Research On The Integration Path Of Basic Medical Insurance System In Shanxi Province

With the development of economy,the government pays more and more attention to Social Security construction,including basic medical insurance.The 19 th Congress made it clear that "the three systems and one system of medical reform should be deepened,namely,the basic medical and health system,medical security system and high quality and efficient medical and health service system with China's characteristics should be fully established,and the modern hospital management system should be improved.From the development point of view,"the unified medical insurance system for the whole people" is the major trend of medical insurance development,but also the objective requirement for medical insurance.Shanxi province issued in 2016 the "Shanxi people's government on the integration of urban and rural residents of the implementation of the basic medical insurance system",Shanxi province has since achieved a new rural cooperative medical insurance and urban residents of the integration of basic medical insurance,Shanxi province's basic medical insurance into: urban and rural residents of basic medical insurance and urban workers of two basic medical insurance,but urban and rural residents of health insurance integration is only a step in the process of health insurance reform.How to actualize 'whole province to protect' still need to continue to study and explore.Based on the theory of fairness and efficiency theory,moral hazard theory,coordinated development theory,resource allocation efficiency theory and Pareto optimization theory,this paper expounds the current situation of health insurance in Shanxi province from the aspects of fund raising standard,compensation standard,treatment level,fund management mode,etc.Then it is proposed that the integration of Shanxi medical insurance should take the path of "step by step,step by step,step by step",The first step: to formulate a unified basic medical insurance system for urban and rural residents and improve their medical insurance;The second step is to cancel the personal account in the basic medical insurance for urban workers and to establish an integrated outpatient service system(although not in the unified system,but to lay thefoundation for the overall medical insurance system);The third step is to improve the overall level of urban and rural residents 'health insurance and urban workers' health insurance,unified for provincial planning.The fourth step is to integrate the urban and rural residents 'medical insurance system and the urban workers' medical insurance system,adopt a system of multi-file form,adjust the basic medical insurance new financing mode,and realize the common insurance.Because the integration and reform of the basic medical insurance system is macro-level,to realize the reform steadily,we still need microcosmic supporting mechanism and measures to support the reform of the system.Therefore,we put forward such supporting mechanisms as grading medical treatment system,three medical linkage model and commercial insurance model,so as to speed up the integration of the basic medical insurance system in Shanxi province and achieve the goal of universal coverage.