法国广覆盖的商业健康保险实施经验及启示

Experience and Enlightenment from the Implementation of Commercial Health Insurance with Wide Coverage in France

目的:总结法国以社会医疗保险为主的商业健康保险发展经验,为我国社会医疗保险环境下的商业健康保险发展提出建议。方法:采用文献研究法,梳理法国商业健康保险的运行机制,总结其运行经验与特点。结果:法国商业健康保险覆盖率高,与法定医疗保险的福利待遇衔接紧密,监管制度规范,运行效果良好。结论:我国应不断提升商业健康保险覆盖率,设定基础保障水平,推动商业健康保险多元化发展,并在未来继续促进普惠型商业医疗保险规范化发展,以应对和解决我国商业健康保险面临的一系列挑战。

Objective:The paper summarizes the experience of commercial health insurance development in France,mainly based on social medical insurance,to offer recommendations for the development of commercial health insurance in the context of social medical insurance in China.Method:The paper utilizes the method of literature review to analyze the operational mechanisms of commercial health insurance in France and summarize its operational experience and characteristics.Results:French commercial health insurance has a high rate of coverage,which is closely integrated with statutory health insurance benefits,and operates under a well-regulated system with positive outcomes.Conclusion:China should enhance the coverage rate of commercial health insurance,set basic guarantee level,promote diversified development of commercial health insurance,and continue to promote the standardized development of inclusive commercial health insurance to cope with various challenges in the sector of commercial health insurance.