2.4 Problems of Medical Institution ReformThe main problem that exists in China's medical service market at present, horizontally, is that the administrative monopoly has not been broken, and there is a lack of a level playing field. The government directly owns and manages medical institutions, puts its main focus on running hospitals, and to a certain extent consciously or unconsciously becomes the protector of the interests of public hospitals. This restricts the development of other forms of property rights in medical institutions; the market is inefficient in resource allocation because of the lack of competition; public medical institutions take advantage of their monopoly to pursue economic benefits one-sidedly, with indiscriminate charging, indiscriminate inspections, indiscriminate prescribing of medicines, and poor quality of service, directly victimizing ordinary consumers of medical services. Vertically, irrational regional health planning is the main problem. This is mainly reflected in the compartmentalization of health resource allocation, duplication of construction, structural imbalance, wastefulness and shortage of resources, high operating costs, low overall utilization efficiency, and an inability to satisfy the people's health-care needs. Therefore, medical institutions are in urgent need of reform, medical and health resources need to be reintegrated.
3Establishment of a medical insurance system with Chinese characteristics
3.1Coordination of social and economic development, scientific planning, and strengthening of the macro-guidance of the medical insurance systemThe medical insurance system, as an important social policy, involves a wide range of social activities, and has become inseparable from and closely related to the various insured persons. Therefore, it is necessary to formulate a medium- and long-term medical insurance development plan that is consistent with the level of social and economic development, and that can meet people's medical needs, in order to guide social development, coordinate the relationship between social and economic development, and make it a guide for people's social behavior. Through the medical insurance business planning, the implementation of the basic medical protection for the insured in line with the level of socio-economic development, and strive to realize the mutual coordination and sustainable development of socio-economic and medical insurance business. In the long term, based on the long-term, scientific and democratic planning of the future medical insurance business, correctly recognize and deal with the interrelationship between socio-economic development and the development of the medical insurance business, coordinate the scale, speed and proportion of the development of socio-economic development and the medical insurance business, determine the fund-raising and use of the fund, the cost-sharing and cost-constraint mechanisms in line with the requirements of socio-economic development, accurately grasp the overall situation and local, immediate and long-term, overall and unit and other types of medical insurance. In order to accurately grasp the overall and local, immediate and long-term, overall and unit indicators of various scales, speeds and ratios, correctly deal with the interests of the state, the collective and individuals, coordinate the various medical insurance relationships among medical insurance administrators, medical service providers and insured persons, and reasonably allocate social resources in accordance with the needs of the society so as to realize the rational allocation of resources and avoid wastage. Seeking balance in dynamics, seeking development in balance, seeking balance in development, so that the operation of the medical insurance system is in a virtuous circle, promoting the continuous progress of the medical insurance cause, so that more members of the community to enjoy more of the benefits brought about by medical insurance.
3.2Speeding up the pace of legislation on medical insurance and constructing a legal guarantee for medical insuranceThe reform of the medical insurance system is mandated by the state in order to safeguard the basic medical needs of all laborers, and is characterized by compulsion, mutual aid and fairness. Therefore, in order to ensure the realization of its objectives, it can only be implemented by national legislation through legal channels. The medical insurance fund is a health safety net established to provide financial protection for insured persons in the event of disease risk, and is the "life preservation money" of all insured persons, whose role is of profound significance and great importance. But now its relevant legislation is not sound, lagging behind, to jeopardize the security of the medical insurance fund, the relevant provisions of the law is not targeted, weak penalties, or even law enforcement penalties are not based on the law, it is difficult to effectively play a strong role in the law to achieve the purpose of punishment and warning. For this reason, it is recommended that medical insurance as soon as possible into the legislative program, accelerate the legislation of medical insurance regulations, so as to construct a medical insurance fund security legal protection line of defense to ensure that the operation of the medical insurance system, is the urgent task of the current medical insurance work.
3.3 Strengthening the dynamic study of medical insurance policy is an important prerequisite for scientific decision-making in the reform of the medical insurance system, social and economic development, technological advances and people's health awareness, so that people's demand for medical care continues to increase, the old medical insurance policy can only adapt to the original basic medical needs, can not solve the changed objective situation, and even to solve the previous contradictions or problems caused by new problems. New problems have been created to solve the previous conflicts or problems. There are many relationships affecting the development and change of medical insurance, various contradictions are intricate and complex, various reasons are very different, and various factors interact with each other and cause and effect each other, which makes the situation more complicated. The policy study of the health insurance system is to prevent new contradictions that may arise during the implementation of the health insurance system, to solve new situations and problems that arise during the implementation of the health insurance system in a timely manner, and it is an important prerequisite for scientific decision-making on the reform of the health insurance system. Therefore, only by strengthening the process management and dynamic research of the medical insurance system, and adjusting the medical insurance policy at an opportune moment, so as to avoid or minimize the impact and waste of the medical insurance system and the medical insurance fund due to the lagging behind of the medical insurance policy, and by continuously improving the medical insurance system, can the medical insurance policy be effectively brought into full play in order to meet the increasingly evolving and changing needs of the medical care, and to ensure the steady operation of the medical insurance system. The system will be able to effectively play the role of medical insurance policy in order to meet the increasingly evolving medical needs and ensure the steady operation of the medical insurance system.
3.4 Open-source and cost-saving, focusing on cost-saving Rational use of the medical insurance fund is an important way to implement the strategy of sustainable development of medical insurance. The introduction of the new "Regulations on the Treatment of Medical Accidents" on the hospital in the medical safety requirements are higher, more stringent, must seriously consider the medical safety, a variety of new medical technology projects, new diagnostic and treatment equipment successive inputs, the use of new and high tech medical materials, greatly reducing the medical risk. Therefore, as a medical provider are hoping to reduce medical disputes through the safe use of high-tech equipment, at the same time, it can also bring them lucrative economic benefits. However, this has led to an increase in medical costs, an increase in the social burden of medical care, and a new pressure on the expenditure of health insurance funds. With the accelerated pace of population aging, the proportion of the elderly population in the structure of the insured population has been climbing. The income of the medical insurance fund has not kept pace with the growth of the medical insurance fund's expenditures, and it is facing the double pressure of the difficulty of raising the medical insurance fund and the accelerated growth of medical needs. This is not conducive to the smooth operation and sustainable development of the medical insurance system, and if it is not studied and resolved in a timely manner, it will inevitably lead to the emergence of the doling out of food and food, turning medical insurance into water without a source and wood without a root, and ultimately causing the entire reform of the medical insurance system to fail and lose credibility with the people. Therefore, for the time being, it is necessary to both open the source of income and reduce expenditure, open the source of income and reduce expenditure simultaneously, put the reduction of expenditure in the first place, strengthen the control of medical costs, improve the efficiency of the use of medical insurance fund, rational and effective use of medical insurance fund, to ensure the sustainable development of medical insurance.
3.5 Strengthen guidance, introduce competition, rational allocation of medical resources, and promote the construction of community medical institutions due to the special characteristics of the medical services market, the medical provider to master all the medical information and medical resources, is in a monopoly position, the formation of a seller's market, and thus easy to make the market failure. Market mechanism alone cannot solve the problem of rational allocation and rational utilization of resources. Therefore, in order to ensure fair competition in medical services and the legitimate interests of the insured, government intervention is indispensable. At present, the construction of community medical institutions is particularly prominent, government departments should through macro management, improve health resource planning, allocation, formulation of relevant policies to support community health care, encourage and guide a variety of social funds to participate in community health care construction, multi-channel, multi-faceted increase in community health care institutions, increase the training of general practitioners adapted to the needs of the community health care to improve the level of service of community medical institutions, and create a good community health care institutions, and create a good environment. service level of community medical institutions, create a favorable environment for community medical care, and establish a good image among the public. The medical insurance management department, in determining the fixed points of medical institutions, formulates standards and norms for payment of fees based on the average cost or advanced cost in society, rationalizes the layout based on the actual situation of medical insurance, determines the amount of health resources needed to provide medical services to insured persons, breaks the monopoly, introduces competition, and reverses the passive situation. Guiding medical institutions through internal potential, reduce costs, improve services, improve economic efficiency, at the same time, the eligible social medical institutions to give policy support to accelerate the pace of fixed-point, and from the health insurance settlement policy, the standard on the appropriate tilt, in order to attract the insured patients close to the doctor, the convenience of the insured patients, reduce health care costs, and truly realize the "minor illnesses in the community, major illnesses in the The hospitals".
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