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A Comparative Study on the Medical Insurance of Beijing,Tianjin and Shanghai

Author: ZhengCanBiao
Tutor: ShiMeiZuo
School: Beijing Jiaotong University
Course: Social Security
Keywords: Beijing Tianjin and Shanghai Medical insurance ComparativeStudy
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Type: Master's thesis
Year: 2014
Downloads: 72
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Abstract


In the late1990s, China began to carry out the basic medical insurance system reform and new rural cooperative medical system was put into effect in the rural areas in2003; in2007China began to carry out urban residents (non-employees) basic medical insurance system pilot. At present, three systems have obtained important achievements. Initial formation of urban and rural residents will be fully integrated into the medical insurance network structure pattern. However, due to the imbalance of economic development, there is a big gap between urban and rural residents of Medicare benefits as well as treatment of health care disparities between different area residents. Moreover, even in the same area, the residents of the different forms of employment groups have different health care treatment. How to establish a both fairness and efficiency of medical insurance system on the basis of the situation of our country? It has been an important task to the current medical insurance system in China.This paper mainly uses the literature law, content analysis, comparative analysis and other methods, take Beijing, Tianjin and Shanghai as the breakthrough point, analyzes the differences between the three cities’ medical insurance mode and development, at the same time, take the basic medical insurance for urban employees, basic medical insurance for urban residents and the new rural cooperative medical system for the category, To cover the crowd, ginseng protect the status quo, financing mechanisms and standard, to ensure treatment four aspects to comparativly analyse the dimensions of three cities’medical insurance. With data and theoretical support of the existing problems in the Beijing and tianjin, Shanghai medical insurance:clinic flow unreasonable, urban and rural medical insurance system is still a lack of cohesion, fund balance rate is higher than the rationalization level and orgnaization of medical insurance management ability to ascend. Through in-depth study found that medical insurance payment is not reasonable, the resident’s doctor thought is blind; Urban and rural health care financing gap is huge,; Medical insurance fund payment mechanism too cautious, the public to enjoy health care treatment is generally low; Orgnaization of agency of insurance management is not unified, the existing staff compiled flexibility is poor; The functions of the government does not reach the designated position, insufficient financial input are all the cause of the problem. In to explore the causes of these problems, on the basis of summarizing the medical insurance in the process of implementation of the Beijing, Tianjin and Shanghai’s useful experience, and at the same time, combined with the four major medical insurance mode of our country abroad experience, put forward the following suggestions:improve the medical insurance payment methods, link different health care system mechanism, increase the supervision of medical insurance fund, orgnaization of insurance of primary medical treatment of proper introduction of market mechanisms, and governments at all levels clearly positioning to build optimization countermeasures of medical insurance system.

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