International comparison of the financing mechanism of basic medical insurance and its implications for China

Abstract

Background: For more than 20 years, China's basic medical insurance system has realized the span from "system construction" to "improving quality and efficiency". At present, as the core issue of medical insurance system design, the current financing mechanism is difficult to adapt to the current situation and tasks. Objectives: Based on the theory of social equity, this paper uses literature analysis and comparative research to analyze the forms of social health insurance financing in four developed countries: Germany, the United States, Singapore and the United Kingdom. On this basis, it makes a systematic reference and reflection on the financing mechanism of basic medical insurance in China. Methods: The author adopts the method of literature analysis and comparative study. Through the existing research literature and the theoretical analysis of the medical insurance financing mechanism, the conceptual connotation and dimension of the basic medical insurance financing mechanism are further summarized and analyzed, which provides the reference and theoretical basis for the writing ideas of this paper. By analyzing and comparing the typical practice of the social medical insurance model in four developed countries, the basic ideas, main practices, direction goals, principle adherence, implementation results, realistic difficulties and obstacles of obtaining medical insurance financing are discussed. This paper analyzes the development status of medical insurance financing mechanism between China and four developed countries by means of classification, induction and comparison, and puts forward the optimization path based on the experience of the latter's fair practice. Results: it proposes that the current funding mechanism of China's basic medical insurance has three problems: An unbalanced funding structure and unreasonable sharing of responsibility; low level of coordination and unfair funding method; and dynamic growth mechanism of endogenous medical insurance funding has not yet been established. Main Contribution to Evidence-Based Practice: On the basis of the international experience, the author puts forward some enlightening reform measures to solve the existing problems in China: first, through the reasonable definition of the rights and responsibilities of multi-stakeholder, to construct the appearance of fair implementation; Second, reform the existing fixed financing methods and establish a fair financing mechanism linked to income; The third is to improve the actuarial mechanism of fund adjustment and promote the dynamic and sustainable growth of medical insurance funds. We will further optimize the financing mechanism of basic medical insurance and promote the high-quality and sustainable development of China's basic medical insurance.