Study On The Optimization Of Urban Employees’ Health Insurance System From The Perspective Of De-commoditization

Medical security is a necessary means to protect citizens’ right to health.Especially after the Healthy China strategy was put forward,the role of medical security is particularly prominent.As an important part of China’s medical security system,the medical insurance system for urban workers has built up a medical security network covering urban workers after more than 70 years of continuous reform and improvement.However,there is still a long way to go to solve the problem of "difficult and expensive medical treatment",especially how to reduce personal medical expenditure.To the extent that the promotion system decommercializes the insured,further promotion is needed.The medical insurance system for urban workers is an income redistribution system guaranteed and implemented by the national compulsory force.The policy content is the basis of the system operation,and the policy tool is the basic tool for the system reform and development.In this paper,the medical insurance system of urban workers and the relevant literature of policy instruments were reviewed,and found that the existing research on the use of policy instrument theory is relatively limited,lack of systematic research on policy instrument theory.Considering the importance of the "three medical linkage" in the medical and health system,this paper defines the urban employee medical insurance system,organically combines medical institutions and medical drugs with the medical insurance system,in order to discuss the urban employee medical insurance system in a more comprehensive and systematic way.Through a comprehensive and detailed search of Chinese urban employee medical insurance system policy texts from "Peking University Magic Weapon" and the official website of the government,the most relevant 139 policy documents are sorted out.This paper analyzes the government policy text by using literature research method,content analysis method and other research methods,and classifies the policy into compulsory,free and mixed tools.The actual effect of the policy tools is examined by means of commercialization,and the reform effect of the urban employee medical insurance system is re-examined by taking it as the foothold of the system optimization.After coding the policy text and combining the de-merchandising theory and the theory of policy tools,it finds that the reason for the insufficient de-merchandising degree of insured in urban staff medical insurance system in our country lies in the improper combination of policy tools.On the one hand,the compulsory tools don’t reform the system with the core factor of the de-merchandising of insured--personal expenditure.On the other hand,In the market economy environment,forced tools miss the target,resulting in the use effect imbalance between voluntary tools and forced tools.On this basis,by referring to the experience of employee medical insurance system in western countries and combining with the reality of China,this paper puts forward: Compulsory instruments are still the main focus of the optimization of the urban employee medical insurance system.Therefore,compulsory policy instruments should be consolidated,strengthened and reasonably matched from three aspects: medical institutions,medical drugs and medical insurance system,so as to finally realize the de-commercialization of the medical insurance system and better protect the rights and interests of the insured.