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Study on Health Insurance Regulation System Evaluation of Health Insurance Regulation in Wuhan

Author: LiaoPiPi
Tutor: XiongGuangLian
School: Huazhong University of Science and Technology
Course: Public Health
Keywords: Health insurance regulation ma rket government system
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Type: Master's thesis
Year: 2013
Downloads: 25
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Abstract


Objective:With10years building of the health insurance system in China, we slowly formed a health insurance regulation pattern. There are many problems in the regulation system including low legislative level,inadequate supervision in diversity local practices,shortage of hardware and software in system and supervision system can not go with insurance payment system reform.We should construct a comprehensive health insurance system and make sure the system can adapt the reform of health insurance and can supply an objective and fair management. After that,we can improve the quality of medical service,promote the fund allocation efficiency and increase the sustainability and equity of the fund.Methods:This article information is mainly from Chinese databases as CNKI, WangFang database et. and foreign databases as PubMed and WHO library et. I grasped condition of health insurance regulation development and learned relation knowledge about economics, sociology and health insurances et. On the base of those studies,I collected documents and data about health insurance regulation in Wuhan health insurance management center. I used Excel and SPSS19.0to analysis data and evaluation Wuhan city medical insurance regulatory situation.Results:There are four foreign countries is more typical in health insurance regulation. Britain implemented internal market competition mechanism and used the third-part to monitor the internal market.German implemented self-management in each health insurance companies and used worker union to monitor the system in the base of negotiation mechanism,.France implemented SHI and VHI in insurance system and regulated in different ways. The Netherlands implemented a internal market mechanism and formed a managed competitive health insurance insurance regulation. Foreign health insurance systems always have a complete medical insurance regulation system, governments and insurance companies have a clearly function, the regulation index system is always clear and definite and the third-party management are widely used.When it comes to Wuhan health insurance evolution,I assess it through fund management,service management and agency management in fairness,efficiency,quality and sustainability. The light point in Wuhan health insurance including formulated a series of local regulatory documents,classified regulations combined with Wuhan real situation and strengthen the supervision on institutions. And the insufficient in Wuhan health insurance including system construction is imperfect, the lack of certain indicators, the insufficient funds supervision, the low leave in allocation efficiency,the lack of quality supervision,poor evaluation feedback mechanism establishment and the low level in supervisions et..Conclusion:In future development,we can take examples in foreign health insurance system practices and reconstruct ourself health insurance regulation system. Firstly,we should construct the framework of health insurance regulation,specific health insurance regulatory process and perfect the index system of health insurance.secondly,we can do from now to strengthen legislation in health insurance regulation,improve health insurance plan as a whole level, to improve regulatory efficiency, developed the quality of medical service through regulation and constructed supervision feedback system et.

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