商业保险公司承办城乡居民大病保险现状研究

Study on the current situation of commercial insurance companies undertaking serious illness insurance for urban and rural residents

根据政府与保险公司业务结合的紧密程度不同,经办类型分成四种,将商业保险公司在经办工作中的作用主要为弥补人员不足、协助医疗控费和分担资金风险。分析认为,不同商业保险公司参与业务程度不同,在经办工作中处于被动和从属地位,专业优势没有发挥出来;社保信息系统"碎片化"现象明显、数据共享性较差;城乡居民大病保险属于基本医疗保险,目前商业保险公司参与大病保险经办的效果不好。

According to the situation of the investigation area and the different close degree of the combination of government and insurance company, the operation type is divided into four types, and the function of the commercial insurance company in the operation work can be attributed to making up for the shortage of personnel, assisting medical control and sharing the risk of capital. The results showed that different commercial insurance companies participate in different degree of business, they are in a passive and subordinate position in the operation work,and their professional advantages have not been brought into full play. The phenomenon of fragmentation of social security information system is obvious, and the data sharing is poor. The urban and rural residents＇ serious illness insurance belongs to the basic medical insurance, and the effect of commercial insurance companies undertaking serious illness insurance is not good.