Research On The Employee Basic Medical Insurance Fund Management In S Province

As an important part of medical insurance fund management,basic medical insurance fund management refers to the the general work of plan,organization,coordination,control and supervision on the collection,payment and use of the medical fund by a relevant agency according to the operation rules of the medical insurance fund.Under the negative effect of the economic downturn,the supply side reform from coal industry,the aging population and other factors,the basic medical insurance fund for employees in S Province is facing huge challenges.Therefore,it has become a major task of how to improve the level of basic medical insurance fund management and ensure high-quality medical service for the insured by the limited fund.However,due to the the imbalance between income and expenditure,frequent occurrence of extracting and cheating medical insurance fund,the stable operation of the basic medical insurance fund has always been affected in S province,and even the sustainable development of the medical insurance system suffered a lot.By undertaking research on the current situation and further analysis of the existing problems and their causes in the process of of the basic medical insurance fund management of S Province,the basic medical insurance fund management can be understood further.The level of basic medical insurance fund management,as well as the management level of other fund,can be improved significantly.Thus,not only the basic medical rights and interests of the insured can be guaranteed,but the efficiency of fund use can be improved as well.Mutual aid can be achieved and the stress of fund paying can be relieved.The sustainable development of the medical insurance system can be promoted.Therefore,this paper,from the perspective of an agency of medical insurance,did literature research on the system,situation and mode of basic medical insurance management in S Province.A method of qualitative and quantitiative analysis,combined with case method,was applied in the exploration of the problems existing in the process of medical insurance fund management and their causes.Countermeasures and suggestions were finally put forward to improve the level of basic medical insurance fund management of S Province.Five chapters were employed to elaborate on the management of Employee basic medical insurance fund.Chapter One is an overview of Employee basic medical insurance fund management.By explaining the concepts of employee basic medical insurance fund and management of employee basic medical insurance fund,it introduced the concepts of the pooling fund of employee basic medical insurance and the fund for individual accounts.Subsequent explanation of the principle,method for employee basic medical insurance fund management was undertaken.As a result,is emphasized the consequence of strenthening employee basic medical insurance fund management.Chapter two is mainly about the current situation of employee basic medical insurance fund management in S Province.Based on the analysis of the relevant system,the management organization,the duties of its employee basic medical insurance fund management,the current situation of its fund raising,paying,and investment was made clear.The problems existing in employee basic medical insurance fund management in S Province were analysed in Chapter three,including the imbalance between income and expenditure of the pooling funds of basic medical insurance,frequent occurrence of extracting and cheating medical insurance fund,and the imperfect management and organization.Chapter four explored what caused the problems existing in employee basic medical insurance fund management in S Province.The reasons are imperfect policy of Fund management,imperfect control mechanism of fund expenditure,problems of the fund supervision system respectively.Countermeasures and suggestions for improving employee basic medical insurance fund management in S province were put forward in Chapter five.Some practical suggestions were based on personal work experience: 1)to perfect the policy of fund management,it is necessary to seek more resources of fund raising,readjust the proportion of financing and remitting funds,and improve the investment policy system;2)to perfect the fund management mechanism,it is necessary to improve the control mechanism of fund expenditure,strengthen incentive and restraint mechanism,establish o a mechanism for linking departments;3)to improve the fund supervision system,it is necessary to establish a professional audit team,raise the level of information technology supervision and establish extensive social supervision.In this paper,problems existing in the process of employee basic medical insurance fund management in S Province were analysed from the practical thinking and the perspective of an agency dealing with medical insurance.Some concrete and practical countermeasures and suggestions were put forward in hopes of supplying intelligent support of improving the level of employee basic medical insurance fund management in S Province as well as of other fund management,raising the capability of employee basic medical insurance fund in resisting risks.