Abstract
Objectives: This article aims to introduce, compare and analyze the design and development of Critical Illness Insurance systems in different parts of China under different social and economic conditions, to explain their characteristics and similarities. It may provide references to other countries, especially developing countries, to solve the problem of high medical costs. Methods: According to the methods in Comparative Economics, 3 areas (Taicang in Jiangsu, Zhanjiang in Guangdong, Xunyi in Shanxi) which are in high, medium and low socio-economic condition respectively were chosen in China. Their critical illness insurance systems were analyzed in the study. Results: Each system shares several common points, including coordinating urban and rural medical insurance fund, financing from the basic medical insurance surplus, and exploring payment reform and so on. But in the way of management, Taicang and Zhanjiang cooperate with commercial insurance agencies, but Xunyi chooses autonomous management by government. In Xunyi, multi-channel financing is relatively more dispersed, while funds of Taicang and Zhanjiang are mainly from the basic medical insurance surplus. The specific method of payment is different among these three areas. Conclusion: Because of the differences in economic development, population structure, and sources of funds, each area took their own mode on health policy orientation, financing, payment, coverage, and fund management to design their Critical Illness Insurance systems. This might provide references to other areas in China and other developing countries in the world.
Highlights
Critical illness always leads to high disease burden.[1]
It represents the future direction of development of medical insurance, which is reflected in the critical illness insurance
Coordinating urban and rural medical insurance fund can largely solve the problem of insufficient funding, reduce management costs and highlight the social justice, which has laid a solid foundation for success of critical illness insurance
Summary
Critical illness always leads to high disease burden.[1]. High medical expenses of critical illness treatment often influence a family a lot, especially for families with low income. Taicang established the urban and rural residents’ basic medical insurance in 2008, which is managed by social security department of the local government together with UEBMI.[5] The fund of critical illness insurance is mainly from the surplus of basic medical insurance fund. Zhangjiang transfers 15% of urban and rural residents’ basic medical insurance fund to buy “supplementary medical insurance for high expenses” from Zhanjiang branch of People’s Insurance Company of China (PICC) This has greatly increased the reimbursement level. In 2010, Xunyi county established a new rural cooperative medical allowance system for critical illness in the process of exploring solution to the problem of “poverty for disease” or “back to poverty for disease”, which provides the references of critical illness insurance for less developed areas of the whole country. Global budget is chosen by new rural cooperative medical system center
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
