[1]李晓涵,树婷婷,李雯靖,等.专属普惠保险发展挑战与优化路径 ——以海南省“惠肝保”为例[J].卫生经济研究,2025,42(04):1-4.
　LI Xiaohan,SHU Tingting,LI Wenjing,et al.Development Challenges and Optimization Paths of City-customized Inclusive insurance ——Taking "HuiGan Insurance" in Hainan Province as an Example[J].Journal Press of Health Economics Research,2025,42(04):1-4.
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专属普惠保险发展挑战与优化路径
——以海南省“惠肝保”为例
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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
42
期数:
2025年04期
页码:
1-4
栏目:
医疗保障
出版日期:
2025-04-02

文章信息/Info

Title:
Development Challenges and Optimization Paths of City-customized Inclusive insurance
——Taking "HuiGan Insurance" in Hainan Province as an Example
作者:
李晓涵1; 树婷婷1; 李雯靖1; 李雯婷1; 徐 伟1
1.中国药科大学国际医药商学院，江苏 南京 211198
Author(s):
LI Xiaohan;  SHU Tingting;  LI Wenjing;  LI Wenting;  XU Wei
School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing Jiangsu 211198, China
关键词:
专属普惠保险; 惠民保; 可持续发展; 补充医疗保险
Keywords:
city-customized inclusive insurance;  Huimin insurance;  sustainable development;  supplementary medical insurance
分类号:
F840.684
文献标志码:
A
摘要:
目的：分析专属普惠保险发展现状，提出发展建议。方法：以海南省“惠肝保”为例，总结专属普惠保险的特点及面临的挑战。结果：专属普惠保险具有针对性较强、保障待遇较高及设置等待期等特点，也面临对特定风险群体保障不全面、与惠民保具有同质性的挑战。结论：因地制宜设计专属普惠保险，强化与惠民保的差异性和互补性，实施等待期简易核保，联动多元主体协同发展，从而实现专属普惠保险与惠民保协同、互补可持续发展。
Abstract:
Objective To analyze the existing development challenges of city-customized inclusive insurance, and to put forward suggestions for optimizing development. Methods Taking "HuiGan Insurance" in Hainan Province as an example, the characteristics and possible main challenges of city-customized inclusive insurance were summarized. Results The city-customized inclusive insurance was characterized by stronger targeting, higher protection benefits and a certain waiting period. Meanwhile, there were some problems such as incomplete protection for specific risk groups and homogeneity with the Huimin insurance. Conclusion It is necessary to design city-customized inclusive insurance according to local conditions, strengthen the differentiation and complementarity between city-customized inclusive insurance and Huimin insurance, implement simple underwriting during waiting period, and link up multiple main bodies for synergistic development, so as to realize the synergistic, complementary and sustainable development of city-customized inclusive insurance and Huimin insurance.

参考文献/References:

[1] 刘阳，郭珉江，李亚子，等.多层次保障体系下城市定制型商业医疗保险保障研究[J].中国医疗保险，2024（03）：106-113.
[2] 许荣庭，沈袁恒.普惠型医疗保险发展：实践困境与优化方向[J].西南金融，2022（01）：40-51.
[3] 胡杨木，刘敬，钟碧霞，等.普惠型商业医疗保险的保障效果研究[J].卫生经济研究，2024，41（02）：27-30.
[4] Hyuna Sung,Jacques Ferlay,Rebecca L.Siegel,et al.Global cancer statistics 2020:globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J].Ca:a Cancer Journal for Clinicians,2021,71:209-249.
[5] 王群，肖杰雄，杨震宇.应对惠民保逆向选择问题的创新做法研究[J].卫生经济研究，2024，41（04）：61-65.
[6] 吴蓉，庞庆泉，赵云.惠民保可持续发展挑战和高质量发展路径[J].现代医院管理，2024，22（02）：9-12.
[7] 何文，申曙光.医保“保小病”能否兼顾健康保障与费用控制?[J].保险研究，2018（11）：93-106.
[8] 翟京，徐晓芬，陈伟洁.公立医院与商业保险合作模式的探索[J].卫生软科学，2024，38（03）：82-84，90.
[9] 姜志敏.“药店+商保”生态链雏形初现[J].中国药店，2023（12）：44-47.
[10] 张宗良，褚福灵.中国多层次医疗保障体系再思考——兼析补充保障的模式创新与协同发展[J].经济社会体制比较，2023 （01）：79-92.

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更新日期/Last Update: 2025-04-02