A Primary Exploration Of Chinese Characteristic Managed Care

In the new millennium, the medical security of all the countries are facing the kinds of challenges that come from economical globalization, aged population, renewal of health concept and new types of diseases.The author classifies all the existing system of medical insurance by the principle of type and attachment into three categories, which are paid by the government, paid by the third party and paid by the individual's savings. This classification will play as a helpful instrument to explore the game relationship among the doctors, patient and insurers, which in turn identify how this relationship changed accordingly under the different systems of medical security as well as the different stage of the same one.Managed care, which is classifies as a general concept, is a medical security model that bonds the supply of medical services and management of security funds. Because of coordinating the relationship among those three parties and solving the problem of converse option and medical information dissymmetry, it has greatly deduced the medical expenditure. Therefore, almost all the countries are turning to be on the road of managed care when confronting the problems of fast rising of medical expenditure and heavy load of finance.Medical service belongs to the public goods that have nature of welfare and commonweal. The government depends on the well running of it to maintain social steadiness and equity. On the other hand, it is a limited one, having the character of consumption huddle, which is necessarily controlled in a certain by the government to avoid the increasing expenditure of medical treatment. The author analyzes the managed care character of the British National Health System that represents the type of national security, the German legal medical insurance that represents the type of the payment made by the third party andthe Singapore medisave that represents the type of the payment made by individual. China now is in the transferring time. The Chinese government is playing as a big insurance company during the systemic transferring process of turning from medical welfare based on public and enterprise expense to medical insurance supported by social members. Generally speaking, the venerable of the Chinese society are not in the protection of the medical security.The policy of fixed hospital and drugstore that implemented from 1998 belongs to the managed care. The author makes spot investigation in the pilot reforming city, Zhenjiang, to primarily appraise the performance made by the local medical security department by using such evaluating index as coverage rate, paying rate, medical accessibility and economic burden rate. This new type of managed care will provide an opportunity for the further development of Chinese medical security from treatment insurance to health security. This part of analysis and appraisal forms the key points of the article. Following the analysis of the tendency of Chinese medical insurance reform, the author points out that it is feasible for China to build a multi-arrangement and nationally-covered medical security system that are based on the value of health equity and scientific payment mechanism.