The Historical Inevitability of Integrating Critical Illness Insurance into Basic Medical Insurance for Urban and Rural Residents
The reimbursement policy for significant expenses due to severe illnesses under the New Rural Cooperative Medical Scheme(NCMS),initiated in 2009,evolved into a critical illness insurance scheme for urban and rural residents(referred to as"critical illness insurance")in 2012.This scheme operates independently from basic medical insurance,despite sharing common objectives and funding sources.Managed by commercial insurance companies,critical illness insurance is positioned as a supplementary counterpart to employee mutual insurance,creating a structure of a"two-tiered system with the same funding source."This paper analyzes the theoretical and practical challenges of critical illness insurance,which creates a split in basic medical insurance for residents,and asserts that it leads to losses in both fairness and efficiency.This misalignment contradicts the values of social insurance and the intended goals of critical illness insurance.The article underscores the limitations of the"limited government and efficient market"paradigm in medical insurance and advocates for high-cost guarantee policies integrated within the basic medical insurance system at the current stage.Considering the requirements of fair,unified,and efficient medical insurance,the article posits that the integration of critical illness insurance into the basic medical insurance system is inevitable from both a theoretical and historical perspective.
basic medical insurance for residentscritical illness insurancecritical illness policyfair medical insurancefee rateexpenditure-based revenue
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维普
