Research On The Comprehensive Evaluation Of Social Medical Insurance In Chongqing

As an important part of the social security system, the social medical insurance hasalways been a widespread concern in the society. Establishing a completely covered,urban and rural coordinating social medical insurance system has been an importantgoal for our country to achieve. As a national experimental city of urban and ruralcomprehensive social supporting services reform practice, Chongqing has beenactively exploring and promoting the integrated development of social medicalinsurance for a long time. The new rural cooperative medical insurance and basicmedical insurance for urban residents have been combined together in Chongqing inaccordance with their similarities, which is known as the urban and rural residentscooperative medical insurance. But because the city is located in China’s western region,the impacts brought by both the urban and the rural structural characteristics are stillvery obvious. With the new urbanization progresses and the continued integration ofurban and rural development, the urban and rural cooperative medical insurance is farinferior to the basic medical insurance for urban workers both in the presentdevelopment situation and in the operational efficiency and effectiveness. This problemwill bring about huge obstacles and adverse effects on the integration of the socialmedical insurance when the city develops into a higher economic stage.The traditional evaluation of social medical insurance usually concerns only oneaspect of the evaluation and analysis. But in today’s complex society, the evaluationonly from a certain aspect, a single perspective of social medical insurance has beenunable to meet the requirements of research and development of medical insurance.Only the comprehensive research and analysis which carried out from multipleperspectives can meet the requirements of today’s academic research. Therefore, in linewith the guiding ideology of this study, in addition to the use of the social insurancetrunk theory, this paper also applies different methods of management research, financeresearch and sociology research. The paper uses the urban employees’ basic medicalinsurance and urban and rural cooperative medical insurance in Chongqing as studytargets, and aims to find out the specific reasons for the differences in the operatingefficiency of the two social medical insurances and offer some relevant suggestions toeliminate the differences in order to provide theoretical support for the integration of thetwo social health insurance in the future and the ultimate realization of social health insurance integration by building comprehensive assessment of its comprehensiveevaluation analysis. Carrying out this study can not only bring about significance of thedevelopment of Chongqing social medical insurance system, but also provide a criticalexploration and case for the two social health insurance nationwide integration.Firstly, this paper introduces the background, meaning, content, and route researchmethods. Secondly, it elaborates the concept of a review study of social healthinsurance-related and domestic and foreign. Then, according to the Delphi method(expert investigation), it has identified the Chongqing six city-level indicators of socialhealth insurance system and the comprehensive evaluation index21secondaryindicators, which followed by the use of AHP analysis determined the total weight ofeach six-level indicators of the weight and21secondary indicators decentralizationweight. And it carries out a comprehensive analysis of the two medical insurancesystems and draws the conclusion based on the data analysis of a comparative analysisof data estimates for six terms and overall operating efficiency of two social healthinsurance. Finally, it offers some relevant suggestions which can reduce thedifferences in operating efficiency between the urban and rural cooperative medicalinsurance and urban employees’ medical insurance in Chongqing.By establishing social medical insurance assessment system and conducting acomprehensive evaluation for urban employees’ basic medical insurance and urban andrural cooperative medical insurance in Chongqing, we found that there are obviousdifferences in the operating efficiency and results between the two insurance systems.These differences mainly result from a large gap between the two fund raisingproductivity and efficiency of the stock of medical resources and the use of social healthinsurance. In addition, two social medical insurance fund operations, the level ofprotection, system coverage and differences in terms of supervision and managementalso have some impacts on both operational efficiency. To solve these problems, thewriter did a lot of reading at home and abroad through the relevant literature, andcommunicated with some experts, scholars and leaders in Chongqing community sector,health meter department and recorded and collected their opinions and suggestions.Some suggestions have been figured out. First, in terms of covering the medicalinsurance, the government will continue to increase insurance rates, and solve theproblem of duplicate insured as soon as possible. Second, it should also improve raisingthe efficiency of the urban and rural residents medical insurance fund and strengthenlegislation on health care, and actively expand financing channels. Third, it should strengthen, unify the operation and management of two social health insurance andestablish health insurance fund management evaluation system. Fourth, it shouldestablish and improve the mechanism of supervision and management of social healthinsurance, in order to control and defense against internal and external risks. Fifth,optimizing medical insurance should be done to improve the degree of protection formedical insurance payment policy, the three directories should be unified for socialhealth insurance and services, and give full play to the personal account ofcompensatory function, and accelerate the system of payment out of Chongqing. Sixth,the government should try to accelerate the upgrade of the level of medical and healthservices, and increase investment in health care resources, and focus on medical teambuilding, and encourage the development of private hospitals.