A Policy Analysis Of The Effects On Convenience Of Cross-District Medical Treatment In Medical Insurance System For Urban Employees

With the establishment and implementation of Universal Basic Healthcare Insurance System, people are becoming more demanding on the healthcare system, including the elimination of limitation on being covered remotely in order to obtain more convenient medical care with better quality. Several recent convenient policies of cross-district medical treatment have earned various credits as they dedicate to benefiting everyone. However, there are two sides with any public policy. This article will discuss some of the benefits brought by such facilitation policy, while focus on their negative side.This article will be based on the involvement of the convenient policy of cross-district medical treatment in medical insurance system in C from2004to2013, analyze the relevant health insurance data of the local workers, study the influence of policy change on medical flow and the local health insurance fund. Firstly, the article will study the general medical flow of covered workers in the last decade with statistical methodologies, and then study how the facilitation policy influence medical expenses, type of disease, and where people turn to for medical services. The study reveals that the majority with moderate and minor disease went to other regions for medical treatment, which was in turn contradicted with the "solving minor problems locally" principle. The next step is to analyze the influence of convenient policy on local medical care fund, with a specific focus on the change of expenditures of these funds under the convenient policy. The regression analysis estimates the increase of both health care expenses and health care fund expenditures. The article also studied the possible tolerance of health care fund on such policies. According to these studies, an increased CNY16,265,500in the health care fund expenditure occurred as a result of the convenient policy in the first year (2007), and it is expected to foresee an ongoing increase in the following years. It therefore predicted that expenses of health insurance fund in city C will exceed the Fund’s income, and the imbalance of payments will be expanded. Without adjustment of the policy, the fund balance will be exhausted, and pose a severe threat on the safety and sustainability of the health insurance fund.Based on theoretical analysis and quantitative analysis, in order to make social security system fairer and more sustainable, we should recognize positive and negative effects and making overall plans to satisfy people’s need, also improving medical insurance system and relevant policy. According to the above, this article puts forward some suggestions, including improving local medical level, building up constraint mechanism, increasing the fund raising channel and bringing risk control system for fund overspending into force.