The Mechanism Of Commercial Insurance Companies Handling Social Medical Insurance

Firstly, this article elaborated the theory of social health insurance by commercial insurance companies managers and divided the form of social security organizations into Government swept type, government-led and government-assisted which is based on the government involvement. Then analyzed and compared of the interactive relationship between the status and role of various system types under the commercial insurance companies, as well as social and medical insurance participating subjects and the principal. New Public Management Theory asked the government to shift its mode of operation from power for the center to rules for the center, Market-oriented public Service Theory mentioned the introduction of market mechanisms into public services through a contract outsourcing, principle-agent theory dissertated both the principal-agent information asymmetry game. These three theories provided theoretical support for the commercial insurance companies to participate in the social medical insurance business.On the basis of the theoretical support, we continue to analyze the motivation of principal and trustees in the service of the social health insurance. Firstly, we analyzed the trend of global social health care reform, and found that the current health care reform world in toward the middle of the line, which means balance the status and role of government and the market in the health insurance system. Secondly, analyzed the problem of the basic medical insurance faced by the government-run social health insurance operating inefficiencies, the basic role of the supplementary medical insurance, medical insurance funds sources and expenditures instability, then pointed out that using the introduction of commercial insurance companies by improving fund management and optimize the quality of service to solve the efficiency problem, through the use of the organization’s network of commercial insurance companies to reduce the management costs of the government in the management of social health insurance, cost management techniques by commercial insurance companies favor-control the excessive growth of medical costs, to reduce the risk of social medical insurance fund run. Finally analyzed from the feasibility and necessity of commercial insurance companies to participate in social health insurance motive and derive the possibility of commercial interests.After the analysis of the motivation, this article continues the commercial insurance companies entrusted Managers mechanisms of social medical insurance business. Firstly, introduced and compared some more mature manage model around the world and some successful local mode of our country. Then analyzed the powers and responsibilities of the relationship of government and commercial insurance companies in handling mechanism, and pointed out the something can be improved in the process of commercial insurance companies entrusted with the handling of social medical insurance business.At the last place, this article put forward mechanism for optimizing the way commercial insurance companies entrusted with the operation of the social medical insurance business. Including bidding innovation, management of project funds innovation as the core of Managers optimization; basic medical security convergence and unified structural innovation; innovation regulatory establish the mechanism of the performance appraisal system of social health insurance entrust Manager.