惠民保治理模式的推进机制与经验启示

The Promotion Mechanism and Experience Enlightenment of the City-Customized Commercial Health Insurance Governance Model

近年来,各地惠民保的发展质量一般,无法满足群众的医疗保障需求。本文以浙江省L市实践为例,深入探讨惠民保治理模式的推进机制与经验启示,从价值、支持与能力三个维度分析L市惠民保的成功要素。研究发现,惠民保的成功不仅在于政府、民众与商保公司的价值共识,还依赖于制度与技术的双重驱动。L市充分发挥政府对市场的宏观调控作用,找准商业保险和基本医保的结合点,实现医保制度的“小切口、大改革”,为有效改善群众“看病贵”“因病返贫”问题提供现实和理论参考。

In recent years,the low-quality development of city-customized commercial health insurance cannot meet the healthcare security needs of the masses.Taking the practice of City L in Zhejiang Province as an example,this paper discusses the promotion mechanism and experience enlightenment of the governance model of city-customized commercial health insurance,and analyzes the success factors of city-customized commercial health insurance in City L from three dimensions of value,support and capacity.The study finds that the success of city-customized commercial health insurance not only lies in the value consensus of the government,the public and commercial insurance companies,but also depends on the dual drive of system and technology.City L gives full play to the government's role in regulating the market,finds the combination of commercial insurance and basic medical insurance,realizes the"small incision,big reform"of the healthcare security system,and provides practical and theoretical reference for effectively improving the problem of expensive medical treatment and returning to poverty due to illness.