China’s Commercial Health Insurance Risk Control Study

Risk prevention of commercial health insurance issue is not just about business success or failure of the insurance company, and the stability of society as a whole, have a very important role in the development of the national economy. In this paper, in-depth analysis of the current situation and problems of commercial health insurance in our country at this stage, combined with the actual situation of the health insurance business, learn from practical experience and research results of the risk management of foreign commercial health insurance, made of commercial health insurance risk prevention mechanism The overall design and preliminary research, trying to provide a reference for the operating activities of the professional health insurance.In this paper, some of the economics research, analysis and demonstrate the economic implications of adverse selection and moral hazard, the causes, manifestations, and consequences, pointed out that the information asymmetry problems of adverse selection and moral hazard phenomenon is hampered The fundamental reason for the healthy development of the commercial health insurance, adverse selection and moral hazard is the biggest obstacle to insurance mechanisms play a role, and some of the methods proposed to solve this problem. Finally, contact the U.S. managed care insurance model proposed for the actual situation of our country, to prevent and control adverse selection and moral hazard specific measures and feasibility of the program.The first chapter describes the research background, significance, issues raised, and the research status review and synthesis: second chapter analyzes the basic concept of the commercial health insurance market characteristics of the actors and the information is not symmetric problem, the analysis of the commercial health insurance insurablc conditions and of the status of commercial health insurance issues in-depth and detailed analysis: third chapter analyzes the performance and the Origin of adverse selection and moral hazard: Chapter IV studies U.S. Department of Health medical insurance model, for our country, we can draw on relevant experience: Chapter V in the policy environment in which China’s commercial health insurance market on the basis of more comprehensive investigation through the perspective of adverse selection and moral hazard reform of medical sen ice fee payment from information asymmetry countermcasurcs angle, to improve the system of insurance intermediaries to avoid adverse selection and moral hazard in the commercial health insurance market ideas and methods, analysis of information asymmetry weakening angle strengthen national the regulatory system, the construction of enterprise credit system and the personal credit system, the establishment of health insurance information exchange platform, the implementation of managed care, to building and reform of China’s commercial health insurance system to provide reference and inspiration; Chapter Ⅵ Conclusions and further research problems.