发展衔接基本医保商业健康保险:国际做法与启示
The Development Convergence of Private Health Insurance in Basic Medical Insurance:International Practices and Implications
王嘉韵 1王力男 1朱碧帆 1金春林1
作者信息
- 1. 上海市卫生和健康发展研究中心(上海市医学科学技术情报研究所) 上海 200040
- 折叠
摘要
商业健康保险是我国多层次医疗保障制度体系的重要组成部分,通过补充和衔接基本医疗保险,以满足人们多层次、多样化的健康需求.文章旨在借鉴典型国家的实践经验,为我国发展与基本医保衔接互补的商业健康保险(以下简称商保)提供参考.依据各国医疗保障制度模式以及商保的功能定位差异,选取法国、德国、澳大利亚、英国、美国5个国家为借鉴对象,梳理5国商保的宏观制度体系、覆盖人群、保障内容(福利包)、与医疗和医药的协同特点、配套监管举措等政策法规,并总结相关经验.立足国情提出下列启示:完善制度体系建设,丰富产品供给,扩大商保投保人群,探索制订商保保障清单,细化配套监管政策等.
Abstract
Private health insurance(PHI)is an important component of China's multi-tiered medical security system,meeting people's multi-level and diversified health needs through supplementing and connecting with the basic medical insurance(BMI).It aims to draw on the practical experience of typical countries to provide implications for developing PHI that complements BMI in China.Considering the different models of medical security systems in various countries and the diverse functional positioning of PHI,France,Germany,Australia,the United Kingdom,and the United States are selected as reference objects.After examining the macro institutional systems of PHI,coverage population,benefits packages,characteristics of coordination with health care and medicines,as well as supporting regulatory measures,the experiences are summarized.Based on China's context,it proposes to improve institutional system building,enrich product supply,expand the insured population,explore the coverage list formulation,and refine supporting regulatory policies.
关键词
商业健康保险/医疗保障体系/国际经验/政策启示Key words
private health insurance/medical security system/international experience/policy implication引用本文复制引用
基金项目
上海市"科技创新行动计划"软科学研究项目(23692109000)
上海市发展和改革委员会委托项目(20230701)
出版年
2024
NETL
NSTL
万方数据