| As a basic social security system,birth insurance and insurance of basic medical treatment are the basis for guaranteeing the basic survival and living needs of the whole people.They also play an extremely important role in maintaining social stability.Under the background of releasing two or even three children,it is more important to improve the maternity insurance policy.Both maternity and basic medical treatment occur in medical institutions.There must be medical behavior in the process of fertility behavior,and the two are staggered.Maternity insurance and basic medical insurance is also related in the collection and reimbursement process.Birth insurance must involve basic medical insurance.Therefore,the implementation of the combination of maternity insurance and basic medical insurance(hereinafter referred to as "the combination of two insurances")is worth discussing.In the 13 th Five-Year Plan of China in 2016,the merger of the two insurance schemes was proposed for the first time.And the amalgamation of these two systems,is not to mean birth insurance disappears from now on,however as the sub-item risk of insurance of primary medical treatment is planted existence.On January 19,2017,The General Office of the State Council officially issued a document,suggesting that in 12 cities to carry out the merger of the two insurance pilot,after the implementation of the pilot,expand the coverage of maternity insurance,enhance mutual fund capacity,improve the level of supervision,improve the level of services,treatment is more convenient,to achieve the expected goal,applicable to the national push.After two years of pilot and achieved certain results,the implementation of the merger of China's two insurance officially opened.This paper uses the methods of literature research,comparative analysis,case analysis and interview to study the problems and Countermeasures in the implementation of the merger of two insurance companies.Firstly,taking W City as an example,this paper observes the results of optimizing handling and standardizing guarantee in the implementation of the merger of two insurances;Secondly,by comparing the relevant policies and data before and after the implementation of the merger of the two insurances,this paper analyzes the changes in the number of participants,fund revenue and expenditure before and after the merger of the two insurances,as well as the problems in the implementation of the merger of the two insurances,such as different fund collection and payment standards,different treatment levels,insufficient comprehensive handling capacity,etc;Then,using the system management theory,management coordination theory and other related theories,this paper analyzes the causes of the problems,such as the low level of medical insurance overall planning,unscientific collection mode,inconsistent treatment policies and so on;In addition,combined with the excellent experience of other cities,such as Dongguan's experience in improving the efficiency of collaborative management,establishing the fund co-ordination mechanism,Taizhou's experience in expanding and improving the treatment level and innovating the intelligent monitoring mode;Finally,the analysis draws a conclusion,and puts forward some suggestions and countermeasures on the application of system management,enhancing synergy and realizing sustainable development in the implementation of the merger of the two insurances,such as gradually expanding the coverage and unifying the fund collection standard;Unify the payment standards of the two insurances and appropriately improve the treatment level;Integrate and optimize handling resources and improve comprehensive service capacity;Rely on multi-channel technical means to enhance people's sense of experience;Implement the fund management responsibility and increase the mutual aid ability of the fund;Strengthen multi-party supervision and management to ensure the safety of medical insurance funds. |
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