| Along with the quickly development of China’s economy and the continuously growth of the People’s life quality, commercial health insurance is becoming more and more popular among Chinese people after nearly 30 years’ development. People buy health insurance to cope with high medical expenditure and to get medical security for themselves. In 2009, Chinese government issued document to regulate and direct the health system of China. In the same document, the development direction of commercial health insurance was pointed, which was an good news for the development of it. But unlike the developed countries, China’s commercial health insurance start late and its current development process is also encountered with many problems, including its small size, the high compensation rates, and the low degree of specialization. These problems not only restricts the healthy development of commercial health insurance, but also affected our health system. Therefore, it is particularly necessary to explore and find the path for the development of commercial health insurance of our country. However, the running of a health insurance company is different from the running of other insurance companies, because health insurance companies have to deal with social security institution and medical institutions properly during their running. This makes the operating of a health insurance company more difficult. In order to deal with this problem and find a suitable way for the development of the health insurance companies, we use value chain theory which was advanced by Michael E·Porter and value chain integration as an analytical tool. This will extend our analysis to the view of the health insurance industry, and even give advices to the whole health system of our country.The introduction chapter explains the purpose and significance of this study, research status, methods and contents, and innovative and weaknesses of this thesis. The rest of the thesis is divided into four parts, of which the contents are described briefly below:Part 1:Basic theories. This part describes the basics of value chain and value chain integration, including relevant definitions and the design of the value chain integration. The principle of value chain integration not only lays a theoretical foundation, but also set out the analytical framework for this dissertation.Part 2:Overall introduction of health insurance value chain in China. This is the main part of this thesis. Based on previous analysis, this paper lays out the definition of health insurance value chain, and as well it analyzes the present operation situation of health insurance value chain. Analysis on the inter-connection among all the relevant parties and present operation situation of health insurance value chain is presented from health insurance corporations’ perspective. Thus it demonstrates the significance of value chain integration and problems to be paid attention to.Part 3:The comparison around the globe. Firstly, a brief introduction is given to commercial insurance value chain in U.S. and Britain. Then Specific introduction is given to AETNA International and BUPA UK, both of which have a mature operation model. The purpose of introduction to these companies is to draw experience from those highly developed market and benefit the development of our health insurance.Part 4:The design of health insurance value chain integration. This is the key chapter of the thesis. The process of health insurance integration is described from three parts—objectives, modalities and the establishment of cooperation mechanisms. Considering both the business goals and strategic objectives of the health insurance company, this part gives full analysis and interpretation on the ways that medical institutions, pharmaceutical suppliers, and competitors are integrated. At last, a series of cooperation mechanism is proposed, including the benefits distribution, mutual restraint and trust mechanism.In the previous studies of commercial health insurance, the development of health insurance has been analyzed and made constructive comments for different periods, but they had a certain lack of systematic and comprehensive. This article has certain innovation in predecessor’s research foundation:On one hand, this thesis has an interdisciplinary theoretical foundation; on the other hand, this thesis has a view as broad as considering the whole health insurance industry. |
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