摘要
保险业参与新型农村合作医疗试点工作，取得显著成效，这种“政府主办，保险公司经办”的社会化管理模式，有助于转变政府职能，完善制度运行机制，提高制度运行效率，节约社会总成本，充分发挥保险业的社会风险管理职能。保险公司承担新农合基金运行风险，主要分为“委托管理”、“风险管理”和“风险共担”三种模式。保险业应继续深化与政府的合作层面，扩大参与合作覆盖面，在完善新农合制度，整合农村三级卫生服务网络方面，继续发挥应有的作用。要探索多种支付方式，提高保障的可及性；积极引入管理式医疗，合理配置医疗资源；加大宣传力度。提高农民参保积极性；介入农村卫生设施建设，提高新农合的医疗服务。
The insurance industry achieved prominent results in participating to the pilot work of new type of rural healthcare scheme. The socialized management model of ＂government control, insurance company operate＂ is conducive to transforming the function of government, improving implementation mechanism of the scheme, enhancing operational efficiency, economizing on total social cost, and fully playing the social risk management role of the insurance industry. The insurance companies assumes the operational risk of the new type of rural cooperative fund by managing the fund with one of the three models, namely, ＂entrusted management model＂, ＂risk management model＂ and ＂risk sharing model＂. The insurance industry should further deepen its cooperation with the government, participate into the program on a larger scale, and play its due role in improving the new type rural cooperative healthcare scheme and consolidate the three-level public health network. It should provide more channels of payment, increase the accessibility of the scheme, introduce the managed healthcare system to rationally allocate medical resources, further raise publicity of the scheme to encourage rural population participation, and get involved in construction of public health facilities in rural areas to improve service quality of the scheme.
出处
《保险研究》
CSSCI
北大核心
2006年第11期47-49,55,共4页
Insurance Studies
关键词
商业保险
新型农村合作医疗
社会化管理
社会风险管理
commercial insurance
new type of rural healthcare scheme
socialized management
social risk management
作者简介
张楠，经济学学士，经济师，美国健康保险协会会员（HIAA），中国人寿保险股份有限公司健康保险部高级主管；
张研，经济学学士，助理经济师，中国人寿保险股份有限公司健康保险部主管。
