Study On The Medical Insurance Of Serious Diseases For Urban And Rural Residents In Heilongjiang Province

Medical security is a basic livelihood project.Since the implementation of the basic medical insurance system for urban workers in 1998,after more than 23 years of reform and development.the coverage of China’s medical security system has grown from small to large.the level of security has changed from low to high,and the management service has changed from rough to fine.A medical security system with Chinese characteristics has been gradually established.In practice,although the basic medical insurance can guarantee the basic medical level of residents,the level of insurance is relatively low,the scope of insurance is limited,the burden of medical costs borne by individuals with serious diseases is still too heavy,and it is difficult to curb the phenomenon of returning to poverty caused by serious diseases.Therefore,it is urgent to establish a serious disease medical insurance system.According to the government work report for 2020,government subsidies for serious disease medical insurance for urban and rural residents will be increased by 30 yuan per capita for basic medical insurance,of which 50 percent will be used for serious disease medical insurance for urban and rural residents.We will lower the threshold for serious illness medical insurance for both urban and rural residents.We will raise the reimbursement rate from 50%to 60%.Heilongjiang Province identified Harbin and Suihua as pilot cities for serious illness medical insurance for urban and rural residents in 2013.Heilongjiang Province implemented the serious disease medical insurance system for urban and rural residents in 2015.After several years of development,the financing level,the insured number and the insured level of the serious disease medical insurance have all been improved,but there are still problems to be solved in the operation.In order to further study of the urban and rural residents of heilongjiang province medical treatment of a serious illness insurance,on poverty cycle theory,quasi public product theory,the welfare pluralism theory and based on the theory of public service outsourcing,illustrates the importance of development of urban and rural residents medical treatment of a serious illness insurance,through the data query and thus the data collected by the questionnaire objectively illustrates the operation situation of a serious illness medical insurance of urban and rural residents in Heilongjiang province,analyses the problems existing in the system,including the fund operation instability,compensation mechanism is imperfect,underpowered commercial insurance institutions,policy awareness is not high and the lack of effective regulatory measures,etc.On this basis,the internal reasons are further explored,which are manifested in three aspects:vague system positioning,low level of system coordination and inaccurate government function positioning.At the same time,this paper introduces the development of serious disease medical insurance in Germany,Japan,Singapore and other developed countries,as well as Shanghai,Shanxi and Zhejiang provinces,and summarizes their successful experiences.Aiming at the existing problem of the urban and rural residents of Heilongjiang province serious illness medical insurance,on the basis of successful experience at home and abroad for reference,put forward to promote the urban and rural residents of Heilongjiang province the concrete scheme to the healthy development of the medical treatment of a serious illness insurance,including medical treatment of a serious illness insurance system clearly positioning,and improve the stability of the fund of insurance of medical treatment of a serious illness,perfect the compensation mechanism of medical treatment of a serious illness insurance,clearly define the positioning of the government in cooperation with commercial insurance company,strengthen supervision and improve the policy of recognition,etc.