optimization and innovation of China’s commercial health insurance service model from the perspective of demand,in order to promote the supply-side structural reform of China’s commercial health insurance,build a "healthy China",and even realize the "four comprehensive" strategic layout.Theoretical reference.The general idea of this article follows a logical connection of "factual induction,scientific demonstration,and practical application." Based on the actual situation in China,this article analyzes the development of China’s commercial health insurance,and then based on the factual induction,Starting from the three perspectives of individual demand,social demand and the demand of disease prevention and pension,this paper conducts scientific demonstration on the optimization of China’s commercial health insurance service mode,and provides feasible guidance for China to promote the supply-side structural reform of commercial health insurance.Therefore,according to the above logic,there are eight chapters in this paper.The specific contents are as follows:The first chapter introduces the research issues,research background,research methods,research ideas,and main contributions of this article.It uses theoretical analysis and fact induction to point out that optimizing and innovating China’s commercial health insurance service model is of great significance,and the content arrangement of the subsequent chapters of this article is given.The second chapter is the literature review and review of the existing related research.This article reviews and combs this from three aspects.The first is the analysis of the concept of health insurance and the research on the functional positioning of commercial health insurance;the second is the research on the individual and social needs of commercial health insurance;the third is the research on the market system and institutional system of commercial health insurance.At present,the health insurance system arrangements in China,as well as in Germany,the United States,Japan,and South Korea,each have their own characteristics,and the connotation of health insurance-related concepts in different regions are also different.This article discusses several concepts related to health insurance.The identification of categories is an important support for subsequent research.In addition,by reviewing and combing the literature related to the research objectives of this article,it not only lays the foundation for the research in the subsequent chapters of this article,but also helps to find the shortcomings of existing research and launch complementary research.The third chapter is the analysis of the development status of China’s commercial health insurance,mainly analyzes the development status of commercial health insurance in China from the perspectives of demand side,supply side and diversified health insurance demand in the context of "healthy China" and aging population.Grasping the deficiencies in the development of China’s commercial health insurance and the development prospects of the commercial health insurance market is the starting point of this article.The fourth chapter discusses the functional positioning of commercial health insurance in China’s multi-level medical security system.This paper combines a multi-layered medical security system in China to build a systematic theoretical model for evaluating individual welfare and poverty reduction effects.Based on this,we discuss the functional positioning,supply-side structural reform,and the issue of structural reform of the multi-level medical security system provides reference for China to improve the multi-level medical security system and develop a large health industry.The fifth chapter discusses the optimization of China’s commercial health insurance market structure based on individual needs.This chapter considers factors such as demographic characteristics,personal economic status,and macroeconomic status from the perspective of individual needs.It also considers the aging of the population and the poor,and uses the multiple probability selection model to influence the choice of commercial health insurance Factors and the interaction between commercial health insurance,social basic medical insurance,and commercial life insurance were analyzed,and theoretical suggestions were provided for segmenting the commercial health insurance market and optimizing the supply side structure of commercial health insurance.The sixth chapter discusses the social needs-oriented poverty alleviation model of commercial health insurance.Based on the prospect theory,this chapter simulates the production and consumption decisions of rural residents,and combines the connotation of precision poverty alleviation to establish a dynamic system theoretical model that evaluates the effects of insurance poverty reduction.And other issues,and expanded research ideas for the theoretical research of poverty alleviation.The seventh chapter discusses the supply-side structural reform of commercial health insurance under the background of population aging.This chapter combines the basic status quo of China’s population aging and uses inter-provincial panel data to explore the impact of population aging on China’s commercial health insurance demand and consumption.Furthermore,it provides theoretical reference for commercial health insurance companies to subdivide the elderly health insurance market,optimize the product supply structure,and provide theoretical Suggestions for the supply-side structural reform of China’s commercial health insurance.Chapter eight is the main conclusions and policy recommendations of this article.This chapter sorts out and summarizes the research conclusions of the previous chapters.In terms of service concept innovation,supply subject innovation,linkage mechanism innovation,and insurance system innovation,it is recommended to develop a smart big health industry model,optimize the commercial health insurance supply structure,build a diversified health financial ecology,and improve the health insurance system.Suggestions were given to optimize the business health insurance service model and promote the transformation and upgrading of the business health insurance industry.Based on the above research,this article draws the following conclusions:Commercial health insurance development status.This paper analyzes and finds that China’s commercial health insurance is still in the initial stage of development.Generally speaking,the protection of commercial health insurance in China is still very limited;the depth and density of commercial health insurance are still low,and there are obvious differences between regions.In addition,China’s Internet commercial health insurance market has developed rapidly,and the "Internet + insurance" model has become a new growth point for China’s commercial health insurance.From the perspective of market supply structure,China’s commercial health insurance market is gradually changing from oligopolistic to competitive.The degree of market competition is getting higher and higher,but there are still obvious inadequate competition.At the same time,the structure of the main body of commercial health insurance supply is unbalanced and some guarantee functions There are serious shortages,lack of product and service innovation,and a significant lack of response and ability to meet diversified consumer needs.From the perspective of market demand and supply,China’s residents and society’s demand for commercial health insurance has undergone a fundamental change.The imbalance between the supply and demand structure of China’s commercial health insurance market is obvious.China is facing an increasingly diversified health insurance demand and a huge potential medical insurance market for the elderly.Health insurance products that segment populations and specific diseases have become mainstream.Commercial health insurance not only plays an increasingly important role in the multi-level medical security system,but also plays an increasingly important role in areas such as disease prevention and old-age care and financial poverty alleviation.Functional positioning of commercial health insurance.The study found that there are differences in the welfare and poverty reduction effects of different commercial health insurances on residents participating in social security and those not participating in social security.The relative poverty of the group,but it also increases the probability of low-income groups falling into relative poverty.And for residents who are not participating in social security,there is a synergy effect between commercial medical insurance and social basic medical insurance,and there is a crowding-out effect between disability income loss insurance and social basic medical insurance;for residents participating in social insurance,There are obvious synergies between commercial medical insurance and social basic medical insurance,disability income loss insurance and social basic medical insurance,and they all show a supplementary effect on social basic medical insurance.In the fourth chapter,this article not only demonstrates the necessity and rationality of developing commercial health insurance and constructing a multi-level medical security system in China,but also to a certain extent confirms that there is a structural imbalance between the main body of commercial health insurance in China and the society Insufficient coordination of basic medical insurance.Therefore,it is suggested that the structural reform of the supply side of commercial health insurance should be guided by individual needs and social needs,deepen the rational positioning of commercial health insurance in the medical security system,and optimize the multi-level medical security resource allocation.Supply side optimization of commercial health insurance based on individual demand.The study found that age,gender,health status,work status,education level,household registration status,family size,region and industry category are all important factors affecting residents’ purchase of commercial health insurance.Diversified commercial health insurance demand has become an important basis for subdividing the health insurance market and optimizing the structure of the health insurance market,health insurance products that segment the population and specific diseases have become the mainstream of current consumer demand.From the perspective of the relationship between commercial health insurance and social basic medical insurance and commercial life insurance,many products of commercial health insurance in China have obvious substitution effects with social basic medical insurance and commercial life insurance products.Commercial health insurance is not differentiated and specialized enough,and its supplementary role in basic medical insurance is limited.Therefore,it is suggested that China’s commercial health insurance market should be subdivided,the commercial health service model of our country should be optimized,and the commercial health insurance service capabilities and service quality should be improved;improves the product supply system of China’s commercial health insurance market,segment China’s health insurance market based on residents’ differentiated health insurance needs,improve professional and personalized service capabilities,and promote the development of small-scale health insurance and preferential tax insurance,increase innovation in commercial health insurance;the institutional system of the health insurance market in China should be improved,the medical information sharing and updating mechanism should be established,improve the synergy between China’s commercial health insurance and basic medical insurance,and accelerate the process of informatization and standardization of the commercial health insurance market;promote the integrated development of the commercial health insurance industry and health management,medical services,the Internet and other industries,Realize innovation from multiple perspectives such as insurance products,service models,management operations,etc.,and improve the ability of commercial health insurance to meet residents’ increasingly diverse health protection needs.Optimization of poverty alleviation model of commercial health insurance based on social demand.The study found that there are differences in the causes of poverty among individuals at different income levels in rural areas.The greatest poverty alleviation benefit of insurance is the elimination of potential poverty.For explicit poverty,the role of insurance alone in poverty alleviation is limited.Therefore,the current situation of rural poverty can be divided into three categories,explicit poverty,potential absolute poverty,and potential relative poverty.Social basic medical insurance can alleviate the potential relative poverty of residents,and when residents participate in social insurance,the poverty reduction effect of social basic medical insurance is more obvious;taxes and premiums will worsen the relative poverty of some people.Social basic medical insurance,commercial medical insurance and disability income loss insurance will increase the probability of poverty for low-income groups,but at the same time insurance will improve the relative poverty of middle-and high-income groups.Specifically,for the non-participating social security groups,the poverty reduction effect of disability income loss insurance is more obvious;for the social security participating group,the commercial medical insurance’s poverty reduction effect is more obvious for low-income groups.The effect of income loss insurance on poverty reduction of middle-and high-income groups is more obvious.Combined with the number of people expected to reduce poverty,compared with micro health insurance,commercial medical insurance and disability income insurance,on the whole,micro health insurance shows superiority in reducing absolute poverty,while commercial medical insurance has an advantage in reducing relative poverty.In addition,rural residents in a state of explicit poverty show obvious liquidity constraints.Individual insurance tools cannot solve such deep poverty problems."Insurance + credit" as an innovative model of financial poverty alleviation can effectively alleviate deep poverty.Therefore,it is suggested that when formulating insurance poverty alleviation policies,it is necessary to accurately identify the poverty alleviation targets and adopt different insurance poverty alleviation tools for the poor groups in different income segments.In addition,in view of the impact of health risks on rural residents and their different attitudes towards risk appetite,insurance products should meet the different needs of different groups at different levels and levels of risk protection.Therefore,it is necessary to accurately identify the poverty alleviation objects and optimize the design of health insurance products to provide a precise product system for insurance poverty alleviation.Second,alleviating the mobility constraints of the poor,enhancing their ability to resist risks,and increasing the willingness of the poor to purchase insurance are the keys to developing insurance poverty alleviation.At the same time,we should actively develop and innovate financial poverty alleviation models,combine the advantages of microinsurance with other financial or policy tools,and exert better poverty alleviation effects to ensure that insurance poverty alleviation can be recycled and sustainable.Commercial health insurance for disease prevention and retirement.Under the impact of population aging,people’s rational demand for health insurance will increase significantly,but at present China’s commercial health insurance market has significant shortcomings both in terms of overall scale and supply structure.The study found that the proportion of children and children,the degree of aging,the level of social medical security,the size of the family,the level of urbanization,the level of individual income,and the level of residents’ awareness of commercial health insurance are all important factors affecting the demand and consumption of commercial health insurance.Comparing rural and urban areas,it is found that rural residents are facing a more severe population aging situation than urban residents,and the ability to protect commercial health insurance in rural areas is even more inadequate.From a macro perspective,there is a clear substitution effect between social basic medical insurance and commercial health insurance in China.However,in regions with a high population age,the impact of social basic medical insurance on commercial health insurance is no longer significant.As the population ages,the demand for commercial health insurance by residents has become increasingly irreplaceable and has become a rigid demand.Therefore,it is suggested that,in terms of the disease prevention and elderly care service model,the combination of medical care and elderly care,prevention and treatment should be promoted,the health management of the elderly population should be enhanced,and the elderly’s ability to resist disease should be promoted;the commercial health insurance service model innovation should be promoted and active participation Emerging pension industries such as housing pensions and smart pensions will promote industrial integration and develop new formats.In terms of product structure,the product supply structure of commercial health insurance should be optimized,and various types of commercial health insurance such as anti-cancer insurance,disability insurance,and long-term care insurance should be developed,product innovation efforts should be strengthened,and the health insurance market should be further segmented to enrich the supply of commercial health insurance for the elderly focuses on improving the medical security capabilities of commercial health insurance in rural areas.In terms of service awareness,we should increase the publicity of commercial health insurance knowledge,always adhere to "insurance surname insurance",establish a good social image,and commercial health insurance companies should also have the courage to shoulder their due social responsibility. |
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