Research On The Operation Mechanism Of Serious Disease Insurance For Urban And Rural Residents In Jilin Province

With the economic and social development and the continuous improvement of people’s living standards,urban and rural residents have a higher and higher demand for medical security.Since entering the 21 st century,China’s basic medical security system has made a breakthrough,and the basic medical insurance system has achieved comprehensive coverage.But on the whole,China’s basic medical security level is still not high,the residents of the medical economic burden is too heavy,especially serious diseases lead to the common phenomenon of people due to illness back to poverty.Therefore,in recent years,serious disease insurance has been carried out in all regions of the country.By the end of 2019,the serious disease insurance has covered 1.02 billion urban and rural residents.Based on the theory of quasi-public goods,welfare pluralism and public choice,this paper studies the operation mechanism of the critical illness insurance for urban and rural residents in Jilin Province from four aspects: financing,operation,guarantee and supervision.The study found that although the critical illness insurance for urban and rural residents in Jilin Province has made some achievements,to a certain extent,it has made up the deficiency of basic social medical insurance,and to a great extent,it has shared the economic burden of the patients with critical illness for urban and rural residents,but it is still far from the ideal state expected by the system.The main reasons are that the current financing capacity of the system is obviously insufficient,there is still irrational competition in bidding,the underwriting capacity of commercial insurance institutions is still limited,and there are still some problems in the prevention and control of medical risks.The main reasons for these problems are that the financing channels of urban and rural serious disease insurance system in Jilin Province are relatively single,the bidding management is not standardized,the principle of "cost preservation and small profit" leads to the low enthusiasm of commercial insurance institutions,and the government and the society are limited in the means and ability of medical risk supervision.In order to further improve the service level and operation efficiency of the critical illness insurance for urban and rural residents in Jilin Province,this paper puts forward some suggestions,such as broadening the financing channels of the critical illness insurance for urban and rural residents in Jilin Province,perfecting the bidding management and access and exit mechanism of commercial insurance institutions,optimizing the operation links,and strengthening the government and social supervision.The aim is to make the serious illness insurance for urban and rural residents in Jilin Province play its proper role in medical security for serious diseases.