Legal Issues Urban Medical Insurance In China

Medical insurance legal system is an important content of social security act, is the legal basis of the medical insurance system operation and standard, it is not only the law confirmation on the medical insurance system reform, but also for the future development of the basic medical insurance system in our country legal basis and safeguard. The author thinks that the reform and perfection of medical insurance system in our country must also be on the premise of the perfection of legal system of medical insurance. In recent years, our country’s basic medical insurance system construction progress soon, but our country’s urban medical insurance as an emerging field of insurance of its laws and regulations, compared with the development of the whole insurance legal system, time is relatively long. Chinese academic circles on the research of the legal system of medical insurance is not long, and basically belongs to the study of the whole social security. This article choose medical insurance legal system as the research object, through focus on led the world in the aspect of medical insurance legal system construction of the experience of the United States, Germany and the experience, mainly from the following four aspects to study medical insurance legal system in our country:1, the legal relationship of urban medical insurance in our country.2, transferring medical insurance in our country.3, urban medical insurance cost control in our country.4, medical insurance of the dispute. Hope that through the study of these four aspects to promote the reform of medical insurance in China and legal system construction.First, I explains the medical insurance law relations. This part mainly analyzed and discussed with medical service institutions as the core, because the author thinks that the medical service institutions plays an important role in the relationship between the parties, with the insurer for the administrative contract relation between (the government), and both have a common medical relation between insurant, also have according to the relationship formed by public law on the basis of health care. Clarify the relationship between its and other main body, is to solve various problems in the medical insurance system in the operation of the premise and theoretical foundation, has very important significance.Second, explores urban medical insurance legal relationship in transferring problem, this part mainly from the transfer of rights to ginseng and treatment in the two aspects, analyzes the current situation of medical insurance legal relationship transferring reference to the eu’s job to principles, open collaboration, proposed consummates our country medical insurance legal relationship for transferring the laws and regulations, the continuity of medical services, ginseng protect the right of reimbursement of portable and detailed rules.Third, in China’s legal system of urban medical insurance cost control, through the comparison of the cost control mechanism, the conclusion, Germany do more successful in terms of cost control, so the main use for reference the experience of Germany to introduce market competition mechanism, establish a strict drug reference pricing system and so on to control the medical expenses of our country.Fourth, medical insurance in our country the dispute on the question of how to solve, through the analysis of the legal relationship between the various subjects, one by one to solve because of the medical insurance disputes between different subjects, and mainly analyzes five steps appeals process in the United States in dealing with medical disputes, according to China’s specific national conditions, suggest insurance of our country in dealing with medical disputes is also set up a social security orgnaization of agency of reconsideration, social labor and social security department review, the court litigation dispute resolution mechanism of medical insurance.