Research On The Feasibility And Implementation Path Of Provincial-level Coordination Of Basic Medical Insurance For Urban Employees In Guizhou Provinc

China’s employee medical insurance system has gone through the stages of public medical system,labor insurance medical system,employee medical insurance system,urban employee medical insurance system and social basic medical insurance system,etc.In the development of employee medical insurance,there are problems such as differences in the level of medical treatment,fairness,poor mutual assistance function and risk-bearing ability of medical insurance fund,and transfer and continuity of medical insurance relations,therefore,to a certain extent In 1998,the state stipulated that the basic medical insurance for employees should be coordinated by administrative regions(including prefectures,cities,states,and leagues)above the prefecture level,and also by counties(cities),and in 2009,the "Guidance on Further Strengthening the Management of Basic Medical Insurance Funds" was issued,which clearly stipulates that "localities should speed up the improvement of basic medical insurance coordination according to the actual local situation.In 2011,the Social Insurance Law of the People’s Republic of China stipulates that "the basic pension insurance fund shall be gradually implemented nationwide,and other social insurance funds shall be gradually implemented at the provincial level,and the specific time and steps shall be stipulated by the State Council regulations." The implementation of the provincial-level coordination of employees’ medical insurance is a requirement of the times.At present,the medical insurance for employees in Guizhou Province is coordinated at the city(state)level.With the in-depth reform of the medical insurance system,the conditions for the implementation of provincial-level coordination of employees’ medical insurance are becoming more and more mature.The paths of implementation are "transfer fund" model,"unified collection and support,hierarchical management" model,and "unified collection and support,vertical management" model.By analyzing the four influencing factors and comparing with other regions that have implemented provincial-level coordination,we can conclude that the scale of Guizhou Province’s participation is increasing year by year,and the conditions for mutual aid are ripe;the income and expenditure of the medical insurance fund are stable and the scale is high;the economic strength is getting stronger,and it is optimistic in terms of volume and growth rate;the medical system is gradually improving,and the medical service capacity is increasing year by year;and in some indicators,it is better equipped than some regions that have implemented provincial-level coordination.Therefore,Guizhou Province has the feasibility of implementing the provincial level of basic medical insurance for urban workers.In terms of the implementation path,due to the large differences in regional policies and unequal economic development in Guizhou Province,this paper suggests a gradual implementation path,i.e.,implementing the "transfer fund" model at the initial stage,and then implementing the "unified collection,unified expenditure,and graded management" model when conditions are ripe.The paper suggests a gradual implementation path,i.e.,implementing the "transfer fund" model at the initial stage,and then implementing the "centralized collection and support,graded management" model when conditions are ripe,and finally moving to the "centralized collection and support,vertical management" model.Finally,based on the literature and the policy,we discuss the key issues and solutions that need to be addressed in implementing provincial coordination.