A Study Of Urban Medical Insurance Pattern

In the late nineties of the last century,China started to carry out the reform of basic medical insurance system for urban employees and made important staged achievements,thus the medical care of urban employees was well protected.However with the steady development of economic society,new situations and new problems in the reform of basic medical insurance system for urban citizens emerged constantly.The reform is faced with new opportunities and challenges.How to extend medical insurance system from urban employees to urban residents and achieve the goal that everyone shares basic medical security has become an improtant issue facing the current urban medical security.This thesis takes Qingdao area as an example to study on the medical insurance system for all urban residents,and put forward some opinions and suggestions against existing problems at present.This thesis firstly makes an economic analysis on the medical insurance system from various angles,and provides a theoretical foundation for establishment and research of residents' medical insurance system:then does a comparative analysis on international residents' medical insurance systems: Outlines four patterns of the mainstream medical insurance systems internationally,and studies its history,current status,problems and reform trends representing the medical insurance system in their own country respectively;Sums up the development trend and characteristics of international medical insurance system:Next expounds general requirements and progress of the reform of medical insurance system for urban residents. Finally,it concentrates on making an empirical research on the implementation of medical insurance system for urban residents in Qingdao area,and calculates the fund surplus of different groups through building fund surplus models; Finally,put forward some opinions and suggestions on completing and perfect the medical insurance system for urban residents.The approach to study is mainly literature research and empirical research. The approach to study is mainly the comparative analysis of literature.The data are from China National Knowledge Infrastructure(CNKI),China Doctor/Master Dissertations Full-text Database(CDMD),China Academic Journals Full-text Database(CAJ),Vip Data System,literatures and information on policies of basic medical insurance for local urban residents collected from Qingdao Work and social security department.The creative points are as follows:First,through a comparative study, summarize and sum up the general characteristics and trends of the current international medical insurance system,conclude that the choice of medical insurance system needs to adapt to the situation of a country,and there should be legislation to protect the system,generally coverage of system includes workers,then gradually expand,medical expenses and the protection effect are of non-positive correlation,the rising cost of health care has become a common problem faced by each country etc.Second,according to the differences of Qingdao urban medical insurance policies among various populations,establish a fund balance model based on the individual approach dividing different population,and made a calcultion. Based on the total balance and results of vertical individual overun cost, concludes that the current urban medical insurance system at present lacks vertical accumulation mechanism,suggest that we should establish the mechanism that finance supports medical insurance funds,reduce the amount charged to individual accounts appropriately,increase the amount residents pay for medical insurance,and f extract a certain percentage from fund balances of the year as risk Strategies.Third,against the problems existed in the current pattern of Chinese urban medical insurance,propose that we should adhere to three reforms simultaneously,coordinate to promote and improve the connection mechanism of medical protection system,improve co-ordination level of medical insurance,further enhance the use of medical insurance funds etc.In the course of the study of this subject,because of China's medical insurance system for urban residents running for only a short time,the statistical data are not sufficient,which may have a certain impact on the accuracy of model results.In future work and study,we will continue to pay attention and amend it.