Determination Of The Attributes And Analysis Of The Return Path Of The "Critical Illness Insurance"

This article focuses on the attributes and return of the "Critical Illness Insurance"system for urban and rural residents in China."Critical Illness Insurance" comes into being to compensate for low level of medical security of basic medical insurance.Part of the urban and rural residents basic medical insurance fund is allocated to commercial insurance institutions,and the high expenses undertaken by urban and rural residents after the reimbursement of basic medical insurance is for second reimbursement by commercial insurance institutions.The implementation of "Critical Illness Insurance" improves reimbursement rate of medical expenses faced by urban and rural residents and alleviates the problem of falling into or falling back to poverty because of catching diseases.However,"Critical Illness Insurance" has always been faced with the problem of fuzzy attribute that results in the chaos of operational mode,the imbalance of rights and obligations of commercial insurance institutions,and the lack of legitimacy and stability of the capital source of "Critical Illness Insurance",that endangers the existence and sustainable operation of "Critical Illness Insurance".Through the analysis on the function of "Critical Illness Insurance" and the comparison between "Critical Illness Insurance" and the basic medical insurance,it is found out that the real and practical function of "Critical Illness Insurance" is to make up for the defects of basic medical insurance of urban and rural residents and there is no substantial difference between "Critical Illness Insurance" and basic medical insurance of urban and rural residents.The high self-paid medical expenses that"Critical Illness Insurance" is aimed at alleviating belongs to risk that basic medical insurance shall respond to and there is no need for "Critical Illness Insurance" to exist and be operated alone.The independent existence and operation of "Critical Illness Insurance" only increase the operating costs in vain.Therefore,"Critical Illness Insurance" shall be adjusted on the basis that "Critical Illness Insurance" belongs to basic medical insurance."Critical Illness Insurance" system shall be integrated into the basic medical insurance for urban and rural residents and the reimbursement scope and rate of basic medical insurance shall be increased dynamically,which is not only the return path of "Critical Illness Insurance" but also necessary measures for improving the basic medical insurance for urban and rural residents.The main contents of this article are arranged as follows:The first part introduces the operational characteristics of the system of "Critical Illness Insurance",and then puts forward the fuzzy performance of the "Critical Illness Insurance" attribute,that is,"Critical Illness Insurance" and the basic medical insurance are entangled,and the positioning and role of commercial insurance companies are of embarrassment.The misunderstanding of "Critical Illness Insurance" has not only led to the plight of the source of funds of "Critical Illness Insurance",but also makes the rights and obligations of commercial insurance companies unbalanced,and the crisis to the existence of the basis and sustainable development of "Critical Illness Insurance".The second part explores the origin of the system of "Critical Illness Insurance".On the one hand,medical expenses reimbursement ratio of the current urban and rural residents basic medical insurance is low,leading to poverty and poverty alleviation problems caused by disease.On the other hand,the basic health care fund balance much.A large number of surplus of the basic health insurance fund,and poverty and poverty alleviation problems caused by disease coexist,which gives birth to "Critical Illness Insurance".The third part analyzes the institutional goals and functional path of "Critical Illness Insurance"."Critical Illness Insurance" system is placed to reduce the medical expenses of urban and rural residents and is expected to play a lot of functions.In fact,compared to the existing medical security system,there is no unique function and positioning with regard to "Critical Illness Insurance".The system goal of "Critical Illness Insurance" is to reduce and alleviate the poverty caused by disease,the problem of returning from poverty,which is the goals of the basic health insurance system for urban and rural residents.In addition,in the realization of the institutional objectives of the functional path,"Critical Illness Insurance" and the basic health insurance of urban and rural residents,are the same:through social insurance to raise funds to reduce medical expenses that urban and rural individual pays.The fourth part focuses on the funding sources of "Critical Illness Insurance",and try to define the meaning and standards of basic medical care."Critical Illness Insurance" gain funds from the urban and rural residents health insurance fund,that is,in fact,urban and rural residents pay and the corresponding government subsidies,breaking the existing "Social Insurance Law" provisions,but also lacking legitimacy basis.Basic medical security is the national commitment of the state,where the survival and health of the necessary health care are essential medical care.Therefore,according to the standard,"Critical Illness Insurance" shall belong to the basic health insurance.The fifth part is to integrate the "Critical Illness Insurance" into the basic medical insurance of existing urban and rural residents.There is no need for "Critical Illness Insurance" to exist and operate in outside the basic health insurance system of the urban and rural residents,and the independent "Critical Illness Insurance" also increase the operating costs of the system.Moreover,from the nature of the property that "Critical Illness Insurance",the scope of protection of the basic medical insurance of the urban and rural residents,and there is no substantive differences,and the existence and operation of "Critical Illness Insurance" is not necessary and lack of legitimacy.