Studies On Unlawful Practice In The Implementation Of China's Medical Insurance System

With the reforming of Government's financial system, comprehensively implementing the value of scientific development and building a harmonious society, China's health insurance is also stepping into a new times. With the rapid development of medical insurance, there are more and more unlawful activities exploded during the implementation of health insurance. The health insurance is not only concerned by all steps of the society but becomes an area where should be take more activities to supervise.In recent years China's medical insurance system into irregularities in implementation of an upward trend, and the various forms of domestic although such breaches have some research, but did not form effective to avoid the forming of the laws and regulations, which requires that we must China's medical insurance system irregularities in the implementation research, lessons learned, so that future health insurance system of laws and regulations related to the development of more targeted, rationality and feasibility of the medical insurance system so as to ensure the smooth and effective implementation. In order to more efficient use of limited resources, we must find a medical insurance system is implemented in a large number of irregularities can cause the loss of insurance funds, the reasons behind and improve relevant policies to effectively prevent the loss of the fund. Medical insurance system for the implementation of the irregularities will affect the smooth implementation of the social security system. Health insurance, once out of the normal course of their own development, not only may increase the market risk, increase the burden on consumers, but also disrupt public order, impair the lawful rights and interests of broad masses of the insured, affecting the overall image of the medical and health undertakings, hinder the social security system successfully implemented.This paper points out that China's medical insurance system is implemented in the existence of a large number of irregularities are mainly due to system design flaws, in order to circumvent the medical insurance system for irregularities in the implementation, we need to learn from overseas experience of successful supervision of medical insurance for its own national conditions, analyze problems the causes and take effective ways to avoid, so that a smooth and healthy development of the medical insurance industry, which is conducive to maintaining social harmony and stability. Such violations have brought new social injustice, the insured person's difficult to safeguard the legitimate rights and interests, thus affecting the stability of society is not conducive to social harmony, for the study of this question has a strong practical significance.This article indicates that China's medical insurance system is implemented in the existence of a large number of irregularities are mainly due to system design flaws, in order to circumvent the medical insurance system is implemented in the irregularities, we need to learn from overseas experience of successful supervision of medical insurance for its own national conditions , analyze the causes and take effective ways to avoid, so that a smooth and healthy development of the medical insurance industry, which is conducive to maintaining social harmony and stability.This paper lists the unlawful activities during the implementation of the health insurance, and elaborates its nagtive effacts frome three approach including medical institutions, pharmacies and health insurers in the way of literature analysis and comparative analysis. And its negative effects include wasting a large number of medical insurance fund, affecting the fluently implementation of the medical insurance system, and bringing social injustice and social contradictions. And analyse the reason of the unlawful activities during the implementation of the health insurance, which attributs to defects of system designing, loosen supervising of the health insurance funds, weakness of the individual moral consciousness. And use the health insurance management experience of American, British, and Japan as a source of referrance, and giving suggestions of avoiding the unlawful activities during the implementation of the health insurance, by combining our state conditions. It consists of rationalization in health insurance ID, severely in disciplinary system, publicly in supervision, legally in health insurance, perfectly in management, and independently of the supervision institutions. This paper concerns the further reasons of the unlawful activities during the implementation of the health insurance, that is not only the system and related laws and regulations, and people's greed. So when formulating a system, we should give subtly consideration of the prblems which may come out first. This paper emphasizes the important of the legalization as well as the people's moral accomplishment. I hope this paper can give an adoptable suggestion of the relevant laws and regulations in future health insurance, and giving contribution to the fluent implementation and harmonious society.