Study On The Operation Mechanism Of Xuzhou Critical Illness Insurance

As an extension and expansion of the basic medical insurance system,the purpose of Critical Illness Insurance is to prevent urban and rural residents to be poor by illness.Under the guidance of Public-Private-Partnership theory,welfare pluralism theory,and public product theory,it carries out public-private partnerships,introduces market competition mechanism in the implementation of the process of Critical Illness Insurance.Commercial insurance institutions is to improve its handling efficiency and quality.Since 2012,the National Development and Reform Commission and other six ministries releasing the views of the implementation of Critical Illness Insurance,its national pilot and promotion work spread out.Subsequent central government and local governments have also introduced measures to promote their further promotion and implementation.Around the implementation of the Critical Illness Insurance adjust measures to local conditions,and make a good achievement.Although there is no pattern can be copied,but they can still learn from each other.By Investigating the present situation of Critical Illness Insurance in Xuzhou,we find the Operation Mechanism of Critical Illness Insurance have some problems that financing channel single and low level of co-ordination,treatment of urban and rural different and low levels of pay,tender transparency not enough and funds operating loss,public and private cooperation limited and commercial insurance institutions lack of participation and commercial insurance institutions frustrated,lack of information disclosure and public supervision.Because the Critical Illness Insurance over-reliance on basic medical insurance,its institutional basis and social economic development level is different,business insurance institutions lack the experience of serious illness insurance operation,service awareness and policy advocacy.To solve these problems,we should propose actuarial financing level and broaden the financing channels,strengthen cooperation between parties and enhance service consciousness,establish and improve professional management platform,underwriting management system,professional medical risk control mechanism and customer service system,improve the information disclosure and multi-party participation.