摘 要：在当前深化医药卫生体制改革的大背景下，江苏是医药体制改革的重点试点省份。商业健康保险作为当前医药体制的一个重要部分，如何能够在当前新医改的背景下健康快速发展成为一个大家共同关注的问题。本文将分析江苏省苏州地区商业健康保险市场的现状，探索在新医疗体制改革的大背景下，新医疗体制改革方案给苏州地区商业健康保险带来的压力及问题：发展空间小、专业化水平低、专业人才紧缺、缺乏有力的监管和政策支持、与医疗机构合作模式不完善等，并试图提出符合苏州自身特点的发展对策，如寻求与基本医疗保险不同领域的发展空间、提高专业化水平、加快专业人才培养、加强监管力度和寻求政策支持以及与医疗机构合作模式等。顺应新医改要求，促进苏州商业健康保险的发展及加快医药体制改革的不断深化。56735

毕业论文关键词：苏州，新医改，商业健康保险，对策

Abstract：Under the background of medical and health system, Jiangsu province is an important experimental unit. As an important part of social medical system, how commercial health insurance could develop healthily and quickly has become an issue of mutual concern. This thesis will analyze the current situation and explore the pressure and problems the new medical system reform has brought to the commercial health insurance. The five problems includes the unhealthy development of market, lack of specialized management, lack of professional talents, short of effective policy and support , and imperfection of the cooperation model with medical institutions. The thesis will try to come up with development strategies, such as promoting the health development, establishing specialized information management system, accelerating the training of talents, striving for the related policy and legal support, and completing the cooperation model between commercial health insurance and medical institutions. Complying with the requirements of new medical system reform, the development of commercial health insurance in Suzhou should be promoted and the reform should be accelerated and deepened.

Keywords：Suzhou, new medical reform, commercial health insurance, countermeasures

目 录

1  引言 3

2  商业健康保险概述 3

3  新医改下苏州商业健康保险的发展现状 4

3.1 市场规模 4

3.2 市场赔付率 4

3.3  产品供给 5

3.4  相关法律监管 5

3.5  风险控制 5

4  新医改下苏州商业健康保险发展面临的问题 6

4.1  发展空间小 6

4.2  专业化水平低 6

4.3  专业人才紧缺 7

4.4  缺乏有力监管和政策支持 7

4.5  与医疗机构合作模式不完善 8

5  新医改下苏州商业健康保险的发展对策 8

5.1  寻求与基本医疗保险不同领域的发展空间 9

5.2  提高专业化水平 9

5.3  加快专业人才培养 10

5.4  加强监管力度和寻求政策支持