A Study On The Crises Of Shanghai Medical Insurance Fund

The past over ten years have witnessed great changes in the medical insurance system of our country. At present, (in cities and towns,) basic medical insurance services for urban and suburban residents, characteristic of China, have been tentatively established nationwide. The system has converted from free medical services to social insurance system. There are two significant achievements of reform and establishment of the system. However, as the coverage of the medical insurance extends and the problem of aging of the population becomes more and more serious, the medical expenditure has increasingly mounted and people concern over medical insurance is growing, complaints have arisen about difficulty in seeing a doctor and huge medical fees.While engaging in appropriating and accounting medical insurance fund in Shanghai Medical Insurance Administrator Affairs Center, the author has taken the MPA courses for two years on the shoulders of the former researches. The author sorted out the several factors influencing fund crises on the whole, including system environment factors and system implementation factors. Meanwhile looking back into the history the author analyzes the most important and the core of fund crises--payment crises. Furthermore, the author concentrates on every stage of the form of payment in medical insurance fund. Eventually, the author has come up with some rough ideas about these crises problems existing in medical insurance fund.The entire dissertation comprises of five chapters: Chapter One basically introduces the background and some phenomenon researched by some former scholars. The Chapter Two retrospects the management of Shanghai Medical Insurance Fund as well as some problems confronted, which contain the following Chapter Three's system environment factors (containing political, economic and social environment factors) and Chapter Four's system implementation factors. Between those factors, the author mainly analyzes the system implementation factors, which are illustrated and compared particularly on the remaining sum of the Fund by some practical working statistics, from the angles of the revenues of Shanghai Medical Insurance Fund raising, allocation of the Fund, the form of payments as well as the revenues balance of the Fund. While the payment of Medical Insurance Expenditures lies in the key point and the most difficult point to handle among all the factors influencing Medical Insurance Fund crises. Finally, Chapter Five summarizes the medical insurance fund crises problems mentioned in the previous chapters in order to come up with some humble suggestions and opinions. For instances, the completion of medical insurance legislation, the enhancement of supply supervisal mechanism, the establishment of"Community Guard"system and etc.