Research On The Payment Capability Of Urban And Rural Residents’ Serious Illness Insurance Fund

In recent years,with the changes in the living environment and the aging of the population,the incidence of major diseases has increased year by year,medical costs have increased year by year,and the financial burden on patients has continued to increase."The phenomenon.In order to reduce the economic burden of sick residents,China proposed to establish a major illness insurance system for urban and rural residents in August 2012,and continued to improve the system in the following 8 years to continuously raise funding standards and compensation rates.The establishment of a serious illness insurance system for urban and rural residents has effectively reduced the economic burden of sick residents and provided a strong guarantee for their lives.However,the sustainable development of urban and rural residents’ critical illness insurance is closely related to their fund’s ability to pay.In other words,the sufficient payment capacity of the fund is the cornerstone of stable and long-term development of critical illness insurance.Therefore,this article starts with critical illness insurance system,studies the income and expenditure of the fund,and forecasts its balance in the next 5 years to find out the possible payment risks of the urban and rural residents’ major illness insurance fund in China.Provide policy recommendations for the critical illness insurance and fund operation.Specifically,first of all,this article defines the basic concepts of major diseases and major illness insurance for urban and rural residents in China.Secondly,after reviewing the relevant literature on critical illness insurance,it is found that the current research on critical illness insurance mainly focuses on the operating mode and mechanism of critical illness insurance system,financing mechanism of critical illness insurance,compensation model for critical illness insurance,the level of protection of critical illness insurance,and critical illness insurance The effect of the mechanism of action,the sustainability of critical illness insurance,etc.Third,a comprehensive introduction to the critical illness insurance system for urban and rural residents in China,including funding levels,levels of protection,the ratio of profit and loss sharing,and supervision models,and pointed out the problems and reasons for the emergence of the critical illness insurance system for urban and rural residents in China.Fourth,according to the current two funding models(proportionate funding and fixed funding),different critical illness insurance fund surplus models are constructed,and the relevant data in the China Statistical Yearbook,China Health and Family Planning Statistical Yearbook are used to calculate various regions in China.Fund balance of payments in the next 5 years.By forecasting the income and expenditure of the major illness insurance funds,this article finds that some areas will face the problem of insufficient capacity of urban and rural residents’ major illness insurance funds within the next 5 years,and this problem will affect the operation of the urban and rural residents’ major illness insurance system.Then this article takes three of them as examples to explain the reasons for insufficient payment capacity of the funds.Fifth,the sensitivity analysis of the factors(funding ratio,compensation ratio)that affect the income and expenditure of the fund,the analysis results show that the funding standards and compensation ratio of critical illness insurance funds should be improved at the same time,so that urban and rural residents are seriously ill While maintaining a stable operation,insurance funds play their protection functions.Finally,based on the conclusions drawn above,this article puts forward practical policy recommendations from the aspects of effectively solving the protection of low-income vulnerable groups,accurately measuring medical expenses,and implementing a flexible incentive settlement system to help urban and rural residents with serious illness insurance.The ability of the fund to pay to ensure the sustainable development of China’s urban and rural residents’ critical illness insurance.