Social Medical Insurance And Medical Insurance Business On The Integration Of Complementary

The title of the thesis is"an analysis of fusion and complement on social medical treatment insurance and business insurance". This thesis, on theories, compares the superiorities of social medical treatment insurance and the business medical insurance, and considers the necessity and the possibility of developing the two kinds of insurance's fusion and complement. The author refers to advanced foreign managerial experience, then summarizes and analyzes this kind of mode. Through the analysis of operational problems in reality, some target-oriented proposals have been put forward. This thesis is composed of five parts: relational fixed position, theories summarize, overseas experience, effect analysis and countermeasure and suggestion.The first chapter mainly includes the object's limits of studying and fixing the position. The author thought that the social medical treatment insurance and business medical treatment insurance's respective development can not advance fully, and take advantage mutually. So, studying the topic on"fusion and complement"is more efficacious than studying on respective one. That will be surely making medical insurance's form more abundant, and pushing forward the establishment of multi-layer system, and also perfecting our country's social medical service safeguard system. The purpose of this thesis is mainly for enriching and complementing medical insurance forms through the fusion of commercial medical insurance's advantages. The author brings in the thesis concept of"fusion and complement"on social medical treatment insurance and business insurance, and treats the new phenomenon in the reform---"huge sum medical treatment insurance"which is undertook by the business insurance company on this new point of view. This new insurance form is the basic attribute which blends social medical treatment insurance and business medical treatment insurance, and it is the formality connection of the two. The author thinks this kind of new form is worthy to initiate and expand. Therefore, social medical treatment insurance in this thesis, concerning the state of our country, refers cities staff basic medical insurance especially. The commercial medical treatment insurance refers the narrow sense concept of commercial health insurance, i.e. disease medical insurance."The fusion complement"in this text means that social medical treatment insurance and business medical treatment insurance link up effectively in formality, and mix both respectively basic attribute but constitute of special medical treatment insurance form, which belongs to the complement medical insurance category. In China, it exists only one medical insurance form which match"the fusion complement"which is mentioned in this thesis---huge sum medical treatment insurance that exceeding orchestration the fund"crest line"and undertaking by business insurance company. Although other forms of social medical insurance and commercial medical insurance also has certain cooperation, but it doesn't conform to this thesis'limits. Therefore, it won't make the discussion of this aspect. The thesis devotes the discussion of"the fusion complement". So there is no thorough discussion of medical insurance's forms and the health system.The practice needs the theory as instruction. The second part, theories summarize, mainly includes: Marxism about social security of foundation theories, western economics concerning the social insurance and the business insurance of theories foundation and contemporary society to social security and business insurance relations research viewpoint. In the Marxism theory and west economic theory foundation, the author induces and refines the research viewpoints of the domestic and foreign social security and the business insurance relations.The third part is the overseas experience. According to differences of payment mode and fund collection way, the author introduces four modes of foreign medical treatment insurance: National medical treatment insurance mode, social treatment insurance mode, deposit medical insurance mode and business medical treatment insurance of the medical treatment insurance as predominant mixed type's medical treatment insurance mode. Know to all, any system pattern is advantageous, and also has the shortcoming. There is no perfect medical insurance pattern. Each medical treatment insurance pattern which is above-mentioned has certain blemish in fairness, the efficiency or social adaptabilities. For example the National medical treatment insurance mode its social microscopic efficiency is not high enough, and it requests to the economic development level excessively high, therefore the social compatibility is bad. The commercial medical insurance pattern's social macroscopic efficiency is low. The deposit medical insurance pattern requests the socio-economic development and the social full employments excessively high; therefore the social compatibility is bad. Although these patterns have its flaw, they still have many valuable aspects for our study and reference. Therefore, the author takes characters of German and Japanese social security and the business insurance as an example, and combines the development present condition of our country according to the characters, then proposes much enlightenment. For example, withdraw a certain proportion from wines and tobacco's income to use for the social security; establish a social security lottery ticket, make up the social security fund with the lottery ticket income; or set up the Chinese characteristic entry-level medical health service and community services organization and so on.The fourth part is effect analysis. The author has analyzed the motive factors of the fusion complement from two aspects: the government and the insurance company. To the government, the mainly motive actions are passing on risk to some extent, and lightening government's burden, and obtaining the service charge according to certain percentage of insurance fee. While the business insurance company's movie parts are: the national macroscopic policy has given the possibility which the insurance company could get involved; it may obtain the good social efficiency through the undertaking huge sum medical treatment insurance; it is advantageous for cultivating the professionals and assimilating the achievements of management; and it may give the insurance company a promotion that improving health insurance's management and operation overall level.The fifth part is countermeasure and suggestion. According to the fourth part of domestic and foreign condition's analysis, the author puts forward some target-oriented proposals, which also amplify separately from two aspects: the government and the insurance company. The government should integrate the commercial medical insurance and social medical service safeguard system to consider the plan, and developing its advantages fully; it should delimit management scopes of the two explicitly; it should give assurance and norm to"the fusion complement"on the institution(The author proposes a general design frame of the institution.); Moreover, it should carry on the support and the guidance through many kinds of ways to the business insurance company. The insurance company should set up the ideas of long-term management, and meager profit; it should strengthen the foundation research, and pay great attention to the accumulation of data; it should enhance risk control ability; it should speed up the cultivation of talented people and the model of professional business; and it should explore the fusion docking projects on various forms.