The Study On Composite Payment Of Medical Insurance Expenses

Since the Chinese government put forward a new round of medical reform in2009, the problem of how to find the new breakthrough of the new medical care to break the deadlock of the new medical reformation becomes very important. In my opinion, the most important goal of the new medical reformation is to reduce the difficulties of seeing the doctor and cut down the price. And the key to this situation is we should control the rising cost of medical care. From this aspect, we can conclude the reason of any problem in Medical security system to be the control and constraints of Medical treatment cost.In order to achieve good effect of controlling the fee we should do three parts as follows:we should ensure the health service's enthusiasm and initiative; we should also meet the participants medical service needs and we should realize the fund balance of social organization of agency of medical treatment insurance. But the most important point is the control of the medical service supplier fee and the realization of the control is by the scientific and reasonable payment mechanism. The payment of Medical insurance cost is not only the important link of design and operation of medical security system, but also the key to the success of reformation of medical security system. During the process of medical health system reform all over the world, the change of medical payment mechanism always be the center of it. So the reform, perfect and combination of the medical payment mechanism is the direct and the most effective way to control the medical insurance cost, meet residents medical service needs and ensure that the hospital enthusiasm and initiative.Firstly, this paper describes and defines the concept of ways about medical treatment payment. And it analyze the medical treatment payment in detail. It also compare the advantages and disadvantages of the medical treatment payment. Besides, it summarizes the macro conditions of the medical treatment payment.Secondly, this paper conclude the reforms and developments at home and abord. This paper takes US, UK, Germany and Japan as examples to introduce their experiences to China in medical treatment payment. It analyzes the evolutionary process and the status on medical treatment payment since1949and make a summary of the changing process of medical treatment payment in He'nan, Beijing and Shanghai.Thirdly, this paper take Zhenjiang City, Jiangsu Province as a example to introduce the forming process and inner meaning of scientific composite payment form. That is to say we take the people who seeing the doctor as the core, the total budget as the basic to form a payment by the service, disease and person. It also analyze the economic effects of this payment by the data in Zhenjiang.Finally, this paper result in the promotion of composite payment form in Zhenjiang City through some theories and developing practice at home and aboard. It advices the government to build a universal medical security system, make the total budget payment as the a premise of controlling the medical fee. And it also hope the government to set the compensation mechanism by person, the scientific system in managing and supervising. The government should also strengthen the construction of community health service system to make a effective breakthrough on keeping the medical fee grow reasonably and steady in China.