吉林省新农合医疗大病补充保险合作模式研究

发布时间：2018-02-27 12:30

本文关键词： 大病医疗保险新农合人保财产保险管理模式　出处：《吉林大学》2014年硕士论文　论文类型：学位论文

【摘要】：2008年10月，国家发改委发布了《关于深化医疗卫生体制改革的意见（征求意见稿）》该稿为国家未来20年的医疗保障制度的总体发展方向提供了政策性指南，2012年经过国家六部委批准后，《关于开展参合农民大病保险工作的知道意见》（发改社会[2012]2605号）正式下发全国开始实施。对于商业保险机构来讲，首次迎来了可以经办“各类医疗保障服务”的政策“放闸”，拓宽了保险公司的业务领域，给那些“具有资质”的保险公司带来了广阔的发展空间。新农合医疗补充保险是对新农合制度的完善和补充，也是一项体现政府责任的惠民政策，在参与经营管理的过程中，商业保险公司必将承担一定的经营风险，如道德风险、政策波动风险、医疗费用快速增长、运营成本控制等潜在的风险，如何在生产经营活动中规避潜在风险，又能服务好参保客户，这一点非常重要也同样值得研究。本文试图通过文献分析法、案例分析法、比较分析法，以吉林省人保财险股份有限公司新农合大病医疗互助补充保险为例，，尝试探索新农合大病医疗互助补充保险委托商业保险公司经办模式选择及其实施过程，从理论分析和国内大病医疗互助补充保险委托保险公司经办模式选择及实施过程研究外实践入手，为吉林省新农合大病医疗互助补充保险委托保险公司经办提供理论和经验支撑，探寻出新农合大病医疗互助补充保险经办过程存在的问题,提出有必要引入市场机制由保险公司经办，并对新农合大病医疗互助补充保险经办模式选择和实施过程提供了可供参考的建议。
[Abstract]:October 2008, The National Development and Reform Commission issued the "opinions on deepening the Reform of the Medical and Health system (draft for opinions)", which provides a policy guide for the overall development direction of the country's medical security system in the next 20 years. In 2012, it passed through six ministries of the country. After the approval of the CPC Committee, "opinions on the implementation of the insurance work of participating in and cooperating with farmers' serious illness" (Development and Reform Society [2012] 2605) were officially launched nationwide. For commercial insurance institutions, For the first time, it ushered in the policy of "opening gates" that can handle "all kinds of medical security services," and broadened the scope of business of insurance companies. It has brought vast development space to those "qualified" insurance companies. The new rural cooperative medical supplementary insurance is a perfect and complementary policy for the new rural cooperative medical system, and it is also a beneficial policy to reflect the responsibility of the government. In the process of participating in the operation and management, the new rural cooperative medical supplementary insurance is also a policy for the benefit of the people, and in the process of participating in the management, Commercial insurance companies are bound to bear certain risks, such as moral hazard, policy fluctuation risk, rapid growth of medical expenses, operation cost control and other potential risks, how to avoid potential risks in production and operation activities, This is very important and also worth studying. This paper attempts to use literature analysis, case analysis, comparative analysis, Taking the supplementary medical mutual insurance of New Rural Cooperative Medical Assistance of Jilin PICC property Insurance Co., Ltd., as an example, this paper attempts to explore the selection of the mode of operation and the implementation process of the medical mutual medical mutual aid supplementary insurance for NCMS, which is entrusted to commercial insurance companies. Starting with the theoretical analysis and the practice outside the study of the mode selection and the implementation process of the commissioned insurance company for the supplementary medical insurance for serious illness in China, To provide theoretical and empirical support for the commissioning of medical mutual aid insurance for new rural cooperative medical assistance in Jilin Province, and to explore the problems existing in the process of handling supplementary medical insurance for new rural cooperative medical assistance in Jilin Province. It is necessary to introduce the market mechanism to be run by the insurance company, and some suggestions are provided for the selection and implementation of the mode of supplementary medical insurance administration for NCMS.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：F842.684;F323.89;R197.1

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