Research On Optimization Of Insurance Compensation Plan For Serious Illnesses Of Urban And Rural Residents

The aim of this paper is to improve the precision of the compensation scheme of the serious illness insurance in order to perfect the development of our country's serious illness insurance system.Due to a serious illness insurance starting line in most regions in urban disposable income or net income of rural residents,who cannot enjoy the treatment of the poor but People with low income left out of a serious illness insurance system.besides,because our country is based on individual ginseng protects the unit,and the guarantee of a serious illness insurance system goal is to prevent family catastrophic health expenditure,there will be in a number of family members in the family,the individual has not been able to enjoy a serious illness insurance but family has the phenomenon of catastrophic health care costs.Therefore,based on the precision of the compensation scheme and the requirement of taking the family as the guarantee unit,this paper intends to establish the compensation scheme for major diseases by the way of age and income stratification and reduce the medical expenses burden of urban and rural residents by simulating the implementation of the family cost-sharing policy.First of all,this paper defines the basic concept of major disease insurance and introduces the related theories of major disease insurance.Secondly,it summarizes and analyzes the compensation scheme for major diseases implemented in various regions of China.The compensation scheme is divided into interval equal compensation mode,interval incremental compensation mode,single closed interval compensation mode and fixed proportion compensation mode.Then it introduces the compensation scheme of major diseases insurance in Singapore,Japan and Mexico,which can be used for reference.serious illness insurance compensation based on different pattern,represented by Beijing,Gansu province and Shandong province,the CFPS(China Family Panel Studies)in the database of three provinces,the combination of three serious illness insurance policy,for different compensation modes of a serious illness insurance compensation scheme based on a serious illness insurance compensation scheme,layering income compensation scheme and the age and income compensation scheme,according to the three kinds of schemes to Family probability catastrophic health care costs,the average gap and relative gap is calculated and compared.Analysis results show that no matter what a serious illness insurance compensation scheme can effectively reduce the severity of the family's catastrophic health expenditure,Although age and income stratification compensation scheme is likely to increase the probability of catastrophic health care costs in higher income family,did not increase the severity of the family's catastrophic health spending.In addition,the age and income stratification compensation scheme has a greater effect on the refinement of the single-closed interval and interval equipartition compensation model and a smaller effect on the interval incremental compensation model.In order to make the compensation scheme more equitable,this paper takes Beijing as an example to simulate the implementation of family budget policy under the implementation of age and income stratification scheme.The analysis results show that the family budget policy can make the catastrophic medical expenditure of families suffer obvious rationalization and effectively reduce the intensity of catastrophic medical expenditure of multi-member families.Finally,this paper uses the linear exponential smoothing method estimation of Beijing residents hospitalized rate and 2017-2017 per capita hospitalization cost,based on the surplus process model,serious illness insurance fund in Beijing over the next 11 years of serious illness insurance for the prediction analysis,prediction results show that the age and income stratification compensation plan of fund utilization is superior to the basis of a serious illness insurance compensation.Although the stratified age and income compensation scheme will increase the expenditure of the serious illness insurance fund compared with the basic scheme,the serious illness insurance fund will still be able to balance the operation in the forecast period.Therefore,the stratified compensation scheme of age and income has the applicability and feasibility of implementation.In order to further improve the accuracy of China's major disease insurance compensation scheme,the stratified compensation scheme of age and income should be implemented as soon as possible.