Research On The Development Strategy Of Critical Illness Insurance For Urban-rural Residents In Tianjin

Critical illness insurance for urban and rural residents serves as a powerful supplement and an extension of China's urban and rural residents basic medical insurance system.It can effectively reduce the burden of medical expenses for urban-rural residents and alleviate the poverty caused by illness.Critical illness insurance has been transitioned from the pilot phase to the national implementation phase.Therefore,a study on critical illness insurance is of important practical significance.In this thesis,Tianjin is taken as an example to analyze the design and operation status of the critical illness insurance system,find problems existing in the operation of critical illness insurance and draw on experience in the operation to provide relevant suggestions for the healthy development of critical illness insurance.This thesis first elaborates the significance and research methods of the critical illness insurance research,adopts the method of literature review to expound its development process,mainly inclusive of the introduction of foreign experience and related researches conducted by domestic scholars.Second,the data of the insurance company's four-year indemnity used to cover critical illness insurance are collected,and examples are raised to analyze its implementation process,the number of people under coverage for critical illness insurance,the number of people reimbursed,the amount of compensation,the source of funds,the funding standard,and the predicted future fund payment ability,etc.Then,problems in the critical illness insurance for urban-rural residents are analyzed,such as the unreasonable rise in medical expenses,lack of coordinating mechanisms for fund collection,small amount of funds raised and a single funding mechanism.A comparative method was adopted to conduct a horizontal analysis of implementation of critical illness insurance for urban-rural residents in different provinces and cities in China.It lists the differences in per capita disposable income in Qinghai,Beijing,and Tianjin,their respective funding standards,reimbursement ratios,and guarantee effects.The final conclusions and recommendations are as follows:Raise the funding standards for critical illness insurance and change the payment method.Reinforce the monitoring of diagnosis and strengthen the verification of payment after illness.Adjust the loss policy and increase financial supply.