| With the growth of disposable income of residents,the social consumpt io n structure has begun to change towards health,safety and enjoyment of development,and the people have a higher level of pursuit of quality of life.However,at the current stage,many factors such as population aging,chronic diseases,and environmental degradation have affected people’s pursuit of healthy and highquality life.In 2016,the "Healthy China 2030 Development Plan" promulgated by the Party Central Committee and the State Council made a comprehensive guiding plan for the development of health undertakings,emphasizing prevention-oriented,and adopting the concept of treating Chinese medicine as a guiding principle to build a health system with Chinese characteristics;Emphasize the role of commercia l health insurance,encourage the development of new types of insurance,and enhance the ability of insurance health management services.The 19 th National Congress proposed to promote the construction of “healthy China” to the national strategic level,and repeatedly mentioned commercial medical insurance in the grand blueprint of “healthy China”,emphasizing the use of market mechanisms to provide people with commercial medical insurance.Multi-level,high level of health protection.In 2018,China’s Engel coefficient dropped to 28.4%.The consumpt io n level has successfully entered the ranks of developed countries.Although the consumption structure has improved,the health management goal of healthy China construction still has a long way to go.In recent years,China’s general commercial medical insurance has developed rapidly.As an important part of the social medical security system,commercia l medical insurance plays an important role in meeting the diversified and multi-le ve l medical health needs of the people in the new era,but medical control fees and people’s health risks have not been effectively controlled.In 2018,the global medical consumption growth rate was 8.4%,which was 5.3 percentage points higher than the 3.1% inflation rate of the year.This reflected both the rapid increase in medical costs and the higher requirements for commercial medical insurance control fees.The overall development of general commercial medical insurance in China is limited in scale.There is no systematic commercial medical insurance manage me nt system and lack of corresponding health management service capabilities.Therefore,adapting to the new needs of the market,promoting the transformation of general commercial medical insurance to health manageme nt,and promoting the breakthrough of commercial medical insurance to achieve "quality" is the main purpose of this paper,and has important theoretical and practical significance.On this basis,this thesis is guided by the theories of economics,insurance and medical hygiene.From the development status and function of commercial medical insurance in China,this paper deeply studies and proposes the transformation of China’s general commercial medical insurance to health management.Necessity and transformational innovation path,trying to change the single cost compensatio n function that ordinary commercial medical insurance currently has,so that commercial medical insurance has the health management function to meet the needs of different people,and truly protects people’s health.The research of the thesis is divided into six chapters.The main research contents and main points of each chapter are as follows:The first chapter is an introduction.This chapter first analyzes the purpose and significance of the transformation of China’s commercial medical insurance to health management from the perspectives of the state,society,insurance companies and consumers.Secondly,by comparing the research status and development practice of literature research at home and abroad,the problem of research is found.It is also the premise of the research in this paper.Finally,the research methods and innovations used in this paper are summarized.The second chapter is the evolution and chal enges of commercial medical insurance in China.The author integrates commercial medical insurance into the social medical security system.By comparing and analyzing the similarities and differences between commercial medical insurance and social basic medical insurance,and combining the themes of this article,the development stage of commercial medical insurance is innovatively divided-increasing comprehens ive health.The management stage;further summarizes the development stage of the general commercial medical insurance and summarizes the main functions of the general commercial medical insurance;the final analysis shows that China’s ordinary commercial medical insurance has serious problems in the product supply end,the interest subject and the operational mechanism.The commercial health insurance health management function is played.The third chapter is the necessity of transforming commercial medical insurance into health management in China.This section first analyzes the definit io n of health management from different disciplines,and combines the theme of this paper to define the concept of commercial health insurance innovation in the process of transformation;further from social basic medical insurance and commercia l medical insurance.From the perspective of social division of labor,economic consumption structure,chronic disease health management,social population aging and medical health big data technology,the necessity of transforming commercia l medical insurance into health management is analyzed.The fourth chapter is the effect and problem of the integration of commercia l medical insurance and health management at home and abroad,which is one of the focuses of this paper.This section first divides commercial medical insurance into consumer groups according to the income level of consumer groups,and fina lly divides ordinary commercial medical insurance into high,medium and low insurance.Case analysis selects the most representative insurance companies or insurance products at home and abroad,the high-end medical insurance case adopts the British Bupa Group,the mid-end medical insurance adopts Ping An Health Insurance Company to provide “Ping An E Health Insurance”,and the low-end medical insurance adopts “ Micro-medical insurance as a case to analyze their respective characteristics and advantages;through comparative analysis,it is found that there are four major problems in the process of commercial medical insurance transformation at home and abroad in the process of transition to health manage me nt,which paves the way for the next chapter of innovation.The fifth chapter is the innovative path of commercial medical insurance to health management in China.Based on the analysis of the integration of medical insurance and health management in the previous chapter,this paper proposes an innovative development path suitable for Chinese characteristics,taking into account the Chinese characteristics and the innovative development path taking into account the direction of the times.One is a chronic disease health management path based on the whole process life cycle of characteristic commercial medical insurance based on traditional Chinese medicine treatment.From the collection of front-end health information to the back-end rehabilitation treatment,the combination of Chinese and Western medicine is used to learn from each other.The masses provide more comprehensive commercial medical insurance health management services;the other is to adapt to the development of modern science and technology,take the road of technology-enabled insurance,and aim at the current hottest modern technology,combined with the design ideas of other insurance types,using modern technology to create A new path for commercia l health insurance and health management services;use cases to identify feasibility of certain pathways that have been explored.The sixth chapter puts forward the supporting policy recommendations on how to take two innovative paths.This part puts forward some supporting suggest io ns from the perspectives of products,companies and industries,and promotes the development of commercial medical insurance to the “customized and individualized” health management.The main research features and innovations of the thesis are:First,the topic is novel.Based on the higher demand of the people of the new era for a better life,this paper demonstrates the necessity and realization path of the transformation of the function of commercial medical insurance from the traditio na l economic compensation to the health management.The topic is forward-looking and novel.The topic of the article comes from the "Healthy China 2030 Development Plan",which only mentions commercial medical insurance in the concept of building a healthy China,but does not propose a specific path for commercial medical insurance to transform into health management.The academic community’s exploration of the integration of insurance and health manage me nt universities is relatively isolated and fails to form a systematic theory.The second is multidisciplinary integration and content innovation.Integrating insurance,Chinese medicine,health and hygiene into a multidisciplinary approach,and exploring the specific implementation path of commercial medical insurance and health management.This paper combines the use of modern technology in the text and draws on the idea of “new mileage insurance” design for new auto insurance products.It has carried out insurance innovation and path innovation for the transformation and integration of commercial medical insurance to health management.These explorations are both difficult and novel.The shortcomings of this paper:First,there are many interdisciplinary content,comprehensive,and medical professional knowledge is slightly non-professional.Second,there is less systematic data and lack of corresponding empirica l research. |
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