Research On The System Of Advance Payment Of The Basic Medical Insurance Fund

Social insurance law of the People's Republic of China has come into operation in July 1,2011 and at the same time the Advance payment of social insurance fund interim measures has also come into operation.It signs the system of the advance payment of social insurance funds has been established.The system includes the system of the basic medical insurance fund advance payment and the system of the employment injury insurance advance payment.The two systems reflect that the Law protect the citizens' social insurance interests fully from different aspects.As one of the main items of social insurance in China,its benefit main body involves a wider range and it plays the role of escort for national health body.At present we have established a comprehensive coverage of the basic medical insurance system basically.But there are still some problems in the practice of the basic medical insurance system.And it often leads to the special circumstances of the insured can not get timely and effective relief to get into the plight of life.By this token,The establishment and implementation of the advance payment system of social insurance fund has the function of supplement and transition to the current social insurance system in our country and it has more realistic significance.This paper is based on the basic theory of the basic medical insurance fund advance payment system,combined with the relevant provisions of the existing legislation to explore the specific deficiencies in the design of this system.And put forward some perfect suggestions from legislation,to achieve the goal of promoting the advance payment system of the basic medical insurance fund of our country.This paper is divided into three parts:The first part describes the general theory of the basic medical insurance fund advance payment system.Firstly,this paper defines the concept of the basic medical insurance fund from the perspective of the advance payment process.Based on the advance payment of the basic medical insurance funds,insurance agencies have the right of subrogation and medical expenses in accordance with the law on the part of the advance payment of recourse to the actual responsibility.Secondly,the paper analyzes the theoretical basis of this system,for example the theory of social insurance right,the theory of state responsibility and the theory of consideration balance,to conclude that thepayment system of basic medical insurance fund is a kind of system design in the field of social insurance law and it is the basic medical insurance fund for citizens to pay the basic medical insurance premium.Finally,the paper furthers clarifying the properties comparing with the civil law guarantee system,law of insurance subrogation system and the industrial injury insurance fund advance payment system.The second part introduces the current legislative provisions of the basic medical insurance fund advance payment system and analyzes the problems of it.In the current legislative provisions,Firstly,summarizes the national legislation on the basic medical insurance fund advance payment application criteria,the provisions of legal liability insurance agencies and related subjects of subrogation.Secondly,summarizes the innovation of local legislation on the basis of the national legislation,for example,the insured person to apply for payment in advance of the node,medical expenses paid in advance and so on.Thirdly,puts forward the problems of system design from the aspects of the system.In application link,the basic medical insurance funds to apply for the payment of the relevant legislative operability is not strong,for example whether or not to meet the conditions for the payment of the first payment criteria and application time is not clear;In the payment link,the upper limit of the amount of advance payment is not prescribed;In the recovery process,The recovery mechanism of health insurance agencies is not perfect,including,the main responsibility of infringement is not established to confirm third people;legal responsibility of each body is not strong;Finally,points out that the connection between the basic medical insurance fund and the industrial injury insurance fund is still not clear.The third part third part,puts forward some suggestions on how to improve the payment system of the basic medical insurance fund.For example,improve the basic medical insurance fund to pay the advance payment of the relevant legislation operability;clear the amount of the advance payment;improve the basic medical insurance fund advance payment mechanism of compensation system and regulate connection between basic medical insurance fund and employment injury insurance fund.