摘要
本文以遂宁市城乡居民参保人员患大病的人数、医疗费用、基本医保报销、大病保险赔付和商业保险公司经办人员配备情况为基础,分析大病保险效果和基金亏损的原因,提出了做好大病保险工作的建议:一是科学确定起付标准和保障水平;二是完善商业保险公司经办大病保险措施;三是地方人民政府应切实负起大病保险风险管控责任。
Based on the numbers of insured with serious illness in Suining, the medical expenses, basic medical insurance payment, serious illness insurance reimbursement and personnel structure of commercial insurance company, we analyzed the results of serious illness insurance and the reasons of fund defi cit, and made suggestions for improving serious illness insurance performance. First of all, it is necessary to determine the payment level and security level of serious illness insurance scientifi cally, then, complete insurance management measures for commercial insurance company, and last, the local governments should take the responsibility to supervise and control the risk of serious illness insurance.
出处
《中国医疗保险》
2016年第6期31-34,共4页
China Health Insurance
关键词
城乡居民
大病保险
教训
分析
urban and rural residents
serious illness insurance
lesson and experience
