Medical Insurance Expenditure Control Mechanism Research Based On The New Health Care Reform

With the rapid economic development, our country established urban basic medical insurance system in1998, and established a new type of rural cooperative medical care system in2003and the basic medical insurance for urban residents in2007.This three social health insurance include the vast majority of the population of the country into the scope of medical insurance system. An important issue that universal health care can not be avoided, is how to control the rapid growth in health care costs. The cost of health insurance in a broad sense, refers to the sum of the medical expenses incurred after the illness of the insured. Medical insurance expenditure control is an important tool in the management of medical insurance expenses. Control object is within the scope of medical insurance types of medical expenses, in order to maximize the basic medical insurance medical purposes, to safeguard the basic rights and interests of the insured. As we all know, control the cost of health insurance is a major problem worldwide. From August2009, China started a new round of health care reform, referred to as the new health care reform. The new health care reform has made many encouraging results, so that people truly enjoy more benefits. But in the new health care reform forward at full speed at the same time, there are still some resistance to the inevitable, which, the excessive growth of health insurance costs from a certain level is still the biggest obstacle. Now the "difficult and expensive" is still a major livelihood issues. Therefore, it is necessary to improve relevant policies and to take appropriate measures to curb this trend, explore new mechanisms and governance structures to provide medical services to the public more effectively, so the residents to get the maximum health insurance benefits, which not only has important theoretical value, but also has important practical relevance, can promote healthy and sustainable socio-economic development and building a harmonious society ".This article based on the new health care reform, the basis for identifying problems, analyzing problems and finding solutions to those problems, control health insurance costs as the focal point and the core divided into the supply and demand of third parties, different from the main starting analysis lead to medical costs growing factors, identify which controllable factors, combined with cybernetics, game theory, theoretical knowledge, establishing health insurance, suffering among game and its twenty-two relationship to analyze, explore effective governance strategy, and then means of control of foreign state-of-the-art medical costs, the analysis of which are of similar background or implementation conditions, to learn while integrated with China’s national conditions and reality on the basis of the feasibility of the corresponding effective policy recommendations.The full text is divided into a total of seven parts:The first part is the General, is divided into four sections, the first article research background and theoretical and practical significance, enables us to understand why this issue deserves to be studied, and then summed up the domestic and international literature review, and then is introduced to the entire article ideas and innovation and shortcomings; second part is divided into two small pieces to introduce medical insurance system as well as the history of China’s medical insurance system reform analysis, where the main mode of the medical insurance system reform and the new health care reform measures focus; the third part introduces the theory of origin of the medical insurance cost control, the theory of the law of large numbers and insurance, medical insurance, supply and demand theory, game theory and cybernetics; began to expound the fourth part of the status quo of the medical insurance cost control, analysis the control of medical insurance costs and third parties, as the main body to supply and demand, stand on a different point of view of the reasons for rising health care costs; fifth part is for the medical establishment, Paul, suffering from three relationship game analysis and strategy research, analysis of the medical insurance, suffering from the Game relationship between any two tripartite obtained should establish a tripartite the harmonious interaction mechanism, reasonable incentives and strategies; sixth part is the introduction of foreign medical insurance cost control experience and revelation, the United States, Germany and Japan chose these three develop better control of the health insurance costs of better analysis and innovative measures countries such as the United States will be state-of-the-art science and technology applied to control health insurance costs, the establishment of a powerful information management system, German pharmaceutical separated system, the implementation of strict regulation of pharmaceutical premiums monthly income classification; final part is based on our own situation and integrated all of the above analyzes related to effective policy recommendations, and not only from the point of view of both supply and demand specific policy proposals, such as the supply-side, in medicine, the use of medical resources should improve relevant laws and regulations should be set up; demand side, the proportion of scientific pays from third-party perspective, proposing the introduction of third-party control mechanism.Innovation of this paper in that proceed from a new perspective, divided into the supply and demand of third parties, different from the main0to start the reasons for the rising cost of health insurance, then the introduction of game theory to the medical, suffering, Paul tripartite carried twenty-two game relationship research, draw effective solution strategies. However, because of itself mathematical statistical knowledge is limited and weak, the article lacks the resolve of some of the mathematical model, certainly so in the analysis of the problem there are many deficiencies to be in the future to further improve and perfect.