我国惠民保发展现状、实践挑战与对策建议  

Development Status,Practical Challenges and Countermeasures of Universal Health Insurance

作　　者：李高洁 陈磊[1] 席晓宇[1] Li Gaojie;Chen Lei;Xi Xiaoyu(The Research Center of National Drug Policy&Ecosystem,Nanjing,211198,China;不详)

机构地区：[1]中国药科大学国家药物政策与医药产业经济研究中心,南京211198

出　　处：《中国卫生经济》2023年第7期17-20,26,共5页Chinese Health Economics

基　　金：江苏高校哲学社会科学研究项目(2019SJA0062)。

摘　　要：近年来,飞速发展的普惠型商业补充医疗保险(以下简称惠民保)为多层次医疗保障体系的完善提供了有益补充,但也面临着诸多问题。文章通过探究现有惠民保的开展情况,总结出惠民保目前在参保与筹资、运营与监管、理赔与支付等环节存在的问题,并从政府相关部门明确在惠民保中的职能定位、商业保险公司积极发挥作为商业主体的市场优势两大方面提出优化建议。In recent years,the rapid development of universal health insurance has provided a beneficial supplement for the improvement of the multi-level medical security system,but it also faces many problems.Through exploring the current development of universal health insurance,it summarizes the problems in the areas of participation and financing,operation and supervision,and claims and payment.The optimization suggestions are put forward from two aspects:clarifying the functional positioning of relevant government departments in benefiting the people and making commercial insurance companies actively play their market advantages as commercial entities.

关 键 词：普惠型商业补充医疗保险 医疗保险 可持续发展 多层次医疗保障体系 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] F840.625[经济管理—保险]