| The history of cooperation between commercial health insurance and social medical insurance is lasting for 10 years in China. The feature of the cooperation in this period is the independent innovation under the framework of the existing system in China, the commercial insurance companies have innovated various cooperation modes, typically including:"Luoyang model", "Xiamen model", "Jiangyin model", "Zhanjiang model", "Taicang model" and so on. These models provide a basis for the reform of relevant national policy, but at the same time, these models present unsustainable and have the problem of replicating. Under the background of reform in China, the national six ministries jointly issued " Guiding opinions on carrying out the work of Serious Illness Insurance for urban and rural residents " in August 2012. "Government-led, business operation" is the core of the Serious Illness Insurance Policy. It is the first time that commercial insurance institutions were allowed to participate in organization of social insurance at the policy level through the way of purchasing service. The new policy provides an important support of the cooperation between commercial health insurance and social medical insurance.Firstly, this article tries to find out the theory basis of the Serious Illness Insurance Policy through researching of PPP theory. Then this article analyzes the differences in policy implementation in different regions and finds the main problems in the cooperation under the existing system based on the Serious Illness Insurance Cases of Jiangsu province. Based on the analysis the article tries to find out the Performance Evaluation System. Finally, under the background of the reform of Social Medical Insurance in China, the article put forward a model of "The integrated management of social primary medical insurance and Serious Illness Insurance ". The article also pointed out the support policies and measures for further reform that the government should have. |
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