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改革中国医疗风险转移体系,必须发展具有一致性的、多层次的医疗保险可持续运作模式。目前,中国健康保险的补偿型计划仍存在困难,政策环境不够明朗,政府与商业保险公司的合作刚刚起步。发展商业医疗保险是国际潮流,各国(地区)在制定和实行医疗保障制度中,普遍采取降低居民直接支出的策略;商业参与程度不断加强;建立多层次保障体系。实践证明,医疗改革必须有效运用市场力量;医疗与保险相结合;市场运作,政府监督,提高经济效益。中国医疗保险体系改革的目标是要提高社会公平性,将健康保险提供给所有民众,达到广覆盖。中国医疗保险体系改革可以通过鼓励政商合作、理顺激励机制、提升行业标准三个重要策略来完成。
To reform China’s medical risk transfer system, we must develop a consistent and multi-level sustainable operation mode of medical insurance. At present, the compensation plan for China’s health insurance still faces difficulties, the policy environment is not clear enough, and the cooperation between the government and commercial insurance companies has just started. The development of commercial medical insurance is an international trend. Countries (regions) generally adopt the strategy of reducing the direct expenditures of residents in the formulation and implementation of the medical security system. The degree of commercial participation has been continuously strengthened. A multi-level guarantee system has been established. Practice has proved that medical reform must make effective use of market forces; combining medical treatment and insurance; market operation and government supervision so as to enhance economic efficiency. The goal of the reform of China’s medical insurance system is to improve social fairness, provide health insurance to all people and achieve broad coverage. The reform of China’s medical insurance system can be accomplished through encouraging three major strategies of business cooperation, rationalization of incentives and promotion of industry standards.