Causes Analysis And Countermeasures Of Social Medical Insurance Fraud

In the past two years,with the outbreak and development of COVID-19,people have gradually realized the importance of health.In the current China’s social security system,social medical insurance is one of important part in 2018 movie Dying to Survive,to promote the social medical insurance system reform,the same year include 17 kinds of anticancer drugs in medical insurance reimbursement directory,and the implementation of import anti-cancer drugs zero tariff policy.At the end of 2021,it was also the "soul bargaining" video of negotiators from the National Medical Insurance Administration.It shows that the stable operation of social medical insurance is related to the health and social stability of Chinese people.Unfortunately,due to the seriousness of the medical insurance fraud problem,the payment of the medical insurance fund is facing serious risks,some enrollees borrow other people’s medical insurance cards to see a doctor,prescribe excessive drugs for resale and so on.Some designated medical institutions and their medical staff over-diagnose and treat,over-prescribe drugs,live in one bed with more than one patient,and declare diseases not covered by medical insurance as diseases covered by medical insurance,etc.The existence of these problems are eroding the security of medical insurance fund and seriously affecting the steady progress of social medical insurance in China.Therefore,it is necessary to conduct in-depth research on these problems.This paper first expounds the research status quo of domestic and foreign scholars and the research ideas of their papers,combs and analyzes the development process of social medical insurance in China,expounds the current situation of social medical insurance fraud,and classifies and summarizes the causes,types and anti-fraud strategies of current social medical insurance fraud.Based on game theory,using model analysis,case analysis and other research methods,through the construction of tripartite game model to analyze the social medical insurance fraud causes and put forward the corresponding countermeasures.Hope that through this analysis,to solve the current increasingly fierce social medical insurance fraud to contribute my own strength.