By Zhang Jiahui, Research Department of Social Development, DRC

Research Report No.111, 2016 (Total 4994) 2016-8-25

Abstract: In recent years, Chinese people’s total demand for health has increased substantially and has taken on a multilevel and diversified trend. Basic medical insurance has played an important role to meet the basic health needs of the people. However, the overall level of protection is still inadequate with limited coverage and growing pressure from the balance of payments. Under these circumstances, the government has given strong support to the development of commercial health insurance. But in practice, some problems still exist in the development of commercial health insurance such as excessive pursuit of scale, low degree of specialization, weak management and risk control, and the failure to meet the requirements of the people through multiple channels because of its limited coverage. It is suggested that relevant department clarify the respective functions and tasks of commercial health insurance and basic medical insurance, explore ways for the deep integration of the health industry including health management, make efforts to actively participate in data sharing and enforce regulation of medical institutions, and improve the degree of specialization and risk control capacity of commercial health insurance so as to promote the sound and sustainable development of commercial health insurance.

Key words: medical and health system reform, commercial health insurance, problems, suggestions