The Research On China Basic Medical Security System Development

The basic urban employee medical insurance(UEBMI), the basic medical insurance for urban residents(URBMI) and the new rural cooperative medical system(NCMS) had almost covered all urban and rural residents. The universal health care system moved into a new stage. The State Council Reform and Functional Transformation Program issued in 2013, clearly stated that the relationships of responsibilities of those departments should be coordinated and the duties of UEBMI、URBMI and NCMS should be unified and put to one department. Currently, it is necessary to analyze the problems in the development of the basic medical insurance system and put forward related suggestions accordingly.Chapter 1 introduces the concepts of basic medical insurance system and describes the research progress both in China and abroad. The main object of this dissertation is the system composed by UEBMI, URBMI and NCMC. The domestic research on the basic medical insurance system mainly focuses on the establishment of all the people’s health insurance targets; the ways to achieve the integration of urban and rural health protection and commercial health insurance business’ s position in the medical insurance system, etc. While the foreign research mainly focuses on the following two categories: firstly, in the developed countries which has already established its medical insurance system for a long time, their researches are based on a higher level of medical insurance which has generally provided, through the reconfiguration of health resources to improve the medical service efficiency; secondly, in the developing countries including China which have established its medical insurance system not for long, the researches mainly focus on how to use limit resources to cover the health care of most people.Chapter 2 analyzes the current status of the basic medical insurance system in China. On the implementation of the basic medical insurance system policy, it summarized the target population of the three basic medical insurance systems, and their management system, coverage level, financing as well as payment way. On the operating of basic medical insurance system, a comparative analysis and secondary data analysis are used. By using the number of insured people, the Fund’s income, expenditure and balances and other related indicators, the development of three basic medical insurance systems during 2007-2013 is analyzed.Chapter 3 raises the problems in the development of a basic medical insurance system, such as the integration of three basic medical insurance, the off-site medical reimbursement difficulties, the medical insurance fund balance of payments, the pay model is not suitable, double insured, and the link-up of the basic medical insurance system.Chapter 4 introduced the development of the international medical insurance system. Firstly, from the aspect of medical insurance management system, use secondary statistical data analysis to sort the medical insurance management modes of 171 countries/ regions, it’s found that every country or region should select the suitable medical insurance management system according to its own situation. Secondly, the world health care reformation experience and fund raising mode are introduced. And the mainstream international health care fund raising methods are tax, social insurance and community health financing. Thirdly, the experiences in international medical insurance payment mechanism and reformation are described.Chapter 5 put forward six proposals for the development of the basic medical insurance system. The first proposal is to integrate the basic medical insurance management functions. Second, to take some measures to resolve the off-site medical problem. The third is to maintain the balance of medical insurance pool fund. Forth, continuing to promote the medical insurance payment reformation. Fifth, to strengthen the network development. The last one is strengthening medical insurance supervision...