社商合作视角下的城市定制型商业健康保险——基于深圳市的实践分析  

Urban Customized Commercial Health Insurance from the Perspective of Social Business Cooperation—Based on the Practical Analysis of Shenzhen

作　　者：江艺 

机构地区：[1]重庆大学公共管理学院,重庆

出　　处：《社会科学前沿》2024年第8期6-15,共10页Advances in Social Sciences

摘　　要：新一轮医改以来,我国已建成全世界最大、覆盖全民的基本医疗保障网络,在社保取得巨大成绩的同时,我国商业健康保险市场也迎来了高速发展的黄金时期。结合国际经验,我国逐渐探索出医疗保险领域的社商合作路径,这种公私合作伙伴关系既可以保留政府的主导权,又可以发挥私人部门的资源优势,更大程度的提升医疗服务供给效率和水平,推进多层次社会保障体系建设。近年来火爆中国各省的惠民保产品(又称城市定制型商业健康保险)无疑是我国社商融合发展的成功典型,具有较高的研究意义。本文通过梳理我国一、二线共五十个城市的惠民保产品政策,归纳其保障内容、目标市场、承保模式、产品特点,并基于社商合作视角,以深圳市惠民保(深圳市重特大疾病医疗补充医疗保险)实践作为案例,试图厘清惠民保背后的社商合作行动逻辑,以期为其他城市提供经验建议和推动惠民保产品市场的创新和健康发展。Since the new round of medical reform, China has built the world’s largest basic medical security network covering the whole people, while social security has made great achievements, China’s commercial health insurance market has also ushered in a golden period of rapid development. Combined with international experience, China has gradually explored the path of social cooperation in the field of medical insurance. This public-private partnership can not only retain the government’s leading power, but also give play to the resource advantages of the private sector, improve the efficiency and level of medical service supply to a greater extent, and promote the construction of a multi-level social security system. In recent years, the popular Huimin insurance products (also known as urban customized commercial health insurance) in various provinces of China is undoubtedly a successful model of the integrated development of social business in China, and has high research significance. By combing the product policies of Huimin Insurance in 50 cities of the first and second tier in China, this paper summarizes their protection content, target market, underwriting mode and product characteristics. Based on the perspective of social business cooperation, this paper takes the practice of Huimin Insurance in Shenzhen (Shenzhen Supplementary Medical Insurance for serious and serious diseases) as a case to try to clarify the action logic of social business cooperation behind Huimin Insurance, in order to provide experience and suggestions for other cities and promote the innovation and healthy development of Huimin’s product market.

关 键 词：惠民保 社商合作 深圳市重特大疾病医疗补充医疗保险 

分 类 号：F42[经济管理—产业经济]