Study On The Individual Account’s Function Optimization Of Urban Employer Basic Medical Insurance

In the 1990 s, China introduced "individual account" into medical insurance reform. The individual account of medical insurance has played a certain role in controlling the excessive growth of medical costs, and relieving the pressure on the firm contribution. However, with the development of the medical saving funds, its operation has been in a predicament and its support function has been weakened.In general, the surplus of the medical saving funds is growing, and the proportion of medical saving funds is increasing. For the healthy people and most young men, their rising medical saving funds face the risk of devaluation, not only reducing the saving, but also probably inducing moral hazard of cash out. While for the patients and most old people, they can’t make both ends meet, the function of medical saving funds has become invalid.In the progress of deepening medical insurance system reform which focuses on personal health, people turn diseases healing to diseases preventing, the individual account’s inefficient operating results is more and more obvious. So how to develop the medical saving account in the process of current health insurance reform has become an important issue which must be faced and solved.This paper is divided into five parts.(1) In the first part, based on the literature review, the author summarizes the developing process and present situation of individual accounts, and finds that the original aim of individual account which was to emphasize the obligations related, enhance the ability for guarding against risks, control the rapidly rising of medical expenses and relieve the burdens of the country and enterprises.(2) The nextpart is the theoretical analysis with the concept of health protection, providing the theoretical framework and basis for optimization design of the medical individual account.(3) The third part is the description of medical individual account mode in the aspects of sources of funds and ways of operation. Based on the description of present situation analysis, the author admits the positive function of individual account and puts forwards the main reason of inefficiency is that it cannot satisfy the current demands of people now.(4) On the basis of analysis of international comparison and foreign experiences introduction, the author introduces the concept of prevention first into the reform of medical individual account, and emphasizes the coordinated development of social medical insurance and commercial medical insurance.(5) The last part includes the function optimization design of the medical individual account and suggestions in the respects of microeconomics of health and insurance, adding it to the management of health and supplementary medical insurance system. After summarizing the experiences of the experimental cities selected for individual account reform, the author suggests clarifying the responsibilities related, supporting deep reform of medical insurance system environment and innovating the using ways of individual account for the best optimization and for the guarantee of the sound development of the basic medical insurance system.