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Issues of commercial health insurance study

Author: LiHong
Tutor: AiSunZuo
School: Southwestern University of Finance and Economics
Course: Finance
Keywords: Medical Insurance Several Issues Commercial Medical Expenses Risk Factors Insurance development Commercial health insurance Demand for medical services Health care providers Risk of loss
CLC: F842.6
Type: Master's thesis
Year: 2000
Downloads: 533
Quote: 4
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Abstract

With the reform of China’s economic system deepening continuously, the tree of human diseases changing and the medical expense skyrocketing, the reform of medical protection system has become the hottest social issue concerning the broad masses of the people. Determined by the comparatively low levels of the productive forces in the primary stage of socialism, China’s social MEI is and will remain pretty limited for quite a long time. So business MEI will play an increasingly important role in the national system of medical protection. However, vicious growth of medical expense, lack of effective supervision and control on over-consumption in medical treatment and weakness of insurance companies’ tech power make the present insurance line development of China’s MEI at this stage unsatisfactory, leaving the supply of business MEI greatly incommensurate to the people’s booming demand. By dint of a detailed analysts on the risk of medical expense insurance (MEI), this paper puts forward some suggestions and solutions on the frame of the limitations of MEI, in the hope of offering the line development a valuable reference and enlightenment .The subject therein mentioned is how to conduct the line development compatible with the situation of China and extend correlated market with effective demand. This article’s essential hypothetical premise includes the continuous and steady growth national economy and the incessantly elevated income of individuals, which enhances the inhabitants’ purchasing demand for MEI; the stable <WP=8>normalization of the financial market and the increase in the investment channels for insurance fund, which will strengthen China’s life insurance companies’ solvency. This article falls into three parts as follows: The first part is the analysis of several issues relative to the research on the limitations of MEI, including "the concept of MEI", "features of health service activities" and "features of demand for MEI". The term MEI means that the insurer reimburses for the insured’s medical expense generated by accidents and sicknesses, the medical expense being the core of loss by accidents covered by MEI. Medical expense results from medical consumption, which differs from other commodity consumption due to the complexities of health service activities, such as the passivity of demand for health services, the variability of demand under the condition of reimbursement for medical expense, the monopolization character of health service suppliers, and the complexity of management. All these contribute to the medical expense’s fluctuation, which has great impact on the operation of MEI .The risk control of MEI, therefore is the behavioral control of suppliers and demanders in health service activities. Because of the universality and unexpectancy of sicknesses, and its possible economic burdens of substantive medical expense up families, the exists a huge potential demand for the <WP=9>MEI market. Whether or not it will be practically transferred to application behavior, in another word, effective demand, is to be influenced by many factors of consumers’ income levels, MEI products’ sale prices, consumer preferences, social medical protection levels and so forth. Consumers differ, so differ their demands. The discrepancy and diversity of inhabitants’ demand for MEI now, decide the polymorphism of China’s MEI. At present, the demands for MEI of China’s inhabitants are of three distinct curves, indicating that lines of different formats and sale prices must be drafted, in accordance with their price-option variances and different elasticities of demand. The second part is the risk analysis of MEI, which forms the theoretical basis of the planning of MEI’s limitations by analyzing the loss, accidents and factors of risk.Risk loss of MEI takes the form of the medical expense. Because of the monopoly feature of health service suppliers, and doctors’ clinical decision-making which determines medical expenses, apparent subjecti

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