Research On The Basic Health Insurance For Urban And Rural Residents In Shanxi Province

Shanxi Province has established a coverage of basic health insurance system for urban and rural residents. In recent years, the probability of participating health insurance has been greatly improved, most of the residents are able to access to basic health care. But in the field of health insurance, there are still many problems such as high cost of management, low efficiency of management, the uneven distribution of health resources, and the unfair treatment of insured residents. Overall planning for urban and rural residents of the basic health insurance has positive significance, for deepening the reform of the health system, protection of fair, to break the urban-rural dual structure, and to solve the problems in the field of health insurance. January 2016,the State Council released a document which is named "about the integration of urban and rural residents in the basic health insurance system for opinions"( referred to as views).It puts forward the specific requirements on integrating the health insurance.The basic health insurance for urban and rural residents has been put on the agenda.This paper studies on the integration of health insurance with the help of social equity theory and urban and rural development theory. Firstly, I study the necessity and feasibility of co-ordination of two health insurance, knowing the current situation and problems of health insurance in Shanxi Province. And using the method which unified with qualitative and the quantitative analysis to indicate that the resources unbalance,the system difference and compensation effect difference happens in health insurance of urban and rural residents in Shanxi Province. Through the overall analysis on the major obstacles and the key problems of the basic health insurance for urban and rural residents in Shanxi Province, emphasizing that Shanxi Province need to pay attention to those matters. Referencing to domestic and international experience, the author puts forward suggestions that the Shanxi Province should follow the principle of“should adhere to ensure fair, appropriate tilt, to ensure efficiency, the principle of gradual and orderly”. In the overall path, the level of co-ordination, referral policy, the convergence between the system and other factors into account. In the overall content,based on the "opinions" "six unified" basic requirements, detailed overall planning and overall details of the process and the need to pay attention to the matter. In the path, we should take the factors into account,such as level of co-ordination, referral policy, the convergence between the system. In the content,we need to formulate the detailedoverall planning and the process which is based on the "six unified’”requirements. In the model, using the"fund meger—the crowd separated" model, and the establishing the mutual transfer channels of the residents health insurance and the worker health insurance, could achieve a smooth transition between residents and workers.