Social Health Insurance Cost-control Methods Discussed

The medical safeguard is worldwide basis difficult problem.The present stage our country's medical safeguard also is paid attention specially.It is related with each person's birth and death and entire society's security stable. In among, the medical expense control also is difficult difficult, since on century 70's, the various countries facing the fast rise medical expense, has carried on the discussion to the medical expense control mode, and summarized the beneficial experience and had the effect practice outstandingly. Our country has started the medical insurance reform since 1998, the medical insurance already penetrates into cities everyone, in the question has obtained the enormous effect, but because our country medical insurance system establishes late, the system is still imperfect, at present the management quite is simple, facing the medical expense which surges upward unceasingly lacks the actual effective control method. Therefore, this article mainly carries on the discussion on the society medical insurance expense control mode, mainly revolved the society medical insurance essential attribute,the question which the medical safeguard system face, the factor which influence expense control ,the role which the government should undertake. the explanation to these question Is helpful in our country medical service safeguard reform.This article main body part altogether divides into five chapters, the content is as follows:The first chapter, first analysis the theory root of the insurance's formation, we know why had to carry on the expense control , analysis society medical insurance essential attribute, obtained why had the society medical insurance expense control.The second chapter, main analysis each kind of factor which influence medical insurance expense control, descripte the role of supply and demand, pointed out that medical insurance should be controlled to control medical care for supply, mainly. Described the role of the medical insurance agencies in the medical market and analysis the reasons for the failure of the Government. The third chapter, be discussed the control method of the medical insurance from two aspects,pointed out its merit and shortcoming.One is a way of control supply and need, two is a way of microscopic control and macrocontrol.The fourth chapter, summarized the overseas's medical expense control measure and experience. Take two entirely different expense control mode(DRGs and HMO) as an example, has analyzed their characteristic, the function and the operation mechanism thoroughly.The fifth chapter,according to the present situation of our country expense control, clear about the mentality and key of medical insurance expense control, proposed the transformation of medicine health system, develop community health service, innovate and rich the Settlement pattern, introducte third party's supervising and managing mechanism.