The Exploration Of Optimizing The Critical Illness Insurance System For Urban And Rural Residents In The View Of Government Purchase Of Public Services

Objective:Based on the relevant literature,this paper systematically analyzes the definition,motive,content,value and problems of the government purchase behavior in the critical illness insurance system for urban and rural residents.It clearly defines the respective goals and responsibilities of the government and commercial insurance institutions to explore the theoretical basis and analysis framework of the critical illness insurance service for government.And it analyzes the practice of government purchasing the critical illness insurance service in the sample area,summarizes the effect and problems,and makes the optimization of the purchase and purchase pattern of the critical illness insurance service for the purpose of providing reference for other areas.Methods:(1)Literature research:the domestic and foreign research results,the relevant theoretical works,policies and regulations on the government purchase of public service and critical illness insurance system were collected to understand and grasp the status and direction of research in the related fields,and establish theoretical basis.(2)Field research:The policies and status of the critical illness insurance system for urban and rural residents in Three samples(Wuxi,Yangzhou and Yancheng)in Jiangsu as well as the different attitudes of governments and commercial insurance institutions were investigated by questionnaire survey and semi-structured interview.(3)Empirical analysis:It was a descriptive analysis of the basic operation,effectiveness and problems of the critical illness insurance system for urban and rural residents in 3 survey areas.Conclusions:(1)Theoretical basis:The current critical illness insurance system is a manifestation of the government purchase of public services.Government and commercial insurance institutions formed a contractual relationship.Government departments who act as the principal subject or buying party take the responsibilities of decision-making,financing,contract management and supervision.Commercial insurance institutions who act as accepting or the trustee undertake the responsibilities of business operation and service construction.The incentives of government including the pressure from finance and operation of fund,the modernization of national governance systems and governance capacity,improvement of the quality and efficiency of insurance services,and the development of commercial insurance institutions.(2)Empirical analysis:The targets of insurance system are system security and management innovation.However,the most prominent achievements are improvement of security benefits and make up for handling resources.There is still a certain distance from the targets to alleviate the burden of disease,improve the quality and efficiency of illness insurance and develop commercial insurance.Under the current mode,commercial insurance institutions only offer human resources,deal with daily affairs,not participate in policy design and risk sharing,government purchase content and cooperation space between the two sides are both very limited.There are still lots of problems.The understanding and legal regulation is not perfect.The market competition is not sufficient.The insurance institutions did not reflect the advantages of professional,standardized and institutionalized management and information construction should be strengthened.Finally,it is the lack of effective internal supervision and other issues.Summary and recommendations:Purchasing critical illness insurance services from insurance companies caters to the actual demands and worth promoting.However,the suitability and sustainability of the current model are open to question.In order to achieve the goal of the policy and optimize the current system,the actions should be taken from the following aspects:The first is the innovation of the concept of modem governance and public service supply.Secondly,a correct cooperation mode should be selected and optimized.The third is to improve the rule of law and market competition environment.For the stakeholders,especially the insurance companies should strengthen the abilities of risk management,actuarial,IT and other professional ability construction.Last but not least,the mechanism of market access and exit,supervision,evaluation mechanism and long-term stability should be established and improved.