Development and reform of the legal system for health insurance in China / 中国卫生政策研究

Health insurance is an important part of social security, and many problems have arisen in the con-struction of its legal system, such as legislative lag, lack of coordination among law enforcement, and serious disloca-tion of judicial relief. Therefore, under the vital time of performing the strategy of “rule by law”, the development and reform of the legal system for health insurance in China should be promoted. On the basis of summarizing the his-torical development of the legal system for health insurance in China, this paper proposes solutions such as centrali-zing legislative upgrades and expediting the process of unitary and special laws from the perspective of“rule by law”. The system of personal credit should be established and judicial transparency should be promoted to improve the legal system for health insurance.

The real rate of reimbursement on urban-rural integration medical insurance:Empirical anal-ysis of Tianjin city / 中国卫生政策研究

Objective:To effectively improve the health insurance security level of urban-rural residents and of-fer corresponding policy recommendations, the paper makes an empirical analysis of the security level of China’s ur-ban and rural residents health insurance system( U&RRHIS) . Methods: Frequency distribution and dummy variable regression tests were conducted with Tianjin’s urban-rural residents health insurance database. Results There is a large gap between real rate of reimbursement and policy rate in U&RRHIS;many factors have significant impacts on the real rate of reimbursement, including deductible tables, nominal rates of reimbursement, the age of the insured, insurance payment levels, medical expenses, medical institution classifications, etc. Conclusion:In order to improve the real rate of reimbursement for the insured, more attention should be paid to the real rate of reimbursement which is an important index of health security levels for health insurance policy adjustments; meanwhile, efforts should be made in terms of implementation, for instance, criteria should be established for an evaluation of the gap between the real rate of reimbursement and the policy rate of reimbursement, while medical insurance policies should be refined and a scientific and laddered policy rate of reimbursement should be established; moreover, the government’s finan-cial input in healthcare should be increased and the medical insurance system should be improved.