An Aim-based Study On China's Reform Of Medical Insurance Payment

As one of the most important areas in the reform of the health-care system,the reform of medical insurance payment has attracted attention from the government and the public alike.In June 2017,the General Office of the State Council promulgated Guidelines on the Further Reform of Basic Health-care Payment,ushering in another round of reforms after the 2009 medical reform.A reform is sure to has its aims or desired effects.The aims of the reform of medical insurance payment are three-fold.First,medial treatment should be regulated and medical expenses be controlled.Second,medical resources should be properly distributed and used.And third,the rights of the insured should be protected and the people should enjoy the benefits of the reform.The paper first introduces the unreasonable rise of medical expenses and shows that the rise is largely down to the prospective payment system.And to control the trend,medical insurance payment has to be reformed.And in the following part,the thesis tries to analyze medical insurance payment with Principal-agent Theory and finds that prospective payment is the best way to avoid agency risks.It goes on to summarize the lessons from reforms of medical insurance payments in classic domestic cities and developed countries,and finds that the transformation from post payment to prospective payment,from single payment to multiple payment is irreversible and necessary.In the last portion,in response to the current situation and problems in the current system,the dissertation puts up some proposals.Firstly,the reform should focus on the transformation from post payment to prospective payment.Secondly,the reform should be aim-orientated--to control unreasonable rise of medical expenses,to properly distribute medical resources and to protect the rights of the insured.Thirdly,what is included in the reform should be clear: the reform of categorizing payments should be carried out to adopt multiple payments;on the basis of prospective payment,great importance should be attached to payment according to the type of disease,and medical insurers should go from being a passivepayer to an active manager.And fourthly,relevant reforms should be carried out.Budgets for medical insurance should be properly managed,the system of supervising and evaluating medical expenses and quality should be established,the system of negotiation and risk-taking between medical insurers and medical service providers should be improved,and the reform of public hospitals should be sped up so as to eradicate the practice that hospitals can maintain their daily operations only by selling medicines.