Research On The Cooperative Model Of Commercial Insurance Supplementing Urban And Rural Residents' Serious Illness Insuranc

The issue of major disease security has been deeply concerned by the state,society and the people.In recent years,the government is committed to further establishing and improving the serious illness medical security system from multiple dimensions and forms,supporting commercial insurance institutions to participate in the development and construction of supplementary serious illness insurance,and has made a comprehensive and profound practical exploration on how to establish and improve the serious illness insurance system.According to the long-term development process of commercial insurance supplementary serious illness insurance,its cooperation mode can be summarized into three types: fund management type represented by "Jiangyin mode",insurance contract type represented by "Zhanjiang mode" and co insurance joint office type represented by "Pinggu mode".This paper analyzes the participants,operation mechanism and mode characteristics of each cooperation mode,compares the implementation effects of the three modes in the four dimensions of administrative efficiency,management cost,risk sharing and incentive effect,and finds that different types of cooperation modes have different effect advantages in different dimensions: the insurance contract type is more effective in controlling cost management and strengthening incentive,The joint insurance type has the advantages of administrative efficiency and risk sharing.Based on the overall research and analysis of various modes,this paper believes that the three cooperation modes currently have common limitations: first,commercial insurance companies lack the operation guarantee of "breakeven and low profit" in the process of undertaking serious illness insurance business;second,the expenditure of various expenses of the cooperation mode is still high;third,there are obstacles in information sharing among insurance companies,government medical insurance departments and medical service institutions,Fourth,the performance evaluation system of cooperative implementation of serious illness insurance is not perfect.Further research from the above limitations shows that the problems stem from the following: the imperfect risk sharing mechanism of all parties in the process of cooperation leads to the lack of guarantee of "breakeven and low profit" in operation,the lack of effective supervision mechanism leads to the high cost expenditure,and the lack of dynamic basis for cooperation between government and enterprises leads to insufficient data docking,which hinders information sharing,The performance evaluation is vague due to the imperfect evaluation system of cooperative implementation.In view of the problems and reasons found,this paper attempts to put forward the following countermeasures in order to improve the cooperation mode of commercial insurance to supplement serious illness insurance for urban and rural residents,specifically by improving the fund loss risk sharing mechanism to solve the problem of fund loss risk,and strengthening the management of serious illness medical insurance expenses to deal with the problem of high medical insurance expenses Explore the establishment of an effective evaluation system of "social business cooperation" to solve the problems of imperfect evaluation system and improve the information sharing platform,so as to get rid of the difficulties of data docking between different subjects.