Research On The Problems And Countermeasures Of The Operation Of The Personal Accounts Of Urban Employees' Medical Insurance In City A

The basic medical insurance scheme for urban employees has been in orperation for 20 years in china,and the mode of "combined accounts" has made historic contributions in reducing the medical burden of employees and controlling the growth of medical expenses.At present,China has successfully completed the transition from public medical treatment to medical insurance.In 2011,hina issued the social insurance law,which established the national basic medical insurance system for urban employees in the form of law.Since then,China's social medical insurance system has entered the legal track.China's individual account system of basic medical insurance for urban workers has developed synchronously with the basic medical insurance system to where it is today,it plays an important role in emphasizing the consciousness of saving and restraining unreasonable medical consumption behavior,but there are also some problems such as huge capital accumulation and poor mutual aid.By the end of 2017,the national health insurance individual account had accumulated 615.2 billion yuan.At present,there is no unified institutional arrangement on how to effectively release huge precipitation funds.The basic medical insurance system for urban employees has been launched in city A since2001,and the individual account system for medical insurance has also been launched simultaneously.With the development of personal account system,great achievements have been made,but some problems have also been exposed,such as large capital accumulation,poor mutual aid and capital abuse.Based on the problems existing in the operation of the basic medical treatment insurance individual account system,the author has carried out detailed research.This paper consists of six sections:The first part is the introduction,which mainly introduces the current situation,that A city's urban workers' basic medical insurance pooling fund is tight,the individual medical insurance account transfer proportion is high and the amount is large.It will weaken the mutual action of health insurance fund,which is the background of this article.In the past,scholars at home and abroad have argued about the meaning of the existence of individual medical insurance accounts,but in recent years,domestic scholars have generally recognized that there are problems in the policy of individual medical insurance accounts.This paper chooses A city as the research object,and uses literature research,comparative research,questionnaire research and other research methods to explore effective solutions to the policy problems of individual medical insurance accounts in A city.The second part explains the basic concepts of social medical insurance and individual account design,and summarizes the basic research theories of Pareto optimality,equity and efficiency,and public goods.The third part studies that in 2016,the proportion of individual medical insurance accounts of urban employees in A city was 45.2%,and the per capita personal account balance was about1228 yuan.The medical insurance department of A city has made some attempts to improve the policy of individual medical insurance account.For example,,the reform of allowing the use of individual medical insurance account funds to purchase commercial health insurance was carried out in 2017,and more than 200,000 people participated in it,achieving good results.To clear up the true feelings of workers in A city on the policy of medical insurance personal accounts,this article carried out a survey on the policy awareness and satisfaction of individual medical insurance accounts,in the lobby of the commercial bank,public service hall and the park.More than 400 questionnaires were distributed in the survey,and many charts were made by processing the survey data with the Excel tool.The fourth part of the study finds that in the operation of individual medical insurance accounts in A city,there are problems such as low efficiency of use of funds,low level of accumulation on the whole,misuse of funds,narrow channels for maintaining and increasing value,deviation in policy cognition and low degree of policy satisfaction.Through analysis,the author finds out the reasons for the problems: insufficient policy design of individual medical insurance accounts,insufficient supervision of medical insurance departments,insufficient policy publicity and so on.In the fifth part,by enumerating the policies of individual medical insurance accounts in Beijing,Shanghai,guangzhou,dalian,Qingdao,suzhou,zhenjiang and other places,the author works out some useful experiences,such as establishing the hierarchical management system of individual medical insurance accounts,innovating the way of supervision,continuing to expand the scope of use,and strengthening the guidance of policy publicity.The sixth part puts forward the adjustment policy of medical insurance personal accounts of three kinds of schemes,which is not one-sided pursuit of reform of the immediate,but stress that individual account transfer total and per capita standard before and after the policy adjustments to maintain basic balance,and then through the new scheme continues to perform total compression medical insurance personal account funds allocating year by year,and to increase the number of pooling funds.Based on the data of medical insurance individual account in A city in 2017,the data is calculated and compared to analyze the advantages and disadvantages of the three schemes.In addition,it is suggested to strengthen the connection between individualmedical insurance accounts and commercial health insurance,continue to promote the use of social security cards,strengthen supervision and expand the general out-patient coordination of medical insurance.In a word,through the analysis of real data and the field survey of insured workers,this paper studies the problems existing in the operation of personal accounts of medical insurance for urban workers in A city.By using the theory of pareto optimality,this paper studies how to reduce the proportion of individual medical insurance account funds in the insured workers of low age and how to increase the proportion of individual medical insurance account funds in the insured workers of high age,so as to optimize the overall utilization efficiency of individual medical insurance account funds.Based on the successful experience of the leading cities in the reform of individual medical insurance account,the author puts forward some suggestions,such as innovating the supervision mode,expanding the overall planning of outpatient service,allowing the use of individual account funds to buy fitness cards and health care and recuperation services.Finally,it is expected that the research of this paper can also provide reference for solving the problem of personal account of medical insurance in similar cities.