我國(guó)商業(yè)健康保險(xiǎn)的發(fā)展現(xiàn)狀及對(duì)策研究

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目錄
第1章 緒論 1
1.1研究背景 1
1.2研究目的和意義 2
1.2.1 研究目的 2
1.2.2 研究意義 2
1.3 國(guó)內(nèi)外研究綜述 2
1.3.1 國(guó)外研究綜述 2
1.3.2 國(guó)內(nèi)研究綜述 3
第2章 商業(yè)健康保險(xiǎn)的理論基礎(chǔ) 4
2.1 相關(guān)基本概念 4
2.1.1 人身保險(xiǎn) 4
2.1.2 商業(yè)健康保險(xiǎn) 4
2.2 相關(guān)理論概述 4
2.2.1 信息不對(duì)稱理論 4
2.2.2 需求供給理論 4
第3章 我國(guó)商業(yè)健康保險(xiǎn)的發(fā)展現(xiàn)狀及問題分析 5
3.1 我國(guó)商業(yè)健康保險(xiǎn)發(fā)展的基本現(xiàn)狀 5
3.1.1發(fā)展歷程 5
3.1.2經(jīng)營(yíng)現(xiàn)狀 5
3.2 我國(guó)商業(yè)健康保險(xiǎn)存在的問題 7
3.2.1 業(yè)務(wù)規(guī)模較小 7
3.2.2 經(jīng)營(yíng)主體懸殊 9
3.2.3 專業(yè)化程度低 10
3.2.4 賠付率高 11
3.3 我國(guó)商業(yè)健康保險(xiǎn)存在問題的原因分析 11
3.3.1 政府支持力度不足 11
3.3.2 經(jīng)營(yíng)主體資源投入不一 12
3.3.3 專業(yè)人才匱乏 12
3.3.4 信息不對(duì)稱 12
第4章 國(guó)外經(jīng)驗(yàn)借鑒 13
4.1 國(guó)外商業(yè)健康保險(xiǎn)經(jīng)營(yíng)模式 13
4.1.1 德國(guó)模式 13
4.1.2 美國(guó)模式 13
4.2 國(guó)外商業(yè)健康保險(xiǎn)經(jīng)營(yíng)模式的啟示 14
4.2.1 與醫(yī)療機(jī)構(gòu)合作 14
4.2.2 保險(xiǎn)產(chǎn)品多樣化 14
第5章 我國(guó)商業(yè)健康保險(xiǎn)發(fā)展的對(duì)策建議 14
5.1 加大政府扶持 14
5.2 改善經(jīng)營(yíng)模式 15
5.3 培養(yǎng)專業(yè)人才 15
5.4 與醫(yī)療服務(wù)機(jī)構(gòu)合作 16
結(jié)論 17
致謝 18
參考文獻(xiàn) 19


摘要 自1982年我國(guó)保險(xiǎn)業(yè)務(wù)恢復(fù)以來(lái)，商業(yè)健康保險(xiǎn)產(chǎn)品種類日益豐富，保費(fèi)收入也逐年增長(zhǎng)。截至2013年，我國(guó)的商業(yè)健康保險(xiǎn)保費(fèi)收入已達(dá)1123.5億元，同比上年增長(zhǎng)了30.2%。雖然目前我國(guó)的商業(yè)健康保險(xiǎn)發(fā)展速度較快，但仍無(wú)法滿足人們對(duì)醫(yī)療保障日益增長(zhǎng)的現(xiàn)實(shí)需求。本文主要運(yùn)用了文獻(xiàn)研究法、比較研究法和定量分析法對(duì)我國(guó)當(dāng)前商業(yè)健康保險(xiǎn)發(fā)展的實(shí)際情況進(jìn)行研究，探討其仍存在的問題，目前發(fā)現(xiàn)問題如下：一是業(yè)務(wù)規(guī)模較小，二是經(jīng)營(yíng)主體發(fā)展懸殊，三是專業(yè)化程度低，四是賠付率高。經(jīng)分析，出現(xiàn)這些問題的原因主要是：政府支持力度不足、經(jīng)營(yíng)主體資源投入不一、專業(yè)人才匱乏和信息不對(duì)稱。本文是在結(jié)合國(guó)外商業(yè)健康保險(xiǎn)經(jīng)驗(yàn)?zāi)Ｊ降那闆r下，對(duì)這些問題提出以下相應(yīng)對(duì)策建議：首先要加大政府扶持，其次要改善經(jīng)營(yíng)模式，再次要培養(yǎng)專業(yè)人才，最后要與醫(yī)療機(jī)構(gòu)合作。
關(guān)鍵詞： 中國(guó) 商業(yè)健康保險(xiǎn) 現(xiàn)狀 對(duì)策

Research on Current Situation and Countermeasures of
Commercial Health Insurance in China
Abstract Since our country restored the insurance service in 1982, the premium income of commercial health insurance has increased every year, and the insurance product has been getting rich. In 2013, the premium income of commercial health insurance has reached 1123.5 billion yuan, which has increased 30.2% than the last year on year-on-year basis. Commercial health insurance grow rapidly, but it still cannot meet people’s growing needs of medical security. Combined with the current actual situation of the commercial health insurance, this paper is based on the current situation of the Commercial Health Insurance in China, analysis its problems, and the put forward some effective countermeasures for improving the Commercial Health Insurance. Now, the problems are as follows: first is the small overall size, second is the great disparity of development of the business entity, third is the low degree of specialization, forth is the high loss ratio. Through analysis,the main reasons for these problems are the lack of government support,main business not a resource input, lack of professionals and the insurer and the medical service institutions information asymmetry. It put forward the relevant suggestion on the problems, which is combined with the foreign empirical mode of commercial health insurance. Firstly, the government should offer more support. Secondly, they should improve the operating mode. Thirdly, the professional team should be developed. Finally, the insurance company should cooperate with medical facilitating agency more frequently.
Key words : China Commercial Health Insurance Current Situation Countermeasures