Objective: The paper explores how to better play the role of policy tools to better empower the development of city-customized commercial health insurance. Method: This paper takes policies related to city-customized commercial health insurance as the research object, selecting 95 policy texts directly related to city-customized commercial health insurance on the websites of central, provincial and municipal governments. This paper sets up an analysis framework of China's city-customized commercial health insurance policy from two dimensions of policy tools and policy objectives, uses Nvivo12 for coding analysis, and comprehensively summarizes the specific application situations of each policy tool in the policy texts. Result: By using matrix analysis, it is found that the combination of policy tools of “publicity and guidance” plus “consumer market” can effectively expand the coverage target, assisting to ease the problem of low participation rate; “Incentive and guidance” plus “goal planning" enables the goal of benefiting the people and enhancing the inclusiveness of development; “Supervision and management” plus “technology empowerment” supports sustainable development goal and ensures sustainable development; “Supervision and management” plus “publicity and guidance” enables the goal of fair claims settlement and avoids the risk of adverse selection. Conclusion: To better play the role of policy tools and empower the development of city-customized commercial health insurance, it is recommended to improve the structure of environmental policy tools and strengthen the whole process management.
Key words
city-customized commercial health insurance /
policy tools /
policy objectives /
text research
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References
[1] 中共中央,国务院.关于深化医疗保障制度改革的意见[EB/OL].(2020-02-25)[2025-02-17].https://www.gov.cn/zhengce/2020-03/05/content_5487407.htm.
[2] 阎建军,于莹.中国健康保险发展报告(2020)[M].北京:社会科学文献出版社,2020.
[3] 孙洁,黄艺飞,罗屿浪,等.惠民保可持续发展研究[J].中国医疗保险,2024(01):29-42.
[4] 王群,肖杰雄,杨震宇.应对惠民保逆向选择问题的创新做法研究[J].卫生经济研究,2024,41(04):61-65.
[5] 赵俊娟,李菲.普惠型商业医疗保险参保意愿影响因素分析——基于Logistic回归和CHAID决策树模型[J].中国卫生事业管理,2024,41(05):523-528.
[6] ROTHWELL R, ZEGVELD W.Industrial innovation and public policy: preparing for the 1980s and 1990s[M].London: Frances Printer,1981.
[7] 国家金融管理总局.关于推进普惠保险高质量发展的指导意见[EB/OL].(2024-05-29)[2025-02-17].https://www.baidu.com/link?url=pYQMLVywuNykJr9vOKkrvQsct9Nc02AYgrEAedIxvfGBvl1lVFQxEei2-A6LDpIdfWn6DbwYLUNcyWXBz_AwZRC1q5ZQE6HbzoEqJLqrzPO&wd=&eqid=f0042ede00061e4e0000000267b28c80.
[8] 湖南省人民政府办公厅.关于进一步支持和规范惠民型商业补充医疗保险发展的指导意见[EB/OL].(2024-02-29)[2025-02-17].https://www.baidu.com/link?url=D5io6q4IV3uRJIASTEcO7QcoBFCbGs0qD1GJPRWMnOU0t4HHpORYMx9zjliwEt1RUcdiCbGj7aB3zlFILlxLQkQS8RsksQOX_uW4gO7Al96nFCiR_nKM11HGZ3GvRkBfKl2BsrYgRYOEzcs_u1b6WikrJLBAHIWY6Of6nfZuqtkfjdBlVZUPmc0Rgow8puarK1FDsAxnkUmSZqoDNNZ15OY6dANOrWF2GhBEXB32uOS357Lfj1RWvZptu5PZfsF0&wd=&eqid=e666fd0a00015b0e0000000267b2888d.
[9] 天津市医保局,天津市金融工作局,天津银保监局.关于支持促进商业健康保险发展的指导意见[EB/OL].(2021-10-13)[2025-04-30].https://www.baidu.com/link?url=Aya2WRIoUZamBCRp7BgeyuiKYNwKw39r3oJiOR55OIypFNXcVrcyat5L9D6gbnUupEspAVb3tPlq3LnZyQ_dLVWSe11B5A8qcoODqw70_Ry&wd=&eqid=e88a38ca001388ee000000036811aa8e.
[10] 云南省医疗保障局,国家金融监督管理总局云南监管局.关于支持和规范云南省城市定制型商业医疗保险发展的指导意见[EB/OL].(2023-11-16)[2025-02-17].https://www.baidu.com/link?url=lUrqJLi7wxsyWj4Htr5YN0tnQmTTc2EQ7JzSjF_HSs-OTDx55ek_rGO8V2lduiL-QLFnelOAL_CRzzhfshIR1_&wd=&eqid=a101f6a8001778940000000267b28aa1.
[11] 黎赵,韦姗姗,张桂凤,等.政策全过程治理:惠民保发展困境与优化路径探析——以“惠邕保”和“百惠保”实施试点为例[J].中国卫生事业管理,2024,41(02):130-135.
[12] 冯庆庆,刘艺恒,陈曦,等.提高“惠民保”业务覆盖率的对策研究——基于浙江省的调查[J].保险理论与实践,2025(02):71-88.
[13] 南开大学卫生经济与医疗保障研究中心课题组.“惠民保”可持续发展的挑战和对策[R].天津:南开大学,2024.
[14] 张莉,耿超.保险行业高质量发展的人才培训体系建设[J].上海保险,2024(05):32-34.
[15] 郭振华.保险的社会属性:理论界定、保险业实践与未来[J].中国保险,2016(04):11-15.
