医改形势下商业保险经营定位和发展要求

Marketing Positioning and Requirements for Commercial Insurance Business under the Situation of Healthcare Reform

我国医疗保障体系在制度框架、保障形式、保障程度等方面还存在一些不足。国家已经出台了一系列鼓励和支持发展多层次、多样化健康保险的政策意见。在这一背景下,商业健康保险应成为基本医保委托管理、大病保险及其他补充医疗保险重要供应商、基本医保以外的其他健康保险主要供应商,同时注重提供综合性健康服务。商业健康保险在业务规模、服务人群、服务模式等方面已经取得了突出成绩,但还应当进一步明确其角色定位,强化多方合作、优势互补,丰富产品、提高能力、完善政策、规范市场。

There are deficiencies in institutional framework, forms of protection, level of protection within the Medical Security System of China. A series of encouraging and supporting policy and advices have been published to encourage and support the development of multi-level, diversified health insurance. Under this background, commercial health insurance should become the major supplier of the basic health care management, catastrophic illness and other supplementary medical insurance; major supplier of health insurances other than the basic healthcare while focusing on providing the comprehensive health services. Commercial health insurance has made outstanding achievements in business size, client, and service model; however, it still need clarify its role, intensify multilateral cooperation, explore complementary advantages, expand products, increase capacity, improve related policies, and regulate market.