摘要
中国确立了走向全民医保的医疗保障发展战略,商业健康保险在全民医保的制度框架中占有重要的地位。目前,商业健康保险依然处在初期发展阶段,在卫生筹资体系中的作用很低,其分摊民众医药费用风险的功能尚未发挥出来。因此,商业健康保险在未来的发展空间巨大。制约其发展的外部因素主要在于政府支持的力度和方式都有所不足,内部因素主要在于专业化程度不高。在国家推进新医改的背景下,商业健康保险在近期内的战略发展领域包括公共医疗保障基金的第三方管理,大病统筹保险和补充性医疗保险。商业健康保险与公共医疗保障体系建立互利互惠的公私合作伙伴关系,至关重要。
China has proposed a strategy of moving towards universal heahhcare coverage, and commercial health insurance plays an important role in its institutional framework. At present, commercial health insurance is still at an early stage of development. It plays an insignificant part in health financing in China, and fails to perform its function of spreading financial risks of medical expenses for potential enrollees. Therefore, there is tremendous space for development of commercial health insurance in China. Among the factors affecting its development are inadequate strength and modes of government support from the outside and low degree of professionalization inside of the sector. Against the background of the government＇s launching new healtheare reforms, commercial health insurance will witness strategic opportunities for development in the near future, namely, third-party management of public health insurance funds,insurance for critical illnesses, and supplemental healthcare insurance. The key is to develop a mutually beneficial public-private partnership between commercial insurers and social health insurance system.
出处
《保险研究》
CSSCI
北大核心
2009年第11期26-33,共8页
Insurance Studies
关键词
商业健康保险
基本医疗保障体系
卫生总费用
第三方管理
补充性医疗保险
commercial health insurance
basic healthcare system
total health expenditure
third-party management
supplemental healtheare insurance
