Study On The Optimized Path Of Public-private Partnerships In Urban And Rural Residents' Serious Illness Insurance

In order to effectively reduce the burden of medical expenses for people with serious illness,alleviating the family of patients with serious illness from social problems caused by illness and poverty,China has fully implemented the insurance system for serious illness of urban and rural residents.The population of urban and rural residents covered by the national serious illness insurance expanded from 700 million in the early 2014 to 1.01 billion in 2016,and the reimbursement ratio of insured personnel increased directly by 10%-15%.The serious illness insurance system of urban and rural residents is the institutional arrangement to further improve the medical security system of urban and rural residents,which can effectively reduce the burden of high medical expenses caused by large diseases and improve the overall medical security level of urban and rural residents,which is a key measure to realize poverty alleviation.The government buy serious illness insurance from commercial insurance companies by public bidding and have intensive collaboration between the public and private sectors.This thesis analyzes the implementation of the insurance for serious illness of urban and rural residents at present,finding some problems in public-private partnerships.This thesis puts forward the countermeasures andsuggestions for improving public-private partnerships between urban and rural residents and it provides decision basis for optimizing the insurance system of serious illness.Taking City as an example,this thesis uses the theory of public products and the theory of public service outsourcing.By using the documentation research method,data analysis method and on-the-spot interview method,this thesis evaluates and analyzes the implementation scheme,financing mechanism and performance of the serious illness insurance for urban and rural residents.This thesis is divided into five chapters: The first chapter is an introduction,the purpose and significance of the topic are introduced,the present research situation and research methods are expounded.The second chapter describes and defines the key concepts of urban and rural residents,the serious illness insurance and public-private partnerships,at the same time,the theoretical basis of the thesis research is put forward.The third chapter carries on the practice analysis to City urban and rural residents' serious illness insurance under the public-private partnerships pattern.The fourth chapter points out the problems and causes in implementation.The fifth chapter draws lessons from advanced experience at abroad,making suggestions on how to optimize the path of public-private partnerships in urban and rural residents' serious illness insurance through practical analysis.ith the deepening of the PPP pattern between the government and commercial insurance companies in the operation of the serious illness insurance,the problems such as the shortage of professional personnel in the insurance service team,the existence of unreasonable medical expenses,the unsoundness of the comprehensive evaluation system,lack of flexibility in operational mechanisms such as financing and compensation are constantly presented.The main reason lies in the lack of planning and management of the training of insurance professionals for serious illness,lack of supervision and audit of operation process,Unsound full play to the professional advantages of commercial insurance companies and the imperfect operating system construction of serious illness insurance.To solve these problems in the path of public-private partnerships path,improving people's medical security level andwell-being,you need to start from four aspects:First and foremost,consummating the operation mechanism of the serious illness insurance,establishing a stable and reasonable financing mechanism,a moderate level of compensation mechanism and clear operational mechanism of public-private partnerships.Secondly,establishing the evaluation system and strengthening implementation capacity.The third,building a comprehensive regulatory system,including the undertaking and supervision of commercial insurance institutions,medical institutions and information publicity while speeding up the construction of information supervision platform.Last but not least,through the implementation of the unified commissioner management system to increase the number of personnel,practical upgrading of professional skills through training and other means so as to strengthen the construction of professional personnel of serious illness insurance for the sake of effectively protecting the sustained and healthy development of the serious illness insurance.