Research On The Design Of The Deductible Line,reimbursement Ratio And Cap Line In The Compensation Scheme Of Basic Medical Insurance

After decades of development,China has now established a basic medical insurance system with Chinese characteristics.With the continuous expansion of population size,China’s medical consumption base has increased rapidly,and the income and expenditure of the basic medical insurance fund have shown a rapid growth trend.However,due to the aging of the population,scientific and technological progress and the increase in the cost of medical services,the increase in the expenditure of the basic medical insurance fund has become more obvious,which has brought great challenges to the balance of income and expenditure of the fund,and affected the sustainability of the operation of the basic medical insurance fund and even the social security system.In order to ensure the smooth operation of the basic medical insurance fund,this article takes the compensation plan of the basic medical insurance fund as the perspective.On the premise of the income of the basic medical insurance fund,the maximum social utility is the goal,and the reasonable compensation plan is designed as the basic compensation plan.The setting of medical insurance starting lines,ceiling lines,and compensation ratio provides a theoretical idea.This article adopts a utility model in healthy economics to give a certain weight to the effectiveness and health utility of wealth and the adaptation of a total utility,and then searches all individual utility within the social scope to obtain total social benefits.First of all,personally make decisions based on your own health status and choose the treatment cost of the greatest use of themselves.On the basis of this,the government,plus the fund collection conditions that are greater than the branch,use the numerical method to simulate through the MATLAB,so that the total social benefits can be achieved to achieve the total welfare of the social welfare to achieve the total welfare of the society.The maximum,thereby obtaining the best basic medical insurance compensation scheme.Next,compare analysis of the three dimensions,compensation ratios,and the capacity of the ceiling lines corresponding to the optimal advantages,and compared with the current policy solutions,and concluded that the basic medical insurance compensation scheme was concluded.And the sustainability of the basic medical insurance fund operation and analysis of the sustainability of the operation of the basic medical insurance fund,and found that the fund’s total welfare is at the largest level when the fund collection is slightly greater than the branch.In addition,considering the constraints in the actual situation: As policy tools allow different compensation plans to design different compensation plans for people with different income,the reimbursement expenses of high-income people are transferred to low-income people,so that low-income groups can get higher relative returns to relatively high returns We joined the reimbursement expense transfer constraint;because doctors are not perfect agents,they will choose to treat excessive treatment to increase income or reduce the risk of being charged with negligence.The display constraints in the design of basic medical insurance compensation schemes have been further analyzed.In the end,policies for improvement of the basic medical insurance system from the theoretical level.The thesis mainly puts forward the following points: the compensation ratio has the most significant impact on the use of social total efficiency.Reimbursement for medical expenses;government should have planned a planned subsidy for the medical insurance fund for a long time to achieve government functions.And give relevant policy recommendations for policy suggestions: the capline is set to more than 60 times the funding cost,or even the top line is not set;The medical insurance fund formulates long-term subsidy policies and includes subsidies into the annual fiscal budget;the re-distribution target of public policies should focus on direct transfer of individuals,rather than reimbursement by distinguishing medical expenses.The efficiency loss caused by the agency problem was reduced to less than 0.2.