Problems And Countermeasures Research On The Serious Illness Insurance System For Urban And Rural Residents In China

The serious illness insurance developed from the basic medical insurance system caneffectively reduce the medical burden of patients with serious illness,and it is the important way to promote 3 d linkage,enhance enterprise union and improve the level of medical services.Ageing is developing at an accelerated speed in nowadays society.According to《Social Services Development Statistics Bulletin in 2016》,the proportion of population aged more than 60 has reached 16.7%up to the end of 2016.《Chinese Family Development Report(2015)》announced that sixty percent of the old was diagnosed with chronic disease.The possibility cf being attacked a disease for these old is more than the normal even several times,thus there is a huge demand for medical treatment among these old.What the anecdotal said "the disease lead to poverty" specificaily refers to the serious diseases.The structure of China’s population and the direction of future development determined the significance of serious illness insuranc.Build sustainable operation mechanism of the serious illness insurance is the need to complete social insurance system,break the gap of economic development between urban and rural areas,accelerate the new urbanization construction,get rid of poverty and realize the goal of activating a moderately prosperous society.It is worthy thinking about the problems about serious illness insurance,there is a long way to go to make the system really play a role.This paper makes an in-depth analysis of the problems existing in the urban and rural residents serious illness insurance system in China based on the above.In addition,the serious illness insurance this paper mentioned refers to the serious ilness insurance for urban and rural residents.First of all.this paper summarized the relevant literature research of domestic and abroad,putting forward the relevant theoretical basis,and analyzing the social effects.Second,it introduced the development of the serious illness insurance and the implementation in the typical region at present.And then so many problems were found such as medical expenses monitoring adverse,medical resources waste,financing mode is single,lack of a stable source of funding,unreasonable deductible and ceiling design,the lack of effective competition and so on,then it analyzed the reasons for these problems.Finally,combining with the relevant system of Japan,the United States and Singapore,from the process of its development experience,our country should think about how to improve our present serious illness insurance.Some suggestions are put forward to solve the problems at the end of the paper.On the one hand,the government should play a role.Government should clear the nature and positionina of the serious illness medical insurance,provide a low cost medical services,establish fund of risk adjustment and multi-channel financing mode,strengthen the support of financial capital,play a greater social benefit,formulate scientific and reasonable pay on line,the top line,strictly control of commercial insurance institutions in and out of the audit mechanism,etc.On the other hand,the commercial insurance institutions should play a role.They should strengthen the cooperation with government,implement the principle of guaranteed profit,set up risk prevention awareness,give full play to the professional advantages,improve personnel training mechanism,build a professional service system,and effectively supervise the medical insurance institutions and medical staff.