| Medical insurance is a vital part of social insurance system which isa basic insurance demand of an individual. Although the medicalinsurance system in China has been reshaped to a large extent after theChinese medical system reform, there still exist many problems such asthe low efficiency in funding utilization, the blind spots in the scope ofcoverage and the insurance level inequality. Especially, for urbanresidents and the group involved in the new rural cooperative medicalcare system, the financial risk posed by severe diseases is still high. Thecontradictions lying in the aspects of the setting of expenses, the designof regulations and the control of risks are especially severe. Thebridging of commercial health insurance and social health insurance is anefficient way to solve these issues. The research on this topic in thesystem of severe disease medical insurance is very important forestablishing a multi-level health care system, raising the performance ofhealth care and improving the development of public health. In this work, the bridging of the commercial medical insurance andsocial medical insurance in the system of severe disease medicalinsurance is discussed. The relevant concepts are defined. We analyze thefunction of the government and the market in the system of severe diseasemedical insurance, based on its basic properties. The interrelationshipsand differences of commercial medical insurance and social medicalinsurance are studied and the positioning, bridging and the transformingof their relationship are analyzed. From the public policy point of view,our work illustrates the necessity and feasibility of this bridging by usingthe classical methods in insurance theory and economics.Second, the background and basic contents in the establishment ofthe severe disease medical insurance system, and the current status of thebridging are analyzed. Especially, we analyze the mode of Zhanjiang andTaicang. The defects of bridging under the current status are illustratedand three key issues are proposed including the bridging of fund-raise andpayment, the bridging of insurance scope and the bridging of the groupsprotected.Last but not least, we study the strategies for the bridging. Abridging model by studying the situation in Shanghai City is designed.And the required internal regulations and external stimulations duringtheir bridging are presented. Through the study of the bridging of the commercial medicalinsurance and social medical insurance in this work, the necessity andfeasibility of the bridging are explained theoretically. The positioning andrelationship between the two are clarified, detailed bridging propositionsand simplified models are given. This work provides an inspiringdirection for further academic researches on severe disease insurancesystem and the implement of the system in the policy. |
