本文關(guān)鍵詞： 大病醫(yī)療保險(xiǎn) 新農(nóng)合 人保財(cái)產(chǎn)保險(xiǎn) 管理模式　出處：《吉林大學(xué)》2014年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：2008年10月，國(guó)家發(fā)改委發(fā)布了《關(guān)于深化醫(yī)療衛(wèi)生體制改革的意見(jiàn)（征求意見(jiàn)稿）》該稿為國(guó)家未來(lái)20年的醫(yī)療保障制度的總體發(fā)展方向提供了政策性指南，2012年經(jīng)過(guò)國(guó)家六部委批準(zhǔn)后，《關(guān)于開(kāi)展參合農(nóng)民大病保險(xiǎn)工作的知道意見(jiàn)》（發(fā)改社會(huì)[2012]2605號(hào)）正式下發(fā)全國(guó)開(kāi)始實(shí)施。對(duì)于商業(yè)保險(xiǎn)機(jī)構(gòu)來(lái)講，首次迎來(lái)了可以經(jīng)辦“各類(lèi)醫(yī)療保障服務(wù)”的政策“放閘”，拓寬了保險(xiǎn)公司的業(yè)務(wù)領(lǐng)域，給那些“具有資質(zhì)”的保險(xiǎn)公司帶來(lái)了廣闊的發(fā)展空間。新農(nóng)合醫(yī)療補(bǔ)充保險(xiǎn)是對(duì)新農(nóng)合制度的完善和補(bǔ)充，也是一項(xiàng)體現(xiàn)政府責(zé)任的惠民政策，在參與經(jīng)營(yíng)管理的過(guò)程中，商業(yè)保險(xiǎn)公司必將承擔(dān)一定的經(jīng)營(yíng)風(fēng)險(xiǎn)，如道德風(fēng)險(xiǎn)、政策波動(dòng)風(fēng)險(xiǎn)、醫(yī)療費(fèi)用快速增長(zhǎng)、運(yùn)營(yíng)成本控制等潛在的風(fēng)險(xiǎn)，如何在生產(chǎn)經(jīng)營(yíng)活動(dòng)中規(guī)避潛在風(fēng)險(xiǎn)，又能服務(wù)好參保客戶(hù)，這一點(diǎn)非常重要也同樣值得研究。本文試圖通過(guò)文獻(xiàn)分析法、案例分析法、比較分析法，以吉林省人保財(cái)險(xiǎn)股份有限公司新農(nóng)合大病醫(yī)療互助補(bǔ)充保險(xiǎn)為例，，嘗試探索新農(nóng)合大病醫(yī)療互助補(bǔ)充保險(xiǎn)委托商業(yè)保險(xiǎn)公司經(jīng)辦模式選擇及其實(shí)施過(guò)程，從理論分析和國(guó)內(nèi)大病醫(yī)療互助補(bǔ)充保險(xiǎn)委托保險(xiǎn)公司經(jīng)辦模式選擇及實(shí)施過(guò)程研究外實(shí)踐入手，為吉林省新農(nóng)合大病醫(yī)療互助補(bǔ)充保險(xiǎn)委托保險(xiǎn)公司經(jīng)辦提供理論和經(jīng)驗(yàn)支撐，探尋出新農(nóng)合大病醫(yī)療互助補(bǔ)充保險(xiǎn)經(jīng)辦過(guò)程存在的問(wèn)題,提出有必要引入市場(chǎng)機(jī)制由保險(xiǎn)公司經(jīng)辦，并對(duì)新農(nóng)合大病醫(yī)療互助補(bǔ)充保險(xiǎn)經(jīng)辦模式選擇和實(shí)施過(guò)程提供了可供參考的建議。
[Abstract]:October 2008, The National Development and Reform Commission issued the "opinions on deepening the Reform of the Medical and Health system (draft for opinions)", which provides a policy guide for the overall development direction of the country's medical security system in the next 20 years. In 2012, it passed through six ministries of the country. After the approval of the CPC Committee, "opinions on the implementation of the insurance work of participating in and cooperating with farmers' serious illness" (Development and Reform Society [2012] 2605) were officially launched nationwide. For commercial insurance institutions, For the first time, it ushered in the policy of "opening gates" that can handle "all kinds of medical security services," and broadened the scope of business of insurance companies. It has brought vast development space to those "qualified" insurance companies. The new rural cooperative medical supplementary insurance is a perfect and complementary policy for the new rural cooperative medical system, and it is also a beneficial policy to reflect the responsibility of the government. In the process of participating in the operation and management, the new rural cooperative medical supplementary insurance is also a policy for the benefit of the people, and in the process of participating in the management, Commercial insurance companies are bound to bear certain risks, such as moral hazard, policy fluctuation risk, rapid growth of medical expenses, operation cost control and other potential risks, how to avoid potential risks in production and operation activities, This is very important and also worth studying. This paper attempts to use literature analysis, case analysis, comparative analysis, Taking the supplementary medical mutual insurance of New Rural Cooperative Medical Assistance of Jilin PICC property Insurance Co., Ltd., as an example, this paper attempts to explore the selection of the mode of operation and the implementation process of the medical mutual medical mutual aid supplementary insurance for NCMS, which is entrusted to commercial insurance companies. Starting with the theoretical analysis and the practice outside the study of the mode selection and the implementation process of the commissioned insurance company for the supplementary medical insurance for serious illness in China, To provide theoretical and empirical support for the commissioning of medical mutual aid insurance for new rural cooperative medical assistance in Jilin Province, and to explore the problems existing in the process of handling supplementary medical insurance for new rural cooperative medical assistance in Jilin Province. It is necessary to introduce the market mechanism to be run by the insurance company, and some suggestions are provided for the selection and implementation of the mode of supplementary medical insurance administration for NCMS.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：F842.684;F323.89;R197.1

【參考文獻(xiàn)】

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