Research On Social Medical Care Insurance Commission Management Mechanism

Throughout international health insurance reform, most of governments introduced "managed competition", actively carry out social medical insurance in the field of public service outsourcing to reduce costs and improve service. The government enacts a law framework, creates the corresponding system and mechanism to restrain and standardize the competition of third trustee organization party, and creates quality guarantee system and the mechanism of promoting efficiency, which adapts to the level of health care costs.Showed on "The Central Committee of the Communist Party of China and the State Council’s opinions on deepening the reform of medical and health system", we not only strengthen the government responsibility in the basic medical and health care system, but also pay attention to playing the role of the market mechanism, widely mobilize social forces to participate in, promote the formation of orderly competition mechanism, improve the efficiency of the medical and health care, service level and quality, meet the demand of people in multi-level and diversified medical and health care. In terms of medical insurance system construction, we must speed up the establishment and the consummation of multi-level medical insurance system, with basic medical insurance as the main body, other various forms of supplementary medical insurance and commercial health insurance for the supplement and covering both urban and rural residents.We speed up to set up and improve multi-level medical insurance system covering both urban and rural residents. Health insurance coverage will expand and contributors will continue to increase. Medical insurance management difficulty also will continue to increase, which will put forward higher request on innovative medical insurance management service system and mechanism, and improving the level of medical insurance management services. This article is under this background; through the analysis of study its aims are to discuss the medical treatment of a serious illness with mutual supplement insurance business of insurance companies participating in management, and to adopt the mode of government purchase in basic medical insurance program.This article is divided into five chapters; the contents and the order of the chapters are arranged as following:1. IntroductionBriefly describes the background and research significance, as well as the research content, research methods and research ideas. It is a brief overview of the main innovation of this paper and deficiencies.2. Social medical insurance entrusted management theory analysisAnalyse the theoretical possibility of social health insurance mandate. It mainly introduces the welfare pluralism theory, the marketization of public service theory and the mode of the outsourcing contract.3.The realistic choice of social medical treatment insurance entrusted management at home and abroadIntroduce the world’s major governments pursuing a new round of reform of medical insurance in order to solve the medical treatment charge excessive growth problem. Some local governments actively explore the medical insurance system, such as Zhanjiang, Deyang and Xiamen. It provides guidance significance to further deepen the medical insurance management mechanism by introducing a competition mechanism or cooperating with third parties.4.The pattern of social health insurance mandate and specific mechanism designIn order to make better use of restriction of framework under entrusted agency, we propose to control medical costs and provide better medical services entrusted management mode choice on serious illness mutual supplement insurance business, consequently take government-purchase mechanism on basic medical insurance business.5.Conclusion and further research problems By summarizing the first four chapters’ research, this chapter gets the conclusion. At the same time, we envisage further research direction of the social health insurance mandate.