普惠性商业健康保险:现状、问题与发展建议  

Current Situation,Problems and Development Suggestions of Inclusive Commercial Health Insurance

作　　者：苏泽瑞 Su Zerui

机构地区：[1]中国人民大学劳动人事学院

出　　处：《行政管理改革》2021年第11期90-99,共10页Administration Reform

摘　　要：以“政府主动介入、保险公司市场运营、居民自愿参保、保障重特大疾病”为主要特征,具有中国特色的普惠性城市定制型商业医疗保险迎来了爆发式增长,弥补了法定医疗保障和传统商业健康保险之间的保障空白,成为我国多层次医疗保障体系建设的重要突破口。但其同时也存在参保率低、逆向选择、健康数据不足及增值服务缺失等普遍性问题,需要通过政府医保及银保监等部门的鼓励、支持与规范来充分调动市场主体的能动性,真正实现“政企合作、惠及百姓”,推动商业健康保险的高质量发展。With the main features of‘government initiative,market operation by insurance companies,voluntary participation by residents,and protection of serious diseases’,the inclusive urban customized commercial health insurance with Chinese characteristics has seen explosive growth,bridging the protection gap between statutory medical insurance and traditional commercial health insurance.It has become an important breakthrough in the construction of China's multi-level medical insurance system.However,there are also common problems such as low participation rate,adverse selection,insufficient health data and lack of value-added health services,which require encouragement,support and regulation by government to fully mobilize the motivation of market players,truly realize‘government-enterprise cooperation,benefit the people’and effectively promote the high-quality development of commercial health insurance.

关 键 词：多层次医疗保障体系 商业健康保险 政企合作 惠民保 

分 类 号：D63[政治法律—政治学]