普惠型医疗保险发展:实践困境与优化方向

近年来,普惠型医疗保险成为多层次医疗保障体系发展的一大热点。文章首先介绍了中国普惠型医疗保险的发展现状及主要特点,其次通过对国内部分保险公司线上及线下调研,发现当前普惠型医疗保险发展面临配套法律法规有待健全、市场认可度普遍偏低、可持续经营能力不强、保险效果低水平重复、相关主体联动不足等困境。进一步分析美国、英国、德国、新加坡相关经验,提出具体的优化路径:以优化顶层设计为立足点,提高保险规制水平;以强化市场环境建设为切入点,提升市场认可度;以优化运行模式为突破点,激发保险生命力;以设计差异化产品为关键点,强化保险增补性;以建立联通机制为动力点,提高相关主体协同度。

The Development of Inclusive Medical Insurance:Practical Dilemma and Optimization Direction

In recent years, inclusive medical insurance has become a hot spot in the development of multilevel medical security system. Firstly, this article introduces the development status and main characteristics of inclusive medical insurance in China. Through the online and offline research of some domestic insurance companies, it is found that the current development of inclusive medical insurance faces many difficulties, such as imperfect supporting laws and regulations, generally low market recognition, weak sustainable operation ability, low-level duplication of insurance effect, insufficient linkage of relevant subjects and so on. Further through analyzing the relevant experience of the United States, the United Kingdom, Germany, and Singapore, this article proposes specific optimization paths, that is, taking optimized top-level designs as a foothold to improve the level of insurance regulation, taking strengthened market environment construction as the entry point to increase market recognition,taking optimized operation modes as a breakthrough point to stimulate the vitality of insurance, taking designed differentiated products as the key point to strengthen insurance supplementary, and taking established linkage mechanisms as the driving force to improve the coordination of relevant entities.