普惠型补充医疗保险参与罕见病保障的指数评估——基于公私合作视角  

Index Evaluation of Inclusive Supplementary Medical Insurance Participating in Rare Disease Security——Based on the Perspective of Public-Private Partnership

作　　者：易沛 金靖宇 马颖颖[2] 杨绿裳 

机构地区：[1]广东金融学院保险学院,广州510521 [2]华南农业大学公共管理学院,广州510642

出　　处：《中国医疗保险》2025年第4期104-112,共9页China Health Insurance

基　　金：广东省哲学社科规划2021年度项目“公私合作视角下普惠型补充医疗保险的供给机制优化研究”(GD21YYJ08);教育部人文社会科学研究青年基金项目“生育保障需求的代际演化与生育保险的政策优化研究”(24YJC840043)。

摘　　要：普惠型补充医疗保险(以下简称“普惠险”)已逐渐成为罕见病领域多层次医疗保障的重要力量。本文构建指标评价体系,评估32款代表性普惠险产品的公私合作模式和罕见病保障指数,通过对比分析,探究公私合作模式对普惠险参与罕见病保障的影响。研究发现,大部分政府主导型普惠险产品的罕见病保障水平较高,而大部分政府推动型普惠险产品的罕见病保障水平相对较低。政府主导型产品罕见病保障指数的平均数和最大值均高于政府推动型产品。基于上述分析,本文提出优化普惠险罕见病保障的政策建议:加强政府与市场协同治理,推动普惠险参与健康管理,强化普惠险产品监管,推动数据共享与技术赋能。Inclusive supplementary medical insurance(hereinafter referred to as “inclusive insurance”) has gradually become an important force in the multi-level healthcare security for rare diseases.This article constructs an indicator evaluation system to assess the public-private partnership models and rare disease security index of 32 representative inclusive insurance products,and explores the impact of public-private partnership models on inclusive insurance participating in rare disease security through comparative analysis.Research has found that the level of rare disease security for most inclusive insurance products led by government is relatively high,while the level of rare disease security for most inclusive insurance products promoted by government is relatively low.The average and maximum values of the rare disease security index for government-led products are higher than those for government-promoted products.Based on the analysis above,this article proposes policy recommendations for optimizing the security of rare diseases in inclusive insurance:strengthening the collaborative governance between the government and the market,promoting the participation of inclusive insurance in health management,strengthening the supervision of inclusive insurance products,and promoting data sharing and technological empowerment.

关 键 词：普惠型补充医疗保险 普惠险 罕见病保障 公私合作 

分 类 号：F840.684[经济管理—保险]