完善我国医疗保险经办机制的思路

Strategies for the Development of Medical Insurance Management System in China

我国医疗保险制度已经覆盖全民,现有经办网络基本保障了这一制度的实施,但总体而言,医疗保险经办机制仍不成熟,还远未达到医保治理现代化的要求。基于中国特色医疗保障制度正在进入成熟、定型发展阶段的需要,医疗保险经办机制也宜按照统一性、独立性、法制化、现代化和配套化的基本思路实现新的建设与发展,为医疗保险制度的高效实施提供稳健的保障。

China’s social medical insurance has achieved universal coverage, bolstered by the existing nationwide network of insurance agencies. Yet the current medical insurance agencies and their management mechanism are not yet fully-developed, fall short of the requirement of good governance in medical insurance. As China has expedited the construction of its health care system with Chinese characteristics, it is imperative to reshape the insurance agencies and their mechanism for managing and operating medical insurance. This paper proposes some general principles for reforming China’s medical insurance agencies and their way of functioning, for the purpose of sustaining the efficient implementation of medical insurance.