摘要
在全球老龄化与医保费用支出持续增长的压力下,商业保险衔接基本医疗保险正成为趋势。德国、荷兰、英国商业保险衔接基本医疗保险的经验显示,商业保险在基本医疗保险体系中发挥了复合作用,与政府在清晰的分工定位下各司其职,并参与到医疗服务的行为约束和费用管控中。我国应探索商业保险逐步衔接基本医疗保险的合理路径,规范商业保险在公共服务定位下的自主运作行为,并加强商业保险与医疗机构之间的协作与制约关系。
Under the pressure of global aging and the continued growth of medical insurance expenditures,the integration of commercial insurance with basic medical insurance is becoming a trend.The international experience of connecting commercial insurance with basic medical insurance in Germany,the Netherlands and the United Kingdom shows that commercial insurance plays a complex role in the basic medical insurance system,and plays its own functions under the clear division of labor with the government and participates in the behavioral constraints of medical services and cost control.China should explore the rational path of commercial insurance to gradually link basic medical insurance,standardize the autonomous operation of commercial insurance under the positioning of public services,and strengthen the relationship between commercial insurance and medical institutions.
作者
王毓丰
陈永法
WANG Yu-feng;CHEN Yong-fa(School of International Pharmaceutical Business,China Pharmaceutical University,Nanjing Jiangsu 211198,China)
基金
2018年江苏省研究生科研与实践创新计划（KYCX18_0838）
关键词
商业保险
基本医疗保险
经办服务
commercial insurance
basic medical insurance
handling services
