基本医疗保险和商业健康保险协同发展对完善我国多层次医疗保障体系具有重要意义。我国基本医保与商保的发展已大致经历商保支持医保、医保支持商保两个阶段,目前进入二者相互赋能、协同发展的第三阶段。基本医保具有经办信息网络、大数据系统等优势,且群众多样化个性化医疗保障需求加快释放,而商保供给相对滞后,为二者相互支持协同发展带来机遇。本文基于湖北孝感的创新实践案例,提出医保商保协同发展“双平台一通道”模式,医保和商保各建综合信息平台,两平台之间建立规范标准的对接通道,通过三个“封装”保障医保、商保相对完整独立运行的同时又可实现内涵外延的逻辑联通相互赋能,以提高经济价值和社会价值。

The integration of basic medical insurance and commercial health insurance is of great significance for improving the multi-level healthcare security system in China. The integration of the two in China has roughly gone through two stages, i.e. commercial insurance supporting basic medical insurance and basic medical insurance supporting commercial insurance. Currently, it has entered the third stage of mutual empowerment and coordinated development. Basic medical insurance has advantages such as claim management information networks and big data systems, and the diversified and personalized medical insurance needs of the public are increasing. However, the supply of commercial insurance is relatively lagging, providing opportunities for the mutual support and coordinated development of the two. This article is based on the innovative practice of Xiaogan City in Hubei Province, and proposes a "two platforms with one channel" model for the integrated development of medical insurance and commercial insurance. That is, medical insurance and commercial insurance build a comprehensive service platform separately, and a standardized docking channel between the two platforms was established. With three "packages" to ensure the relatively complete and independent operation of medical insurance and commercial insurance, it is possible to achieve logical connectivity and mutual empowerment of connotation and extension, in order to improve their economic and social value.