Anti-fraud Research On Quanzhou Urban Basic Medical Insurance Fund Expenditure

To solve the problem of the public’s cost of health care, a country or region gathers, distributes and utilizes medical insurance fund, according to the principles of insurance, which is called medical insurance system. As an important part of social insurance system, it is an effective mechanism of fund raised for the public health care as well as a management mode of medical expense that is widely used in the world. In recent years, sorts of medical insurance fraud is difficult to prohibit and the fraudulent means keep escalating, appearing a trend of co-fraud in and outside of the district. The fraud even shows a trend of gang and professional crime. It not only causes the loss of medical insurance fund, brings serious harm to the interests of the insured individuals, but also threats the safe operation of the medical insurance system and even the whole social insurance system. The construction of an effective anti-fraud mechanism is necessary. The anti-fraud on Quanzhou Urban Basic Medical Insurance Fund Expenditure started late, there are many problems exist.The article is based on anti-fraud on Quanzhou Urban Basic Medical Insurance Fund Expenditure with objective reality. On the basis of social security theory, public products theory, and cost-profit theory, the article uses analysis means like the method of literature study, survey study and case study, combined with the research on Quanzhou Urban Basic Medical Insurance Fund and Anti-fraud, to analyze its existing problems and reasons systematically. The article shows that the measures to promote the anti-fraud level, for example, perfecting the construction of anti-fraud institution, establishing an efficient, professional team, improving the anti-fraud technology, increasing the illegal cost of fraud and strengthening the anti-fraud inspiriting mechanism. In this way, a standard, reasonable and effective anti-fraud institution is expected to be established. It will provide theoretical support for the anti-fraud practice of Quanzhou Urban Basic Medical Insurance, guide the work of Quanzhou Urban Basic Medical Insurance agencies, promote its anti-fraud level, reduce the loss of medical insurance fund, and ensure the rights of the insured persons to achieve medical insurance system’s sustained development.