Summary on China's medical security system selection problem in recent years, there is always a "universal health care" and "universal health care" on the paper through a comparative analysis of both the content and characteristics pointed out that China does not yet have universal free medical care implementation conditions, health care lies in the development of "universal health care", after years of exploration, China's medical insurance system is moving in this direction, but in the process of development, there are still many problems and difficulties, the article on these problems and difficulties are analyzed, and on this basis proposed to solve these problems and improve the fairness, Pratt & Whitney, a multi-level system of universal health care Suggestions.
Keywords Medicare universal health care universal health care comparative papers download
Medicare is related to the vital interests of all the people's livelihood event, covering all citizens to establish a medical security system, not only to enable everyone to enjoy basic medical services, but also for risk sharing and economic development of great significance. Because of this, the development of health care has become our government livelihood security important content of building. Theoretically, China's medical insurance, there are two alternative paths - universal free medical care and universal health care. Universal free medical care through tax funding for all citizens to provide free or low-cost medical services; universal health care (hereinafter referred to as "universal health care", Note) mainly through the collection of medical insurance, the establishment of the medical insurance system, complemented by other ways to provide health care system. These two systems with different features, advantages and disadvantages. Precisely because of this, China should adopt exactly what form, has been widely debated.
In this paper, the development of China's medical security system environment, from the perspective of comparative analysis, pointing out that the development of China's medical security right way is to establish a fair, inclusive, multi-level system of universal health care, rather than establishing universal free health care system, in fact, After years of exploration, China's health care system is moving in this direction, however, from the perspective of universal health care and requirements, the existing health care system in the capital raising, institutional integration, the level of protection, coverage, equity, and other aspects of sustainable development, there are still many problems and difficulties, which makes the country's "difficult and expensive" problem has not been fundamentally resolved, articles address these issues and difficulties are analyzed, and on this basis put forward to solve These problems and difficulties, improve fairness, Pratt & Whitney, a multi-level system of universal health care Suggestions.
Universal free medical care and universal coverage of comparison and difference
In general, the universal free medical care is exempt from payment obligations through tax funding from the public, or contracted private health service providers available to all citizens free or low-cost health services. Universal free medical care so that all people according to the need for medical treatment rather than economic ability to pay to get medical care. most typical representative is the UK's "national health care system" (NationalHealth Service, NHS), the system is the world's largest public health service system, the service covers from prevention to rehabilitation, to hospice care from pregnancy testing, minor ailments from headaches to colds and other serious illness of heart bypass types of medical care services, once the British billed as "the West's most comprehensive health care system." And universal health care is is an overlay of all citizens of the multi-level medical security system. universal health care includes not only income-based, shared by the employer and the individual contributions of the main framework of social health insurance, but also for the minority of vulnerable groups as well as the social medical aid system To meet the medical needs of multi-level complementary commercial medical insurance system so far has been nearly thirty countries around the world by building a social health insurance as the main system to achieve universal health care, which typically represent the country are Germany, Australia and France.
In China's medical security system of choice, the reason why people focus on the universal free medical care and universal health care to choose between, mainly because both meet our health care system from the initial concept, whether it is universal free medical care or universal health care are In order to meet citizens' rights to make Medicare institutional arrangements, with the non-profit nature, both exactly the same purpose: the micro level, in order to solve all citizens are "difficult and expensive" problem, to improve people's access to health health service conditions, macro, healthcare is major livelihood, free medical care and universal health care is to gradually solve the problem of health care, highlighting the progress and development of society, so that all citizens share the results of social and economic development from the system properties Look, free medical care and universal coverage with health insurance is mandatory, mainly relying on state authority, centralized leadership and sponsored by the government, in theory, the system provides the crowd requires all included within the Medicare system. distinguished from voluntary health insurance system , both relatively wide scope of protection, not only catastrophic care, but also protect a minor illness, the insured's health condition without special provisions, whether healthy or sick people who can participate, payment methods are generally based on individual a certain percentage of medical expenses compensation. Throughout the world of medical security system to universal free medical care or universal health care as the representative of the mandatory health insurance status plays subjectivity, can effectively avoid the system of voluntary health insurance premiums due to an excessive burden or lack of awareness of personal insurance caused by lack of medical care.
However, the universal free medical care and universal coverage with different features, will compare the two, the difference is obvious:
Features from the system point of view: first, the two systems under the regime type. Implementation of universal free medical care in countries single health system, often through the establishment of a unified health care system to provide health care services and to social insurance-based Through the establishment of universal health care is often diversified multi-level security system to meet the health care needs, such as Japan's national health insurance system, according to residents of different occupations are grouped into different health insurance organization, the country's health insurance by the Employees Insurance , National Health Insurance and the elderly care three major parts, the German health insurance system in addition to containing statutory social health insurance, also includes private health insurance and medical insurance special populations. Secondly, in different stages of development, the two systems different coverage. Universal free health care system from the beginning of the design system will cover all citizens, based on the national identity of all people, whether it is over 60 years old, children, or low-income people, people in rural areas all enjoy free medical care, and universal health care system Design impossible from the outset to cover all its citizens, its coverage has an expanding process of development, usually by some sort of group gradually expanded to different people, and ultimately as the system improvement to achieve full coverage. third, fairness to different degrees. universal access to free medical care regardless of income and the individual, based solely on medical need for the National offers a full built on top of public funds for medical services, a high degree of fairness, and the subjectivity of universal health care system that is based primarily on social health insurance system to determine whether the insured medical services provided or not, coupled with regional differences, industry differences, income differences, the specific design of the system during the time the system will inevitably cause the gap between, making it the degree of fairness low.
Conditions from the implementation point of view, there are significant differences between the two. Overall universal free medical care requires a more mature implementation conditions. First, with strong financial strength based. Universal free medical care provided by the state means that the full cost of medical coverage, these costs include the construction of hospitals, medical facilities and the introduction of technology, the expansion of health care resources, the burden of all the country's medical staff wages and the patient's medical expenses, which requires countries must have sufficient revenue to guarantee universal free health care system's operation. Second, with good health conditions for the protection. universal free medical care easily lead to medical services and medical technology, lack of competition , in order to ensure good quality of care, you need all levels of public hospitals or private hospitals have contracted with good medical and health resources, especially as a first-level requirements have for the national community clinics to provide basic medical services. third to a balanced development of the national economy and health status as the basis. economic development is unbalanced, the gap is too large, regional health care resource allocation is unreasonable, medical treatment, etc. are obvious gaps universal free medical development barriers. Comparison , the universal health care also has its special conditions for the realization of the first, the subjectivity of universal health care system, namely by the social health insurance system needs to be "multi-pay", all have the ability to pay of individuals and units have the obligation to pay, which will the state's financial burden dispersed units and individuals. Secondly, universal health care needs through a multi-level medical insurance system to achieve, risk-sharing can be in different classes, different regions, between different groups in order to avoid the shortage of health care functions bit. Thirdly, in a variety of system design, both to protect the population according to the different requirements and differ, but also on the whole complement each other, complement each other, there is room for further integration, of course, the specific level of contributions and payments should contact their local economic development and the income-related.
From the level of protection point of view, based on national experience, universal free health care coverage, fairness is high, and its security is usually higher than the overall level of universal health care level of protection. This is because the implementation of universal free medical care or welfare of the majority of developed countries countries, strong economic fundamentals and high industrialization, urbanization level is to achieve universal health insurance in its premise and necessary safeguards. European countries such as Britain, Sweden, Switzerland, Denmark and so the implementation of universal free medical care, in 2009, these countries medical expenses to GDP was 9. 3%, 10%, 11. 4% 11. 5%, showing that developed countries have the ability to provide a generally higher level of protection of the health system. Contrast, universal health care system as a sub-system are more specific systems of various big gap between the level of protection (such as our publicly funded health care system more than 95% reimbursement amount, and the new rural cooperative reimbursement amount is only 30% -40%), the difference between the specific system makes it difficult to reach a universal health care is relatively uniform level of protection, but it is certain that, all the people health insurance after a certain degree of development, its overall level of protection will continue to increase.
The development of China's medical security of the Road - "universal health care"
Universal free medical care in many countries and regions to implement, which makes many people yearn for them. Investigate its reason, "universal free medical care" inherently to the community of the "attractive" --- Everybody wants the state to be able to provide free medical services themselves, however, in the world and there is no "free lunch", in fact, there is no completely free health care system, the so-called "universal free" is relative.
On the one hand, free medical care, compared with other medical institutions, the main difference is that the sources of medical expenses. Universal free medical care is funded entirely from the State and local finances, which rely mainly on citizens to pay taxes or insurance funds in the final analysis people pay their money and therefore, we can say, free medical health insurance funds are to be replaced in the insured person the taxpayers pay taxes on the other hand, free medical treatment does not mean that citizens do not spend money you can get free treatment in accordance Health Statistics Yearbook 2010 China << >> data in the world, 193 national health expenditures, the individual national health expenditure is zero, not one. those that are generally considered to provide free medical care to the population in countries such as the UK, Switzerland , Sweden, Canada, Brazil, in 2007 personal health spending accounted for the proportion of total health expenditure was 18. 3% 40. 7% 18. 3%, 30%, 58.4%, but the free basic medical services, insurance directory other than such as outpatient prescription, dental clinic fees and higher grades will still need to pay for medical services.
In addition, one of the few areas to implement the "universal free medical care" (in Shenmu mode as a typical representative) is not truly "universal free health care system." Truly universal free health care system without insurance, all the household owns or all its residents are automatically entitled to free medical care while under << Shenmu universal free medical care (for Trial Implementation) >> "did not participate in urban and rural cooperative medical care and basic medical insurance for staff not to enjoy free medical care." Another , the tree model also has a variety of cost control, outpatient services only in the cooperative medical insurance premiums paid to free enjoyment. hospital charges a pay line, there are also projects at their own expense, from the fees paid by the patient pays the following line in fact, "tree model" is just a higher level of protection universal health insurance system. Given absolute "universal free medical care" does not exist, taking fully into account at this stage of the macro socio-economic conditions, China in 2009 promulgated the "new medical reform program" universal free medical care eventually abandoned the development path chosen toward universal health care strategic direction and we believe that this experience is a combination of multi-national conditions and reality make the right choice.
First of all, universal health care is more in line with our financial situation. In general, the implementation of universal free medical care country, the government budget health spending in total health costs higher than important national social insurance system, the United Kingdom, for example, in recent years, the British medical expenses accounted for 9% of GDP or more, for the NHS budget of up to 100 billion pounds (£ 1,980 per capita), visible, universal free medical care need to rely on a strong financial capacity to support On the current situation, our country is still in the primary stage of socialism, although the economy has been rapid development, covering 1.3 billion people, but universal free health care system so large, will inevitably lead to a heavy tax burden, like Spain and some other developed countries, prone to heavy financial burden, the deficit rising, free health care system unsustainable situation, so that the country does not have English, America's economic strength as "multi-burden" universal health care system is more feasible and maneuverability, to the whole of society as possible equitable distribution so that medical services sustainable development, only by employing units and individuals to the collection of social insurance, based on the development of multi-level universal health care, in order to meet citizens' basic health care rights.
Secondly, universal health care more efficient and easy to put together a fair and effective manner according to Samuelson's "pure theory of public expenditure", if all health care services are classified as public goods provided by the government, then it will inevitably The "free rider", high cost, low efficiency and so on. Both developed and developing countries, the implementation of universal free medical care appears to improve the fairness, efficiency issues but medical health insurance has become the need to focus on building issues. Individuals do not pay any fees, and will definitely form a large waste of resources and inefficiency, typical examples are: British health service appeared long queues, waiting for free hospitalized patients continue to increase, especially surgical patients and people with chronic diseases, and some areas have to wait months or even years, which caused the majority of the public outcry. Besides, do not spend money to see a doctor may also cause minor illness care, repeating medical care, lack of timely treatment of seriously ill patients, hospitalization rates rising phenomenon of medical resources, eventually leading to fatigue health care system unbearable. comparison, universal health care through a multi-level system design, the types of people Medicare specific, clarification, could be better put to unify both efficiency and fairness, balance together to maximize the class health care system role. conducive in achieving universal health insurance on the basis of fairness, improve health care efficiency, improve the quality of medical services, the medical resources can be most effectively utilized.
Again, universal health care more responsive to all kinds of people multi-level medical security needs of China's economic and social development is uneven, urban-rural gap is too large, the income gap between the obvious and serious polarization phenomena, such as the United Kingdom we can not have a more uniform system environment for the social insurance tax levy to provide support. universal free medical care difference is small, less hierarchical, barely implementation will likely lead to two results: First, the financial burden is too heavy, the second is the level of basic medical insurance coverage is generally low, can not fundamentally solve the medical treatment is difficult and expensive problem. Therefore, our health care system in the establishment of the process, the security system must be designed to accommodate the diverse society all kinds of people multi-level medical security needs. Universal health care in the development process allows multiple systems exist, namely public health, urban basic medical insurance, basic medical insurance for urban residents and the new rural cooperative medical care system to safeguard their corresponding groups. Moreover, universal health care strong flexibility , the region in the implementation of the general policies of the central premise can also develop in line with their development situation of the institutions and policies. Indeed, from a practical standpoint, the ability of some regions have established a direct "dual system" urban and rural medical security system, some areas in the medical insurance system for proper development for specific populations outside the medical aid system or supplementary medical insurance business.
Universal health care problems and challenges facing the development of
In recent years, the central government attach great importance to China's medical and health undertakings have made great progress can be said that the development direction of universal health care in our country has been basically established, we are also along the "everyone equitable access to basic health care "road constantly explore. Nevertheless, China is still in the early stage of institutional development, lack of experience, at this stage of universal health care is still imperfect universal health insurance system, which is to be achieved because of our universal health care is a fair, inclusive, multi-level medical security system, its real meaning is not only to meet unconditionally guarantee all citizens the right to health care, but also to ensure the payment of health insurance costs and medical expenses paid by the insured only related to the ability to pay, and more importantly, to provide basic health services and patients should be primarily linked to the basic medical needs, in order to achieve health care financing and health care services utilization in terms of fairness from China's actual situation, the existing system from the real sense of the universal Medicare still far from the target, universal health care in the further development still faces many problems and challenges.Links to free download http://eng.hi138.com
(A) lack of financial investment, low level of protection
According to the China Statistical Yearbook 2011 >> << 2009 the total cost of health care accounts for only 5% of GDP. 15% of which government health spending accounted for 27 of total health costs. 2%, the proportion of individuals to pay medical expenses since 1978, from 20 percent to 50 percent, the government health expenditure either from gravity or from the absolute numbers are lower than the social and individual health investment while In European countries, health care accounted for about 10% of GDP, of which 80% - 90% paid by the government, showing that China's total health expenditure in public spending in the lower part of the international level. Moreover, due to the basic medical insurance for urban residents and the new rural cooperative medical system funding levels, the proportion of claims are low, so that a considerable part of the population of the personal burden of medical treatment level is still heavy. Individual payment ratio is too high, leading to a lower level medical security people "expensive" the main reason, seriously affected the residents of the availability of health services.
(Two) system "fragmentation", both detrimental to efficiency, but also unfair
Although multi-level medical security is necessary, but this subjectivity medical insurance system under the multi-seed system should eventually go along with the system's sound and integrated to form a unified and efficient health insurance system. Single on this aspect and to Look, our country has at least four different medical insurance system, including basic medical insurance system for urban workers, urban residents' basic medical insurance system, the new rural cooperative medical system, and civil service free medical care system, the gap significantly between different Medicare population, curing the urban-rural dual structure and social class structure coupled with the level of comprehensive health insurance mainly still in the county or city level, each region of a co-ordinating medical insurance system "fragmented" and its specific policy provisions, especially the rights and obligations Relations have large differences can be said that the basic medical insurance system architecture is a "fragmentation" of the system, not only detrimental to the efficiency of health care, and will result in a unified labor market barriers to social integration, contrary to "fairness" principle.
(Three) compensation mode and compensation mechanism design is unreasonable
At present, China's medical insurance system in addition to the common reimbursement ratio is too low, the insured person pays a higher proportion of outside the scope of compensation and compensation in the way there are also disadvantages. Generally, much higher than the incidence of common diseases major diseases, with "serious co-ordination" as the main scope of compensation system design, not only for outpatient reimbursement is relatively small, but weakened against the importance of prevention and treatment of common diseases, and ultimately will increase the burden on the healthcare system treatment. Post-paid system for compensation for low-income groups, especially in seriously ill, requiring long-term hospital, advance medical expenses become a problem. Moreover, post-paid system of compensation reimbursement procedures can also cause trouble, limit excessive compensation issues. Specifically, such reimbursement from the pay line high threshold is too high, some of the basic medical risks are not shared, capping line makes the most of the poor are still suffering from a serious illness when medical burden too heavy, reimbursement of medicines directory narrower making multi-level medical needs are not met, the crowd for remote medical treatment, reimbursement process is hindered complex Medicare transfer payments. various unreasonable compensation mechanism design makes our health insurance system benefit narrow, reach the desired effect.
(Four) on the protection of vulnerable groups, lack of medical
Generally, the lower the income, social insurance participation rate is also lower. Based health care system and the reasons for the initial formation of the difficulties now, there is a class of "medical vulnerable groups", including: the unemployed, the disabled , elderly, migrant workers, as well as being excluded from the "medical system" outside the person (ie, those who have never in the "unit" worked by doing odd jobs, set up stalls breadwinner) and earlier retirement "system within the "people of this part of medical vulnerable groups living in extreme poverty are mostly located on the edge of a large number of poor and relatively poor, they have greater risk of disease, due to the economic capacity constraints, it is easy to fall into extreme difficulties and poverty. our country's health care system is not perfect, the goal of building health system and the way some degree of deviation, this should be most in need of Medicare's "medical vulnerable groups" to get protection is very limited, which resulted in risk protection mismatch. more typically migrant workers, on the one hand the new rural cooperative design of the system for inadequate protection of migrant workers, migrant workers under the system usually own expense, to assume the high and must be the origin of the county levels of government for subsidies, not only the amount of subsidy is low and the program takes a long time to apply for grants, on the other hand, medical insurance for urban workers could easily lead to leakage protection, and illiquid, and some have not signed a labor contract migrant workers are in informal employment exclusion from the system, resulting in the basic health rights are not protected.
(Five) urban-rural split resulting in lack of fairness of health insurance
This is mainly manifested in two aspects, first, the inequitable distribution of health care resources in a long time, excessive concentration of medical resources in the developed areas of the city, the rural health infrastructure is very weak, medical staff, medical supplies in short supply, management tools backward, causing farmers to availability of medical care than poor urban residents. the limited medical resources priority to meet the needs of a few dominant groups, which is obviously unfair. Secondly, urban and rural residents in Medicare unfair treatment. According to statistics, 2008 of China's total health costs 14,535. 400 million yuan, of which the city was 11,255 health costs. 0.2 billion yuan, the total cost of 77. 4%, rural health care costs 3280. 3.8 billion yuan, the total cost of 22. 6 percent of rural residents per capita health care costs in the funding criteria, the number of insurance and reimbursement is much lower than the proportion of urban residents from the perspective of income distribution, rural medical security benefits too, makes a lot of the insured population in the face of disease risk still afraid to seek medical treatment, which led to the adverse social insurance income distribution.
Perfecting Suggestions universal health insurance system
Universal health care is a huge systematic project, in order to eventually achieve multi-level, high-level, wide coverage of universal health care, not only the need to strengthen the government, hospitals, employers and individuals, such as multi body support and cooperation, but also improve the overall universal health insurance system design based on the current situation and the relevant circumstances, combined with the above analysis of the problems and difficulties, respectively, from our coverage of system integration, government responsibility, health care system and the multi-level medical security and other aspects of policy recommendations.
(A) adhere to the principles and mandatory combination of government subsidies, continue to expand health care coverage
As urban residents and the new rural cooperative medical insurance "voluntary insurance" principle, there will be some inevitable result of economic poverty and unable insured person, or for any payment period is not enough to be excluded from the system institutional gaps in the health insurance system the crowd outside, which makes universal health care can not be achieved truly full coverage we want, such as the majority of informal employment, bankruptcy firms in difficulty retired workers, older youth, and rural low-income farmers and other "medical vulnerable groups" as the Medicare Kuomiangongzuo breakthrough, prompting the government to play an active role in the main responsibility for health care, not only from the policy level to be a mandatory requirement for all people to participate in the Medicare system, but also targeted subsidies for low-income populations, such in order to effectively solve the existing problem of adverse financial subsidies in short, to all citizens are unconditionally into the appropriate social health insurance to go, which at this stage is feasible and necessary.
(Two) to accelerate system integration, and take gradual road to universal health insurance
Urban-rural split, regional segmentation, the crowd split a serious impediment to the development of universal health insurance, medical insurance gradually from the "pluralism" or "Three" system to a "dual system" and eventually achieve "a system" has been imperative our country should choose the road of progressive universal health care, for the economic gap between urban and rural areas is not too large, priority should be given to the basic medical insurance for urban residents and the new rural cooperative merging the two systems, and then gradually with the basic medical insurance system for urban workers, standards, For the conditions are not met in areas now have to seriously consider the issue of convergence between different systems, until conditions are ripe, and then merge the different systems. specific approach is: First, eliminate the obvious inequalities exist between the system and by improving the design of the system, health care financing and services to achieve fair utilization, and finally to gradually improve the level of medical care, and promote the improvement of health of all citizens, promote the public welfare. To this end, the central government introduced policies to improve top-level design of the system to encourage the conditions are ripe or almost ripe area (preferably in cities as a unit, when the conditions are right for the unit can also be provincial) for Medicare medical insurance system integration and community-building pilot, we believe, the Pearl River Delta in Guangdong Province, Jiangsu Province, southern region , Beijing, Shanghai, Zhejiang and other regions could become the first batch of pilot areas. Such pilot projects, Medicare could be a pilot community-building, namely the establishment in the region, "barrier-free" system of insurance and medical treatment, it can be system integration of the pilot, the three systems will be merged, or only one of the two systems are combined prior In general, Medicare difficulty of building a relatively small community, you can carry out a wide range of pilot projects, and continue to expand and China Unicom these community, and ultimately to achieve national unity. Currently, many areas of the country have been carried out related work, and has made good progress, however, has not yet formed the country's linkage trend.
(Three) governments bear the primary responsibility to provide basic medical security of vulnerable groups
Universal health insurance does not mean that everyone must pay a fee, in fact, low levels of income for the family, really can not afford to pay people, the state should get rid of in accordance with the principles of market economy and efficiency first approach, to develop medical assistance system based on the to be fair to all social groups enjoy medical insurance, and even give priority to solving medical problems of vulnerable groups, the government-owned health institutions should assist poor and vulnerable populations at low prices to obtain medical and health services. Additionally, you can also arrange the financial system, run Medicaid hospitals and welfare hospital, the health of vulnerable groups into the health care system into one. summarize the successful experience of foreign countries, like the U.S. capitalist countries, government health expenditure concerned about poverty and concentrated in vulnerable groups such as the elderly population protection on, and let the general population through a variety of mechanisms to obtain commercial insurance protection, the French also launched a special public finances shared poor medical expenses scheme significantly reduces the tendency of the rich expert services tend to our country as a social capitalist countries, more attention should be paid to vulnerable groups of Medicare, the proposed national standards for people under a certain income set a lower deductibles and higher co-payment ratio, ease their burden, reduce and prevent sick reluctant to see and shake off poverty phenomenon.
(Four) to deepen the medical and health system reform, the establishment of a sustainable operating mechanism
Medicare is one involving multiple relationships, multiple departments and multiple body systems engineering, scientific and rational health system is conducive to the efficiency of health care play, universal health care is a necessary condition for sustainable development, therefore, in the national health insurance development process, deepening health system reform key issues can not be ignored. accordance with the central decision-making, deepening health system reform is necessary to highlight the "three key": that will quickly improve the universal health care system, reinforce and improve the basic drug system, and run the new grass mechanism, and actively promote the reform of public hospitals, health insurance simply is sound, standardized pharmaceutical, medical innovation. From this perspective, deepening health system reform should pay attention to the following aspects: on the "sound health insurance," we should pay attention to constantly improve the medical insurance fund raising, payment and management system, play to their enthusiasm, so as to establish a state in the future unified universal health insurance system; About "standard medical care", on the one hand to improve the basic drug system to ensure that all public primary health care institutions are able to provide free or low-cost to patients "essential drugs", eliminating health agency shall issue " large prescription, "the incentive to improve the bidding process in order to obtain cost-effective medicines, on the other hand, in order to get rid of medicine medicine mechanism, promote the pharmaceutical sub-sector, to promote primary health care institutions to the public good by the profit-driven orbit on "innovative medical" and to continue to promote the county public hospital reform, expanding urban public hospital reform to deepen, develop non-public medical institutions, medical service price adjustment, carry out a comprehensive convenience Huimin services.
(Five) to encourage the involvement of commercial health insurance, the establishment of a multi-level security system
Commercial health insurance is an important complement to universal basic health care in handling and management services to meet the needs of the community has a great advantage of such a populous country, regional differences is relatively large, commercial supplementary medical insurance will be greater leeway so , in the face of rising health care needs and the increasingly heavy financial burden on public hospitals to increase investment in the premise, but also actively encourage the commercial health insurance and private health institutions. practice, commercial insurance companies to through active market research, grasp the needs of residents of different levels, to enhance the health insurance product development and promotion, in order to meet the needs of different levels of health insurance. government should strengthen macro-management of the insurance market through tax incentives and other related support, If supplementary medical insurance for business operators to give tax breaks, etc., to encourage commercial insurance companies to actively participate in the operation of supplementary medical insurance market among the realization of the basic medical insurance and medical insurance business interaction, and ultimately promote the overall level of medical services increased.Links to free download http://eng.hi138.com