The reform of medical insurance system is an important part of economic system reform. Preliminary study on supplementary medical insurance in China. The reform model of medical insurance system in China should be a mixed model of multiple coordination. The key of this model is to establish a medical insurance operation mechanism with multi-level guarantee mode, multi-channel guarantee fund, scientific payment mode and effective management mode.

The reform of medical insurance system is an important part of economic system reform. Judging from the current practice of China's medical insurance system reform, it has formed such modes as "through", "division of labor", "storage" and "overall planning". Although these models are reasonable, they all expose some deep-seated contradictions and problems in practice, such as the difficulty in raising funds, the failure of medical service and expenditure management mechanism, etc., and it is difficult to form models. According to the basic principle of "low level, wide coverage, burden on both sides and combination of unified accounts" determined in the State Council's Decision on Establishing the Basic Medical Insurance System for Urban Workers, and drawing lessons from the positive and negative experiences of medical insurance system reform at home and abroad, the author believes that the reform model of China's medical insurance system should be a multi-coordinated mixed model, and the key of this model is to establish a medical insurance operation mechanism with multi-level guarantee mode, multi-channel guarantee fund, scientific payment mode and effective management mode.

Establish a multi-level medical insurance system

According to the actual situation, China's multi-level medical insurance system should include the following three levels:

1. Basic medical insurance. This is the foundation of multi-level medical insurance system and an important part of national medical policy. It is a legal government action, mainly enforced, and the financial resources mainly come from the compulsory insurance premium. The basic medical insurance adheres to the principle of "low level and wide coverage", emphasizes "fairness first, giving consideration to efficiency", and only undertakes the responsibility of ensuring basic medical care, that is, it is limited to providing medical services that meet the necessary medical needs of the vast majority of insured employees, can be provided by mature and suitable medical service institutions and can be paid by medical insurance funds.

2. Supplementary medical insurance. This is an indispensable part of a complete medical insurance system. On the basis of basic medical insurance, enterprises (industries) voluntarily pay for employees and employees pay for individuals when economic benefits permit, forming a supplementary medical insurance fund to make up for the fact that the basic medical insurance level is not enough to pay huge medical expenses. Economic paper "A Preliminary Study on Supplementary Medical Insurance in China II". At the present stage in China, the forms of supplementary medical insurance that should be established as soon as possible are:

First, supplementary medical insurance for "serious illness". Basic medical insurance covers basic medical care, but the situation that it exceeds the maximum payment limit objectively exists. Although the probability of their occurrence is very low, the cost is very high, which is unbearable for both units and individuals. For these "overweight diseases" medical problems, we can neither push it off, nor should we put this burden on the employer. The best solution should be to establish supplementary medical insurance for "overweight diseases" in the overall planning area, which is mainly used to solve the medical expenses above the top line of basic medical insurance, reduce the burden of seriously ill workers and ensure their basic livelihood;

The second is supplementary medical insurance for "serious illness". The basic medical insurance adopts the method of unified account, in which the social pooling fund determines the Qifubiaozhun and the maximum payment limit, and the medical expenses above the Qifubiaozhun and below the maximum payment limit are mainly paid by the pooling fund, but individuals also have to bear the corresponding proportion. Although the proportion of personal burden is relatively small compared with overall payment, it is still difficult for employees and their families who can't work due to illness and their wages have dropped significantly because of the large medical expenses. In order to reduce the burden of seriously ill workers and ensure their basic livelihood, it is necessary for enterprises (industries) to establish a special fund for seriously ill workers, make overall use of it, and provide financial assistance to those in need.

3. Commercial medical insurance. This is a relatively standardized level in the multi-level medical insurance system, which plays a role in filling the gap and improving it. It is a kind of insurance that the insured pays insurance money when he is injured due to illness, childbirth or body during the insurance period. In this field, people can choose freely and adhere to the principle of "giving priority to efficiency and giving consideration to fairness". ;