Abstract

In recent years, China's medical insurance negotiations have achieved remarkable results but still have shortcomings. China's medical insurance reform is currently in the exploratory stage. This article looks at the characteristics of the dual role played by the Chinese government in medical insurance negotiations, and analyzes the advantages and drawbacks of enterprises accessing or not accessing medical insurance. The article argues that China cannot replicate foreign medical insurance mechanisms but must establish its own innovative mechanisms. This paper describes the progress and current status of medical insurance negotiations in China and elaborates on the five stages of medical insurance negotiations including preparation, declaration, expert evaluation, negotiation, and announcement. The article highlights some essential points and misconceptions of the negotiation stage. By investigating the medical insurance negotiation mechanisms in the United States, Canada, and Germany, this paper summarizes the practical experiences of developed countries in the control of drug prices and the use of negotiation mechanisms. The article reveals the existing problems of China's medical insurance mechanism and proposes pragmatic and feasible suggestions. It has important theoretical and practical significance for improving the medical insurance mechanism and promoting the healthy development of the drug industry.

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