I浅析城乡居民大病保险运行状况及合理化建议摘要大病保险是为完善我国医疗保障体系，缓解城乡居民“因病致贫、因病返贫”问题而设立的一项创新性制度。本文以城乡居民为主要研究对象，主要研究的内容是大病保险制度在城乡运营的状况、不足之处以及作用。通过研究可以得出虽然这个保险制度可以使患有疾病的人经济负担降低，但由于目前保障水平有限，在操作的过程中，依然有许多不足之处，比如统筹相对混乱、资金渠道较窄、补偿机制不公平性凸显、保险界定范围重合大以及商业保险机构承保效果等，部分人群因达不到大病保险保障对象界定标准，依旧享受不到相关的医疗保障待遇，这并不符合大病保险制度设立的初衷。本文通过对上述问题进行针对性研究，以及对国外大病保险补偿机制进行学习和借鉴其成功经验，为我国城乡居民大病保险制度的进一步发展提出拓宽大病保险筹资渠道、创新大病保险筹集资金机制、建立年龄收入分层补偿方案、完善大病医疗救助对象认定衔接机制、建立动态医保目录、提高商保机构在制度中的参与度等合理化建议。关键词：城乡居民；大病保险；运行状况IAnalysisontheoperationofseriousillnessinsuranceforurbanandruralresidentsandreasonablesuggestionsAbstract：SeriousillnessinsuranceisaninnovativesystemtoimproveChina'smedicalsecuritysystemandalleviatetheproblemof"povertycausedbyillness"ofurbanandruralresidents.Throughtheanalysisofthecurrentsituation,existingproblemsandoperationeffectoftheseriousillnessinsurancesystemforurbanandruralresidents,itisfoundthatalthoughtheseriousillnessinsurancesystemcanreducetheeconomicburdenofpatientswithmajordiseasestoacertainextent,duetothecurrentlimitedlevelofsecurity,therearestillmanyproblemsintheoperationofthesystem,suchasthesinglechanneloffund-raising,thelowlevelofsocialsecurity,thelowlevelofsocialsecurity,andthelowlevelofsocialsecurityLowlevelofoverallplanning,unfaircompensationmechanism,largeoverlappingofinsurancedefinitionandunderwritingeffectofcommercialinsuranceinstitutions,somepeoplestillcannotenjoytherelevantmedicalsecuritytreatmentbecausetheycannotreachthedefinitionstandardofseriousillnessinsurance,whichisnotinlinewiththeoriginalintentionoftheestablishmentofseriousillnessinsurancesystem.Throughthetargetedresearchontheaboveproblems,aswellaslearningfromthesuccessfulexperienceofforeignseriousillnessinsurancecompensationmechanism,thispaperputsforwardsomesuggestionsforthefurtherdevelopmentofChina'sseriousillnessinsurancesystemforurbanandruralresidents,suchasbroadeningthefinancingchannelsofseriousillnessinsurance,innovatingthefinancingmechanismofseriousillnessinsurance,establishingthehierarchicalcompensationschemeofageincome,improvingthequalityoflifeandimprovingthequalityoflifeSomereasonablesuggestionsareputforward,suchasimprovingtheidentificationandconnectionmechanismofseriousillnessmedicalassistanceobjects,establishingdynamicmedicalinsurancecatalogue,andimprovingtheparticipationofcommercialinsuranceinstitutionsinthesystem.Keywords:urbanandruralresidents;Seriousillnessinsurance;OperationIIstatusI目录摘要..................................................................................................................................................I1引言...............................................................................................................................................12制度缘起.......................................................................................................................................13制度运行效果.........................................................
