Study On Operational Mechanism Of Major Illness Insurance For Residents Both In Rural And Urban Areas In Shanghai

After more than ten years of reform and development,Medical security system has made outstanding achievements in Shanghai.With the basic medical insurance as the main system,other forms of supplementary medical insurance and commercial insurance supplement,covering urban and rural residents of multi-level medical security system has been initially established。But from of all,the current security level is still relatively low,which don’t have strong ability to withstand the risk of major illness,personal catastrophic medical expenses is still quite heavy,especially the lack of a stable source of income of urban and rural residents,once encounter on major diseases,tend to fall into poverty,so there is an urgent need to establish urban and rural residents a serious illness insurance system.Chinese Development and Reform Commission jointly issued the six departments on the development of urban and rural residents to carry out a major illness insurance work guidance.Major illness insurance in the country gradually expanded,and initially formed a Taicang model,Zhanjiang model,which provides a certain experience for the development of Shanghai urban and rural residents illness insurance.However,major illness insurance as an innovative project in the implementation process,there are still many problems.This research from the financing mechanism,compensation mechanism and fund operation mechanism research the urban and rural residents major illness insurance present situation in Shanghai,Through the theory and policy,quantitative and qualitative combined analysis of Shanghai urban and rural residents a serious illness insurance positioning and in a serious illness insurance provision and operation of the important rules and system of introducing the theory of public goods and public choice theory,economics theory,at the same time,using the system engineering of quantitative analysis method,carries on the analysis to the Shanghai urban and rural residents a major illness insurance operating mechanism and its present problems.I will focus on solving the problem of major illness compensation currently in Shanghai,the carrying capacity of funds and risk sharing mechanism of urban and rural residents major illness insurance fund.Through the urban and rural residents major illness insurance system convergence,clear its development orientation and establish a reasonable compensation model for serious illness insurance.Through this series of measures to further optimize the operational mechanism of urban and rural residents major illness insurance in Shanghai.