| 引用本文: |
蔺淼,李水娥,丁锦希,等.新加坡政商合作型商业医疗保险对我国惠民保的启示*[J].中国卫生经济,2023,42(7):91-96.[点击复制] |
Lin Miao,Li Shui’e,Ding Jinxi,et al.Inspirations of Singapore’s Public-Private Partnership Commercial Medical Insurance to the City-Customized Com⁃ mercial Medical Insurance in China[J].CHINESE HEALTH ECONOMICS,2023,42(7):91-96.[点击复制] |
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| 摘要: |
| 新加坡的多层次医疗保障体系发展相对成熟，其中商业医疗保险对满足人民群众的多样化需求具有重要意义， 政商合作型商业医疗保险是新加坡的主流商业医疗保险。惠民保作为我国多层次保障的新兴组成部分，带有“政府指导、商保承办”的特色，但是起步时间较晚，服务体系仍有待完善。基于此，文章全面分析新加坡政商合作型商业医疗保险的缴费机制和理赔机制，并与惠民保进行对比，对惠民保提出“向风险定价过渡，调整参保人群结构；拓展医保个人账户适用范围，提高参保率；科学设计保障责任，合理控制理赔支出；建立一站式结算，增加预审核机制”的建议。 |
| 关键词: 政商合作 商业医疗保险 惠民保 新加坡 |
| DOI： |
| 投稿时间：2023-04-20 |
| 基金项目:基金项目：中国药科大学“双一流”学科创新团队建设项目 （CPU2018GY4） |
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| Inspirations of Singapore’s Public-Private Partnership Commercial Medical Insurance to the City-Customized Com⁃ mercial Medical Insurance in China |
| Lin Miao,Li Shui’e,Ding Jinxi,Li Wei,Li Jiaming |
| (School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198 ,China) |
| Abstract: |
| The multi-level healthcare system in Singapore is relatively mature, among which commercial medical insurance is of great significance to meet the diverse needs of residents. Currently, the public-private partnership commercial medical insurance is the mainstream commercial medical insurance in Singapore. Meanwhile, as a newly emerging component of Chinese multi-level health- caresystem, city-customized commercial medical insurance has the characteristics of “government guidance, commercial un- derwriting”, but it started relatively late, and its service system still requires improvement.It comprehensively analyzes the payment and claims mechanisms of Singapore’spublic-private partnership commercial medical insurance and compares it withcity-customized commercial medical insurance to proposes several suggestions.The suggestion includes transitioning to risk pricing to adjust the struc- ture of the insured population, expanding the scope of application of medical insurance personal accounts to increase the insurance participation rate, scientifically designing guarantee responsibilities to reasonably controlling claims expenses, establishing a one-stop settlement and adding a pre-audit mechanism. |
| Key words: public-private partnership commercial medical insurance city-customized commercial medical insurance Singapore |
