基于AHP-SWOT的我国商业保险参与大病保险制度研究

Research on the Participation of Commercial Insurance in Critical Illness Insurance System in China Based on AHP-SWOT

2012年1月1日,国家发改委等6部委联合下发《关于开展城乡居民大病保险工作的指导意见》,明确提出由商业保险公司经办,共同减轻城乡居民的大病负担。2019年12月30日,由银保监会牵头制定的《关于促进社会服务领域商业保险发展的意见》经国务院常务会议审议通过,提出进一步支持商业保险机构参与医保服务和医保控费,致力于完善大病保险运行监管机制。由此可见,推进商业保险发挥社会责任,鼓励其积极参与医疗保障工作已成为必然趋势。但是,在实践中关于大病保险普遍亏损的言论也一直存在,商业保险参与大病保险制度究竟是机遇还是挑战亟需定论。

On January 1st,2012,six ministries and commissions,including the National Development and Reform Commission,jointly issued the guiding opinions on carrying out the work of critical illness insurance for urban and rural residents,which clearly proposed that commercial insurance companies should be responsible for the work to jointly reduce the burden of critical illness for urban and rural residents.On December 30,2019,the opinions on promoting the development of commercial insurance in the field of social services led by the China Banking and Insurance Regulatory Commission was deliberated and approved by the executive meeting of the State Council,which further supported the participation of commercial insurance institutions in medical insurance services and medical insurance control fees,and committed to improving the supervision mechanism for the operation of critical illness insurance.It can be seen that the participation of commercial insurance in the construction of social security system has become an inevitable trend potential.But in practice,there have been many opinions about the general loss of critical illness insurance.Whether commercial insurance participates in critical illness insurance system is an opportunity or a challenge needs to be determined.