Study Of Expense Control Of Social Medical Fund In China

In recent years, China’s medical insurance fund expenditure has been increasing,while the government health expenditure is also growing rapidly. Although both medical fund expenditure and government health expenditure are growing, medical individual burden is still not light and the problem of “see a doctor expensive” continues to today. In the perspective of medical insurance fund payment, this article research without reducing the medical service quality, while guarantee insured people could enjoy the basic social medical insurance actually, the reasonable control method for medical insurance fund expenditures.This study choose medical insurance system of outpatient service expenditure and hospitalization expenditure as main variables, through the combination of relevant variables and fund payments, build a system dynamics model of medical insurance payment system. Adjusting the variable parameters, simulation policy strategy changes will effect the operation of the system, and then testing the established system. This paper designed three policy rules: sources of total funds budget strategy and strategy of outpatient and hospitalization expenses. The main variables of fund budget strategy is the total expenditure policy coefficient—pcf; the main variables which reflect the outpatient expense strategy is the minimized outpatient rate—MLGR and the main variables which reflect the hospitalization expense strategy is least hospitalization days—MIHD.This study results show that the total prepaid payment system is good, it can cut the government expenditures obviously. However, using the total prepaid payment system individually could not meet the goal of “basic security” for basic medical insurance. Mixed mode of payment in the control of medical insurance fund spending and ensure the basic medical insurance level is deserved, the control effect of this combination is much better.Adjusting the parameters of the system, through the simulation of system dynamics model,make predictions of the medical insurance fund balance. It follows that the implementation of policy should focus on controlling pay expenses. Through the simulation analysis, thereasonable policy strategy parameters combination is PCF = 0.575, GR2 = 0.05, MLGR =5.25, MIHD = 5.5; this kind of payment strategy can comprehensively control the medical insurance fund expenditure.