论我国保险制度与家庭医生制度的协同发展【摘要】为了推行分级诊疗制度、促进医疗资源平衡，我国在 2016 开始在部分地区试点家庭医生制度，该政策作为医疗卫生体制改革的其中一环，无疑是大病保险后健康保险的又一机遇。同时，保险制度与家庭医生制度相结合可以有效控制医疗费用支出的同时还有利于改变传统保险行业在赔付中的被动地位。研究将在国内外研究现状的基础上，分别从医疗费用视角、风险管理视角、以及信息对称性视角，探讨国内保险制度与家庭医生制度协同发展的可行性。在探讨和思考后，发现对于这两种制度来说国内的条件还不成熟，亟待解决的问题较多，例如政策空间较小不利于市场发展，家庭医生制度本身也存在推行难度等，因此想要做到国外成熟模式还需要更多地放宽政策条件，并建立一个利于各方进行信息和资源交流的平台，打破信息不对称带来的阻碍。【关键词】家庭医生；商业健康保险；医疗支付；健康管理On the coordinated development of insurance system and family doctor system in China【Abstract】In order to implement the hierarchical diagnosis and treatment system and promote the balance of medical resources, China began to pilot the family doctor system in some regions in 2016. As one part of the reform of medical and health system, this policy is undoubtedly another opportunity for health insurance after serious illness insurance. At the same time, the combination of insurance system and family doctor system can effectively control the medical expenses and change the passive position of traditional insurance industry in compensation. Based on the research status at home and abroad, the feasibility of the coordinated development of domestic insurance system and family doctor system will be discussed from the perspective of medical expenses, risk management and information symmetry. After discussion and consideration, it is found that the domestic conditions for these two systems are not mature, and there are many problems to be solved urgently, such as...
