多层次医疗保障体系视角下普惠型商业健康补充保险发展路径分析

Analysis of the development path of inclusive commercial health supplementary insurance from the perspective of multi-level medical security system

目的:探究在多层次医疗保障体系视角下,提出优化我国普惠型商业健康补充保险发展路径的措施。方法:通过分析我国普惠型商业健康补充保险发展情况,梳理其产品、保险公司以及第三方管理平台情况;并基于典型地区的实践经验,剖析现存的问题。结果:目前我国普惠型商业健康补充保险正处于“井喷式”发展阶段,然而发展路径尚未成熟,仍旧存在产品服务同质化、基础风险数据缺乏、补充作用不突出的问题。结论:建议我国可采用“三步走”发展模式,优化我国普惠型商业健康补充保险的发展路径。具体可通过协调部门职责,完善配套政策及监管措施,建立医保数据共享机制,以及差异化产品设计的方式进行落实。

Objective:From the perspective of multi-level medical security system,this paper aimed at exploring the measures to optimize the development path of inclusive commercial health supplementary insurance in China.Methods:The product situation,insurance company situation and third-party management platform situation were sorted out by analyzing the inclusive commercial health supplementary insurance in China.The practices of this type of insurance in typical areas were studied,and the existing problems were analyzed.Results:At present,inclusive commercial health supplementary insurance in China is in the“blowout”development stage,but the development path is not yet mature.The analysis results showed that there are still problems such as the homogenization of products and services,lack of basic risk data,and lack of prominent complementary effects.Conclusions:It is suggested that China should adopt the“three-step”development model to optimize the inclusive commercial health supplementary insurance development path.The implementation of this policy can be achieved by coordinating the responsibilities of departments,improving the supporting policies and regulatory measures,establishing a medical insurance data sharing mechanism,and differentiating the product design.