Research On Problems And Countermeasures Of Off-site Network Settlement Of Primary Medical Insurance

Since the medical system reform launched in 1988,the medical insurance has played an important role in safeguarding the legitimate rights and interests of the labourer,adjusting income difference and reflecting social fairness,as well as in the reform of economic system,especially in state-owned enterprises reform.With the socialism with Chinese characteristics coming to a new era,people's demand on medical insurance has changed.It's urgent to speed up promoting medical insurance reform,making it keep pace with social development and technological advance and meet requirements from masses and social development in a better way.The remote medical networking settlement is a key and difficult point for recent medical insurance reform.Meanwhile,with the development of economy and society and the improvement of transportation facilities,the total transient population of China is still in a high number.The statistics showed that the transient population of China achieved 236 million in 2019.That resulted in a surging demand on remote networking settlement which had been a livelihood focus of the whole society.Opinions on deepening the reform of the medical security system issued by the Central Committee of the Communist Party of China and the State Council pointed out that to deepen the reform of medical security system,it's needed to “unify systems,improve policies,perfect mechanisms,promote services,and enhance the fairness and coordination of medical security” and “perfect the system of remote medical settlement”.It also specified to list the remote medical settlement as a critical part of medical system and mechanism reform and accelerate the promotion.The grassroots medical security department played a more important role in ensuring the policy holder have a convenient cross-regional medical treatment and precise settlement,shouldering the duty and task of managing the local public service of medical insurance.The paper focused on county-level J city as the research subject and selected three-year medical insurance datum of J city to analyzing its remote networking settlement work.By means of SWOT analysis and studying the advantages,disadvantages,opportunities and threats of J city during implementing remote networking settlement,the paper attempted to build a scientific,complete and tractable judging criteria to present a complete picture of J-city remote networking work better.Meanwhile,the paper analyzed the problems and reasons of remote networking settlement in J city deeply.Combined with the characteristics and reality of medical insurance reform,the paper proposed some targeted countermeasures,such as accelerating the top-level framework design of remote networking settlement,unifying and improving the policy of each coordination area,breaking the information obstruction of remote networking settlement,improving the handling efficiency,and expand business channels.Moreover,the paper explored the practical methods for establishing remote networking settlement of grassroots medical insurance from the perspectives of policy making,system implementation and departments coupling,further greatly improving the public service and management of grassroots medical insurance.