摘要
当前商业健康保险是行业发展的热点,各家寿险公司纷纷布局健康险业务,但整体来看在药品费用支付中的占比十分有限。本文选取了典型商业险模式的美国、全民医保模式的英国和典型社会保险模式的德国作为研究对象,通过分析其商业健康保险在药品费用支付中的作用,明晰中国商业健康险的角色,提出经营策略调整方向、建立控费机制、与医疗服务体系及药品流通体系整合等建议。
At present,commercial health insurance is a hotspot in the development of the industry,and various life insurance companies have laid out health insurance businesses,but the overall proportion of pharmaceutical insurance payments is very limited.This article selects the typical commercial insurance model in the United States,the universal health insurance model in the United Kingdom,and the typical social insurance model in Germany as the research objects.By analyzing the role of commercial health insurance in the payment of pharmaceutical costs,it clarifies the role of commercial health insurance in China and proposes suggestions on strategy adjustment,establishment of fee control mechanism,and integration with medical service system and drug circulation system.
作者
贾宇飞
于保荣
JIAYu-fei;YU Bao-rong(School of Insurance and Economics,University of International Business and Economics,Beijing 100029,China;不详)
基金
中国发展研究基金会资助课题“国家医保药品目录在中国的实施”系列课题之“专题5:商业健康保险在医疗和药品费用补偿中的作用”。
关键词
商业健康保险
药品费用支付
国际经验
commercial health insurance
payment of pharmaceutical costs
international experience
