南通市城乡居民补充医疗保险:问题、根源与对策

Urban and Rural Resident Supplemental Medical Insurance of Nantong:Problems、Causes and Countermeasures

南通市在推动基本医疗保险全面发展的基础上大力发展补充医疗保险,不仅优化和完善了南通市的居民医疗保障体系,同时也有效缓解了老百姓的“看病难、看病贵”问题。但调查发现,南通市现行补充医疗保险在覆盖范围、理赔流程、管理运行、保障水平等方面还存在诸多问题。本文在分析导致上述问题的根源并借鉴国内相关实践经验的基础上,从明确供给定位、培养专业人才、强化监管职能、拓宽筹资渠道及推动机构发展等方面,提出助推补充医疗保险高质量发展的若干对策建议。

Nantong City vigorously develops supplementary medical insurance on the basis of promoting the comprehensive develop⁃ment of basic medical insurance.This not only optimizes and improves the medical security system of Nantong residents,but also effec⁃tively alleviates the problem of“difficult and expensive medical treatment”.However,the survey found that there are still many prob⁃lems in the coverage,claims process,management and operation,security level and other aspects of Nantong's current supplementary medical insurance.Therefore,on the basis of analyzing the causes of the above problems and referring to the relevant domestic practi⁃cal experience,this paper puts forward some countermeasures and suggestions to promote the high-quality development of supplemen⁃tary medical insurance from the aspects of clear supply orientation,training professional talents,strengthening supervision function,broadening financing channels and promoting the development of institutions.