This paper systematically reviews domestic research since the launch of the new healthcare reform in 2009 on the multitiered healthcare security system and the development of commercial health insurance, providing a comprehensive analysis of its theoretical construction, policy evolution, market positioning, and developmental challenges. Currently, academic consensus has been reached on the necessity of a multitiered system, the structural imbalances within it, and the pivotal supplementary role of commercial health insurance. At the same time, significant disagreements persist regarding pathway choices such as the relationship between social and commercial insurance and the boundaries between government and market roles. Commercial health insurance faces multiple constraints, including product homogeneity, data barriers, and ecological sustainability. Its development urgently requires macrolevel institutional consolidation, mesolevel mechanism coordination, and microlevel product innovation. This paper argues that future research should strengthen empirical evaluation of policy effects, design protection mechanisms for key population groups, and construct localized theoretical frameworks, so as to promote the systematic optimization and coordinated development of the multitiered healthcare security system.
Key words
multi-tiered healthcare security system /
commercial health insurance /
public-private collaboration in healthcare /
city-customized commercial health insurance /
Healthy China Initiative
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