大病补充保险该由谁做:商业保险和社会医疗保险的博弈

Responsibility for the supplementary insurance:gaming between commercial insurance and social medical insurance

目的:通过对比宁夏回族自治区商业保险公司和社会医疗保险部门经营大病补充保险的成本,发现更适合宁夏地区的实施方案。方法:采用访谈、专家咨询及文献分析的方法进行数据收集及方案论证。结果:宁夏地区人口少,若实现大病保险全覆盖,商业保险公司经营大病补充保险投入的成本较高,但服务利用率较低,资源浪费。医保部门经营大病保险相对节约成本,且服务效率高。结论:宁夏地区可在国家政策基础上根据自身的地区特点,制定出适宜本地区发展的方案。

Objective To compare the cost of commercial insurance company and social medical insurance department, and obtain suitable scheme in Ningxia. Methods Data was collected with interview, expert consultation and literature analysis. Results Fewer population in Ningxia will result in higher cost but lower utilization for commercial insurance companies in operation of sup- plementary insurance. But it is on the contrary for the social medical insurance departments. Conclusion Based on national policy, scheme suitable for Ningxia can be developed according to its own regional characteristics.