Research On The Development Countermeasures Of The Major Illness Insurance System For Urban And Rural Residents

The Catastrophic Medical Insurance of urban and rural residents(Hereinafter referred to as " The Catastrophic Medical Insurance ")is an important system to benefit people's livelihood,to a large extent can effectively prevent urban and rural residents "due to disease caused by poverty","due to illness back to poverty." However,The Catastrophic Medical Insurance as a new policy,in the early stages of its development,inevitably there are some problems,the urgent need to attract the attention of the community and conduct in-depth study.Based on the theory of social justice,the new public management theory and the PPP model theory,this paper analyzes The Catastrophic Medical Insurance of urban and rural residents from the perspective of fairness and justice,the relationship between government and market.How to ensure the fair treatment of urban and rural residents,how should the government and the market cooperate In-depth discussion.In this paper,Guizhou Province,southwest of Guizhou Province as a sample study,through the Qiannan Province to carry out the actual research,and with the Qianxinan Health and Family Planning Department,Human Resources and Social Security Department,China Life Insurance Co.,Ltd.Qiannan Branch and other related staff And then use the qualitative analysis and quantitative analysis to analyze the current situation of serious illness insurance in Qianxinan province,and use the statistical correlation measurement method to forecast the future payment ability of Qianxinan state funds.Risk assessment of the ability to pay for the future serious illness fund in Qianxinan province.Through the analysis of the population composition of Qianxinan and the income and expenditure of urban and rural residents,the source and operation of serious illness insurance,the protection of serious illness insurance and the situation of the situation of serious illness insurance,it is found that the development of Qianxinan serious illness insurance There are some problems and systematically sorted out,such as urban and rural residents income difference is large,uniform treatment,resulting in unfair;serious illness funding level is low,mutual aid play a lack of;medical insurance management capacity building,medical institutions exist moral Risk,regulate regulatory difficulties and commercial insurance companies to take advantage of the lack of advantages.In view of these problems,the author puts forward to establish the protection mechanism of the serious illness corresponding to the income level,improve the fund coordination level,strengthen the risk confrontation ability,continue to improve the system docking to strengthen the department linkage,further strengthen the medical management team construction,clear the different departments of the division of responsibilities,The establishment of the entire process of medical risk control mechanism,and effectively prevent moral hazard and clear the responsibility of both sides and give full play to the advantages of commercial insurance companies and other recommendations,and ultimately ensure the quality of services to enhance the level of protection of insured patients.It aims to provide some feasible countermeasures for the improvement of The Catastrophic Medical Insurance system and the comprehensive implementation of The Catastrophic Medical Insurance service.