Study On Evaluation And Strategy Of Urban And Rural Residents Serious Illness Insurance In Hebei

Serious illness insurance(SII)is a combination of social insurance and commercial insurance business.SII system need to rely on a sound institutional basis,scientific management methods,advanced technology,strict disciplinary measures and adequate funding.SII not only needs to optimize the method of payment,restrict the risk of moral hazard,but also develop prevention health care,beforehand strict regulatory control,promote efficient compensation,SII service system.In this paper,we analyzed the development process,compensation level and management level of illness insurance in Hebei province through the data obtained through investigation,we found the frequent occurrence of moral hazard,medical insurance information asymmetry,policy risk and fund sustainability problems.Through the analysis,we know the cause of these problems is improper way of cooperation.On the basis of the above,analysis of a SII cooperative relations between the main parties and the factors that affect their decision.It is concluded that the government support and appropriate economic rewards and punishments measures will affect decisions to a SII participants,at the same time management costs affect the quality and operation of serious illness insurance business.In the analysis advanced a SII business model developing in domestic and foreign also reflected this conclusion.In the last part,combined with the SII problem happened in hebei province and summarized advanced these SII pattern characteristics,we provided available advice on the question in the development of SII.In general,I think SII business should setlear bidding standard and risk-sharing mechanism in the preliminary.At the same time smooth and comprehensive information platform between institutions should be established to ensure the validity of the information transmission;Strengthen the medical checks and restrict the risk of moral hazard in the medium term;Latterly,providing a quick and timely medical claims,making an accurate evaluation on the business development,and formulate incentive rewards and punishments measures,so as to promote the healthy and continuous development of a SII in Hebei province.