Study On The Interaction Mechanism Between Government Regulation And Market Competition In Medical Insurance System Reform In China

Medical institution has a significant role in the social security system in terms ofsafeguarding worker’s health, regulating social income redistribution and maintainingsocial stability. The history of this medical institution is more than a century.However, since its own complexity and the particularity, the development of themedical institution is not optimistic and has become a world-recognized problem.Since the founding of new China, our country has made great efforts on the medicalinsurance system planning. By the end of2014, China’s medical insurance coveragehas been over95%. Although we had great achievements in the exploration, problemssuch as high medical care expenses, low regulation efficiency and unbalancedmedicare refund still exist. In fact, some serious issues,"government failure" and"market failure" for example, emerged successively in the development process of themedicare system. Therefore, the comprehensive summing-up of past experience andpositive reaction to problems in the reform will contribute to improving the wholeinsurance system.In November2013, The Decision of the Central Committee of the CommunistParty of China on Some Major Issues Concerning Comprehensively Deepening theReform was adapted at the Third Plenary Session of the18th Central Committee ofthe Communist Party of China. The Decision has a theoretical highlights withprofound influences in terms of identifying the decisive role from the fundamental rollof the market in allocating resources, advocating the open competition and promotingthe public resources marketization. Currently, China is in the economic transitionperiod, issues in the medicare system such as how to open the market competition andcenter the decisive role of the market in allocating resources required to be solved bycombing approaches in other country and the fundamental realities in China. Proceed from the reality to eliminate monopoly and introduce competition in medicalinsurance market. This paper, from the perspective of market competition andregulation, analyzes the institution structure the medicare system in the United States,Britain and Germany respectively, and absorbs the experience of their reform.Reviewing and summarizing the development and reform experience in China. Inaddition, this paper takes an successful example, Zhanjiang with a effective medicarereform, to explore how to balance competition and regulation in the medical insurancesystem development process. Zhanjiang achieve its success by introducingcommercial medicare, which effectively improves the service management and policyefficiency. The medical service resources also benefits from the competition inmedicare market in terms of allocating, management and conservation.The overall orientation of the medicare reform in China is to enhance thegovernmental regulation and complete the market mechanism. Only in this way canthe competition and the regulation form a virtuous cycle and contribute to theimprovement of the medicare system.