The Basic Medical Insurance Legal Relationship Between The Insurants And Medical Service Agencies

The legal relationship of insurant and medical service agencies of basic medical insurance is one of the health insurance legal relationship. It closely linked to the general civil sense of the doctor-patient relationship on the surface. But due to the limited nature of its subjects’range, and considering the restrictive medical services and the difference of the payer in the object, as well as the rights and obligations of different content, the three point determine that the legal relations and general civil doctor-patient relationship is different.Medical insurance, this was a private law legal relationship between individuals and insurance institutions, but due to government intervention, the nature of its private law was infiltrated of the public law factors by the content of the constitutional right--ocial security right, as well as the administration commissioned nature of the contract between agencies and medical service providers. This legal relationship should be characterized both for public and private law at last private law-based rights which under the protection of public authority.This article is divided into four parts, the text totally has over15,000words.Part one focuses on the overview of the basic medical insurance legal relationship between insurants and medical service providers. The the basic medical insurance legal relationship between insurants and medical service providers is the insurants and the medical service providers’rights and obligations which recognised and protected by the basic medical insurance system. It is based on the civil legal doctor-patient relationship, but differs in nature, subject, object, and the content of the rights and obligations of the doctor-patient civil legal relations.Part two focuses on the nature of the legal relationship between the basic medical insurance insurants and medical service providers. There is fierce debate in academia:doctrine of doctor-patient private law relations and the doctrine of both the public and private law of a special contract based on private law relations. However, due to the social insurance rights which under the governmental responsibility protect the right of basic medical insurance insurant, and public agencies develop the basic medical services agreement which provides the obligations of the medical sector. The nature of the legal relationship between the basic medical insurance insurants and medical service providers inevitably affected by the impact of above two factors. Therefore, both public and private law, a special contract of the private law based relationship that, in theory, more scientific, but also more realistic.Part three issues the content of the legal relations between the basic medical insurance insurant and the medical service provider. The private doctor-patient relationship and the legal relations between basic medical insurance insurants and medical service agencies have many in coincidence, resulting in the legal relations between basic medical insurance insurants and medical service agencies the object, the subuject, the content of rights and obligations and responsibilities have a dual nature.Part four, with the development of the basic medical insurance system, China’s social medical insurance system is gradually maturing, many theoretical and practical issues are also in a progressive solution. But still there are many practical issues should be solved, for example, lacking of governmental investment, inadequate control of the medical costs, medical institutions cheating on medical insurance fund, adapting difficulty of health care relationship. Considering the above problems, only deep analysing the theory of basic medical insurance legal relationship between insurants and medical service agencies, can improve our health insurance legislation and promote the reform of the basic medical insurance system.