中国商业健康保险与社会医疗保险协调发展研究

目前我国的社会医疗保险已经达到了制度上的全覆盖,几乎所有的住院病人都能够享受到医疗保险的带来的费用补偿。社会医疗保险和商业健康保险共同构成了我国的医疗保障体系,并且商业健康保险作为社会医疗保险的补充而存在。这样的情况下,商业保险如何在健康保险的市场上发挥其优势并使得我国的医疗保险机制更加完善,居民能够从医疗保险体系中得到更加全面合理的保障是值得我们研究的问题。     

商业健康保险公司介入社会医疗保险的模式及可行性分析

在我国社会结构当中,商业健康保险和社会医疗保险共同构成了我国的医疗保险体系。本文将对商保介入社保的可行性进行分析,并进一步探讨在实践中出现的三种介入方式,并提出了完善商业保险介入社会保险的几点建议,以期能够为我国医疗保险发展做出贡献。     

论商业医疗保险与社会医疗保险的契合

社会医疗保险制度改革后，对保障人们的患病需求和促进社会稳定方面发挥了重大的作用，但仍存在缺口，需要商业医疗保险作为补充。商业医疗保险具有灵活性和便利性，市场潜力巨大、运作机制专业化和市场化等优点，但也同时存在外部环境不配合、产品雷同和单一、缺乏人才、经验数据不足等障碍。章认为，应从产品创新和多样化、与医疗机构的商业化合作、加大宣传力度、吸收国外经验、规范市场与加强监管等方面不断发展和完善我国的商业医疗保险。     

我国商业健康保险发展机遇与挑战

随着我国人口老龄化不断加快,疾病谱和家庭结构发生转变,以及基本医疗保险制度和医药卫生体制改革的进一步深化,我国商业健康保险业迎来了前所未有的发展机遇.目前我国健康保险业发展相对滞后,面临的挑战主要包括:信息不对称引发道德风险;医疗数据缺乏,影响健康保险精算定价;国家医疗卫生体制对医疗机构缺乏有效制约,存在不合理用药和治疗问题,对健康保险赔付支出产生影响;金融市场波动影响保险资金运作;健康险业务经营的特殊性对人才的要求较高.提出转变经营思路,由规模导向向价值导向转变;加大产品创新力度,开发更加切合市场需求的保险产品;整合社会资源,创新业务模式的商业保险转型发展的对策建议.     

社会医疗保险与商业医疗保险的关系分析

随着社会经济的发展和不断完善,人们对医疗保障体系的要求越来越高。通过对我国社会医疗保险和商业医疗保险概念和特点的了解,分析了这两种医疗保险目前的发展状况,提出对这两种医疗保险形式应该进行有效的衔接和配合,实现互为补充和相互融合,共同促进我国医疗保险体系的不断完善和医疗保险事业的健康发展。     

湛江基本医疗保险模式解析——基于市场参与的视角

在我国新医改背景下,广东省湛江市在医疗保险制度中引入市场机制参与制度运行和管理,被外界誉为湛江模式。本文从市场参与的角度分析湛江模式取得的成绩、面临的质疑以及存在的不足。     

浅谈商业医疗保险对社会医疗保险的补充作用

随着改革开放,尤其是加入WTO打开国门之后,国民的眼界也日益开阔起来,资本主义国家在社会福利,尤其是医疗保障制度上的优势也凸显出来。为了进一步完善我国社会保障事业,进一步提高人民的生活保障质量,在国家大力提倡社会医疗保险的同时,商业医疗保险正处在一个前所未有的挑战与机遇面前。在我国现行的保险体制下,将商业医疗保险与社会医疗保险相结合,井逐步将覆盖面扩大到所有城镇劳动者,将会作为我国医疗保障制度改革的方向,并且是当前国情下,真正切实可行的方法。     

浅谈商业医疗保险对社会医疗保险体系的补充作用

发挥商业医疗保险对社会医疗保险的补充作用,把社会医疗保险没有覆盖的人群覆盖,把社会医疗保险所保项目之外的检查、治疗、服务、用药和病种充分地保障起来,由社会医疗保险和商业医疗保险共同构筑我国完整的医疗保障体系。     

商业健康保险和农村健康保障

随着农村医疗卫生系统的市场化改革和合作医疗的解体 ,农民失去了最基本的健康保障。多层次的农村健康保障体系亟待建立。商业健康保险是多层次健康保障体系中的重要支柱。目前开发农村地区对于商业健康保险的潜在需求在经济上是可行的。进一步提出了发展农村商业健康保险的建议。     

商业健康保险和农村健康保障

随着农村医疗卫生系统的市场化改革和合作医疗的解体,农民失去了最基本的健康保障.多层次的农村健康保障体系亟待建立.商业健康保险是多层次健康保障体系中的重要支柱.目前开发农村地区对于商业健康保险的潜在需求在经济上是可行的.进一步提出了发展农村商业健康保险的建议.     

Developing the evidence base of patient and public involvement in health and social care research: the case for measuring impact

While patient and public involvement (PPI) in health and social care research has progressed successfully in the last decade, a range of difficulties with the evidence base exist, including poor understanding of the concept of impact, limited theorization and an absence of quantitative impact measurement. In this paper, we argue that a paradigm change towards robust measurement of the impact of involvement in research is needed to complement qualitative explorations. We argue that service users should be collaboratively involved in the conceptualization, theorization and development of instruments to measure PPI impact. We consider the key advantages measurement would bring in strengthening the PPI evidence base through a greater understanding of what works, for whom, in what circumstances and why.     

The link between corporate social responsibility and customer loyalty: Empirical evidence from the Islamic banking industry

Increased support from customers for Islamic financial services is very important to create resilience and competitiveness in the Islamic banking industry. By highlighting certain social activities, this paper estimates the role of Islamic banks’ CSR in influencing customer loyalty, both individually and through the integrated roles of image, trust, satisfaction, and reputation. These paths explore how CSR makes customers impressed, convinced, satisfied, amazed, and ultimately loyal to Islamic banks. The empirical analysis of partial least square structural equation modeling (n = 283) has shown that CSR directly and positively impacts loyalty. Indirectly, these two aspects have an insignificant relationship through the serial roles of image-reputation and satisfaction-reputation, but significant through the single role of reputation and the serial role of trust-reputation. This study has resulted in an updated prediction model of Islamic banking customer loyalty. The practical implication lies in the importance of developing CSR to generate trust and reputation which ultimately increase customer loyalty toward Islamic banks.     

Incommensurate paradigms? Bridging the divide between technocrats and the lay public in health care planning: recent experience from Wales

The pressure on the UK National Health Service (NHS) to increase public involvement in the planning of future services has never been greater. Politicians and others argue that ‘lay wisdom’ has much to contribute, and that such involvement is essential if public confidence in the service is to be maintained. Many managers and clinicians, however, operating within an essentially technocratic paradigm, remain unconvinced. Their views are often reinforced by a lack of experience of methods for public involvement that can meet the many practical difficulties involved. Using Arnstein’s ‘ladder of citizen participation’, this paper describes the principal nuances of these two paradigms, explores the nature of the conflict between them, and assesses the extent to which they are really incommensurate. It then briefly describes some of the key methodological principles emerging from public involvement work in parts of the NHS in Wales, and assesses their potential to bridge the divide between the paradigms.