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Essay代写:Commercial health insurance in the UK

2019-01-11 | 来源:51due教员组 | 类别:Essay代写范文

下面为大家整理一篇优秀的essay代写范文- Commercial health insurance in the UK,供大家参考学习,这篇论文讨论了英国的商业健康保险。商业健康保险作为英国医疗保障体系的重要组成部分,能满足居民多方位、高质量的保障需求,对于实现医疗风险管控、提升服务效率、完善健康管理以及推进医疗改革等方面都有重要作用。

Commercial health insurance,英国商业健康保险,英国代写,英国论文代写,essay代写

As an important part of the medical security system, commercial health insurance can meet residents' multi-directional and high-quality security needs, and play an important role in realizing medical risk control, improving service efficiency, improving health management and promoting medical reform. Compared with the domestic development status quo, the development of commercial health insurance in Britain is relatively mature, and its development experience is worth learning. This essay focuses on the analysis of the government and insurance companies in the British commercial health insurance market in the development of commercial health insurance in order to enlighten the development of China's commercial health insurance.

On October 14, 2013, the state council issued the state council on several opinions to promote the development of health services, clearly put forward the eight main task to promote the development of health service, requiring further perfecting health insurance services, commercial health insurance products, a big increase in number of ginseng, the commercial health insurance spending accounts for a substantial increase in the proportion of the total health expenses, form relatively perfect health insurance mechanism.

As an important part of the medical security system, commercial health insurance can meet residents' multi-directional and high-quality security needs, and play an important role in realizing medical risk control, improving service efficiency, improving health management and promoting medical reform. Based on similar basic coverage and healthcare structure, the health insurance market in China and the UK has a similar development environment. Under the relatively high welfare basic medical system, the British commercial health insurance market is becoming mature, covering up to 12% of the population. However, under the basic medical security system of "extensive coverage and low level" in China, the domestic commercial health insurance has not really played its supporting role, and its development is stagnant, which still needs reform and improvement in many aspects. Therefore, how to develop the commercial health insurance market has become an important problem for the insurance industry and even the government. This essay will analyze the structure of commercial health insurance in the UK, and on this basis, study the behavior of the government and insurance companies in the UK health insurance market, and put forward valuable Suggestions for the practical development of the insurance market.

At present, there are three typical medical security systems in the world: national health service system, social insurance system and commercial insurance system. The UK is a typical representative of the national health service system. It adopts the public health care for all model, with the national health service system as the leading model and social medical assistance and commercial health insurance as the auxiliary model. The national health service system, social medical assistance and private medical insurance each perform their respective functions and provide targeted protection for different types of people.

Britain's national health service, established in 1948, is the world's largest government-run health service. The national health service covers everything from prevention to rehabilitation, from tests for pregnant women to end-of-life care, from headaches to fevers to heart bypass surgery, and all legal residents are entitled to a near-free NHS. "Near free" means that residents also have to pay for medical expenses that are not covered by the NHS, such as prescriptions, dentists, eye care and travel.

The main beneficiaries of the social medical assistance system include the elderly, the sick, the government subsidy recipients, the tax credits and the low-income people. It includes out-of-pocket costs for those outside the NHS and follows the principle that "those who can afford it must pay for it and those who cannot". For the assistance application submitted by a specific group of people, the government will investigate their living conditions and medical needs, and finally determine their eligibility for assistance according to relevant regulations. In addition to the income standard, residents' health status and family structure will also be taken into consideration when considering the ability to pay of the salvors to ensure relative fairness.

Private medical insurance, also known as commercial health insurance, exists mainly to meet the needs of citizens at different levels of medical services. In 2012, 6.31 percent of the population was covered by commercial health insurance. In the UK health insurance market, the types of commercial health insurance can be mainly divided into three categories: the first is ordinary commercial health insurance. This insurance covers the cost of diagnosis, surgery and hospitalisation in private hospitals, eliminating the waiting time that patients may face in NHS services. Be the same as other insurance type, the draw up of insurance premium because of the person different, the respect such as the amount of compensation of the age that basically bases on protecting a patient, prospective, family to ensure and occupation. Second, the major disease insurance. Such insurance generally covers cancer, heart disease, stroke, organ transplant or permanent disability. Compensation is mostly a one-time payment, the amount is generally tens of thousands of pounds. Third, permanent or long-term medical insurance. Such insurance is used to protect the basic property of a disabled person. Insurance companies are responsible for making sure patients pay for all or part of their private care without having to sell their homes.

The above three systems constitute a relatively stable medical security system in the UK. The establishment of the NHS, on the one hand, provides a solid health guarantee for the British people and realizes the epidemiological transformation, making the diseases with high morbidity and mortality turn from infectious diseases to chronic diseases. On the other hand, it laid the foundation for Britain's economic prosperity and the development of medical treatment for chronic diseases. But over time, the problems of the government-led NHS have become increasingly apparent. Although the NHS is financially funded by the government and is supported by policies and regulations in its operations, long periods of underfunding and long waiting times have led to a sharp decline in people's satisfaction with the system, with some people turning to private medical institutions. Aiming at the inefficient NHS system, the government carried out the "internal marketization" reform in the 1980s and introduced the market competition mechanism, which to some extent improved the system efficiency, but problems such as vicious competition and resource waste still exist.

In Britain, which is famous for its welfare state, the national health service system has reached the guaranteed area covering all the people. On the surface, the development space of commercial health insurance market is extremely limited. However, as shown in table 2, from 1990 to 2012, the number of insured people in the British commercial health insurance market remained above 4 million for a long time, and the proportion of the insured people in the commercial health insurance in the UK remained at 6% ~ 7%. According to Laing & Buisson, in 2010, 6.39% of British people independently chose private health insurance in the form of individuals or groups, and the number of people covered by commercial health insurance reached 7.2 million, accounting for about 11% of the population, compared with 3 million in 1979. In the current process of social and economic development, the security system will not be completely taken over by the government, nor is it suitable for free competition in the market. The market for commercial health insurance is bound to be co-sponsored by the government and insurance companies.

The national policies and regulations clearly define the service scope of public security and commercial insurance, and provide guidance for the complementary cooperative relationship between them. Although the NHS provides near-free coverage, it still requires residents to pay for certain treatment items, such as prescriptions, dentists, eye care and travel. These government free treatment programs are mainly divided into two parts. One part is the high frequency and high cost, such as the cost of dentists. Another part is the expense that residents are supposed to bear, such as the cost of plastic surgery and travel expenses for medical treatment. The definition of laws and regulations provides the development space for the commercial health insurance market, and also indirectly positions the insured population of commercial health insurance at the higher income group, which increases the high-income customer resources of commercial health insurance companies.

In the medical security system of high welfare state, the social security covers a wide area and covers a wide range of projects, and the cost is mostly covered by the government and hospitals. Therefore, when the disease status is uncertain, patients tend to choose more treatments than they need, resulting in a waste of resources. Therefore, in order to prevent the excessive use of medical services and irrational consumption of medical resources, legal medical insurance institutions have established relevant restrictive provisions.

In 1980, the British government began to reduce subsidies for some social security programs. Short-term benefits for patients were reduced by 5 per cent from 1980 to 1981, and income-linked short-term benefits for illness were abolished in January 1982. The reduction of the security level is aimed at reforming the social medical security system, shifting from the government's sole responsibility to the individual's sharing of the cost with the government, so as to enhance the individual's sense of rights and responsibilities in the system. This has reduced the deficit in government spending on health care and boosted demand for better commercial health insurance. Similarly, the dismal state of health insurance in Britain needs such a move. According to table 2, since 2001, the number of people insured in the individual market has decreased from 1229,000 to 993,000 in 2011. During this period, the number increased slightly from 2006 to 2008, but the overall number still reached a decline of 20.5% in 2010. The company, which has the largest share of the UK health insurance market, will stop selling individual health insurance through intermediaries due to the downturn in the individual market. In response, the British government has moderately reduced the coverage of the NHS and controlled the supply of treatment, so as to guide high-income people to choose more convenient private health insurance and more reasonable allocation of existing medical resources.

Service outsourcing mode is formed under the general environment of "internal marketization". Until 1980 Britain's health system was one of the best examples of command and control. Public hospitals generally only provide emergency and in-patient services, without outpatient departments. As the budget unit of the government, the expenditure of public hospitals is fully managed by the government. Under such a system, the medical and health sectors are wasteful, overstaffed and underserved. For economic planning under the market economy of the medical and health sector, the government introduced the "internal market" reform measure, namely the government in maintaining the public sector as a whole organization structure remains the same, in the internal market mechanism simulation, through the way of government purchase services, to promote the competition between public service providers. Its main purpose is to establish a mechanism and organization for the government to purchase medical services, and change the original mode of "government purchasing and providing services" into the mode of "government purchasing and service competition".

Since then, 152 district-based primary health care funds have been the biggest purchasers of health services, controlling 75% of the NHS budget and at the heart of the NHS. In order to improve the purchasing power and management level of PCT, the British government comprehensively promoted the "service outsourcing" model in PCT in 2007, aiming to introduce commercial health insurance companies and further reform the medical system. The government's outsourcing procurement programme has a rigorous pre-qualification process in place, with each agency providing services matching its qualifications to assist the primary health care trust fund in assessing the needs and trends of people in different regions.

The government outsourcing service procurement plan actively promotes the development of local commercial insurance companies, enables insurance companies to participate in the operation of the national health service system, ensures that residents get timely and effective medical security services, and improves the efficiency of the medical security system. Fourteen companies, including Britain's prudential and America's aetna, are bidding to join the British government's outsourcing procurement program. Among them, aetna, unitedhealthcare, hennuo, baobai and other 4 companies can provide all management services. The 14 companies provide quality and efficient health care through four main areas: evaluation and planning, contracting and procurement, performance management, resolution and review, and patient and public participation.

The development course of British commercial health insurance brings good enlightenment to the development of Chinese commercial health insurance. The development of our country can be inspired by the government's policy support for commercial health insurance and the continuous expansion of market share in the market changes that insurance companies themselves are dealing with. Britain's sound medical security system is gradually formed in the process of constant change and reform. It is the product of the comprehensive effects of politics, economy, culture, history and other factors. We need to take into account when learning: on the one hand, nothing can be accomplished overnight. For China's medical reform, the direction is the first step, followed by gradual reform from the grassroots level, for the reform process exposed new problems, we should be honest, efforts to solve rather than perfunctory, cover up, so as to develop in the continuous negative and positive. On the other hand, the development of the British medical security system is based on the national conditions of the UK. Therefore, China cannot completely copy the system, and it should be combined with its own national conditions to achieve the true sense of "for our own use". It is believed that in the foreseeable future, China's commercial health insurance market will flourish under the cooperation of the government and insurance companies, further expand and subdivide the value chain of health insurance, provide residents with high level of protection and better service, and lead the insurance industry to a more professional future.

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