Research On The Fund Payment Of The Basic Medical Insurance System For Urban Workers

Medicare is a worldwide problem, the doctor hands of the medical expenses incurred as a source of difficulty that the pen is difficult to control in the difficult. Medicare is a colorful field of medical expenses paid by the operating system and its handling is one of the most vivid, the most viable place. Necessary to effectively protect the insured’s medical needs; need to maintain health insurance fund stable, sustainable development, which was controlled within acceptable limits, avoid overspending Fund serious problem affecting the health care system sustainable and the insured’s interests.Since the 20 th century to the 1970 s, health care costs around the world are showing rapid growth, the pressure also increases health insurance. Faced with this situation, countries began on how to effectively control medical costs conducted in-depth discussion and practice, and gradually formed a unique method of controlling Medicare costs. Medical insurance system reform in China through the past 20 years, China’s universal health care system in addressing the masses "difficult and expensive" on the issue and achieved good results. But now China’s medical insurance management methods are still relatively simple,due to the late start of China’s medical insurance system, the lack of practical experience, systems are not perfect, so in the face of rising health care costs, lack of effective, mature control mechanisms.From the individual to the number, postpaid to prepaid, the direction of the development of the micro to the macro world today is paid in Medicare funding of both supply and demand trends in the overall presentation. On research trends at home and abroad to pay health insurance funds controlled operation can be found, the focus has been paid from the funds of funds from the simple to control health spending in the past to ensure a balanced fund payments, the basic medical insurance to insured services Under the premise of demand, shifting the direction of reasonable expenses of medical insurance fund. Control the rapid growth of medical costs, and reasonable use of medical insurance fund to strengthen awareness of both supply and demand savings funds,where the aim is to control expenses. In order to form a more scientific and reasonable health insurance funds control mechanism, to seek lower cost for higher medical services to enhance the efficiency of the use of insurance funds, researchers have begun to pay more attention to human design, attention to the demands of the insured’s health and the reasonable demands of the medical side, rather than simply relying on health insurance fund health insurance funds and expenditure figures to determine the effect of control.Medicare funding for the operation of the payment system design theory research questions are: disease risk theory, law of large numbers theory, game theory, health management, and analysis are described in this article.This article related to Medicare payment and cost control methods comprehensive analysis and evaluation at home and abroad, come tolearn from our observations and recommendations on health insurance reform regarding payment options and financial control mechanisms built by; Meanwhile, the province Yueyang City ten years of experience in health care reform to collate and summarize, according to the course of its payment change, assessing control effectiveness analysis of different payment methods to pay for medical expenses, targeted made four suggestions: first, to promote health system and drug distribution system,so that three reforms Medical insurance simultaneously, complementary;Second is to improve medical insurance payment, the implementation of the hybrid method of payment; Third, the positive development of community health service system to guide patients to change health care consumer attitudes; Fourth enhanced control and health management funds to pay for health insurance.