Study On The Third-Party Undertaking Mode Of Urban And Rural Medical Aid In Taiyuan City

As a part of the social assistance system,medical assistance system is also the last line of defense in the multi-level medical security system,playing the function of backstop guarantee.Taiyuan innovated the medical aid undertaking mode and established the government-led and third-party commercial insurance company undertaking mode,which solved the "three nots" problem of government departments having no handling agencies,no professionals and no working funds.The innovative development of this mode plays an important role in perfecting the multi-level medical security system,improving people’s livelihood and building a new pattern of healthy development.Based on the reality and guided by the public service outsourcing theory,risk management theory,social equity theory and Maslow’s hierarchy of needs theory,this paper chooses Taiyuan’s urban and rural medical assistance model as the case,and conducts practical investigation and effect analysis of this model through questionnaire survey and field interviews with the urban and rural medical assistance personnel and insured groups in Taiyuan.Understood and sorted out the contents of the urban and rural medical assistance system in Taiyuan,settlement process and the operation of the third party commercial insurance company undertaking the project.On this basis,by referring to the foreign medical assistance models of Britain and Germany,the domestic advanced experience in the new medical assistance models of Shanghai Changning District,Chengdu Wenjiang District and Taizhou Jingjiang,combined with the author’s own practical work experience,This paper puts forward some suggestions to optimize the rescue system and the rescue mode.Through practical investigation and effect analysis,it is found that this model has achieved certain results,such as continuous standardization of salvage procedures,unified determination of salvage standards,protection of salvage rights and interests,and solving the "three nots" problem of government departments.However,there are also problems such as low degree of cooperation and sharing,inadequate role played by commercial insurance companies,imperfect rescue information system,insufficient specialization of rescue service personnel,need to strengthen publicity,and low awareness rate of policies.From the perspective of commercial insurance companies,this paper puts forward suggestions on improving the mode from the aspects of information,science and technology,personnel,and service.First,cooperation and sharing should play the role of commercial insurance companies.The second is to enable science and technology,optimize the medical assistance information system;Third,professional operation to improve the professionalism of rescue service personnel;Fourth,a variety of propaganda,improve the policy awareness of the recipients;Fifth,innovate services and create a new integration model of "grid + smart services";Sixth,self-evaluation of service to improve the service level of commercial insurance companies.Through the research,we hope to give full play to the professionalism of commercial insurance companies,improve their competitiveness,establish a long-term mechanism of cooperation with the government,and provide useful reference for other insurance companies to participate in the government entrusted business and improve the multi-level medical security system.