我国多层次医疗保障体系快速发展,10年来,关于医保与商保相互关系的研究大体分为两个阶段。前期相关学术研究多侧重商业健康保险对医保的赋能,分析商业健康保险如何利用其组织网络、精算能力、信息化水平等方面优势支持基本医保业务。近期相关研究则侧重利用基本医保大数据、信息网络和监管能力为商保赋能。当前实践层面正在进入基本医保与商业健康保险双向赋能新阶段。本文尝试从时势、场景和环境等角度,研究基本医保与商业健康保险相互赋能问题。

Multi-level healthcare security system in China is developing fast. In the past 10 years, research on the relationship between basic medical insurance and commercial insurance can be divided into two stages. Previous academic research mainly discuss the empowerment of commercial health insurance to basic medical insurance, analyzing how commercial health insurance utilizes its organizational network, actuarial ability, information management ability, and other advantages to support basic medical insurance administration. The main concern of recent research is empowering commercial insurance by the big data, information networks, and regulatory capabilities of basic medical insurance. At present, we are in a new stage of mutual empowerment between basic medical insurance and commercial health insurance. This article attempts to study the mutual empowerment of basic medical insurance and commercial health insurance from the perspectives of current situation, scenario, and environment.