The latest reform measures of unemployment insurance
The whole plan of 2000 to 2.146 million the number of weeks to pay, but in 2002 reached 3.624 million, increase amplitude is larger.Federal unemployment in 2000-2000, according to balance of the trust fund fund revenue of $33 billion in 2000, spending $24 billion, $87 billion of balance of past years of account, but from 2000 to 2003 spending rose by $35 billion, about 2.5 times that of 2000 bills, when unemployment trust fund serious deficit, past suddenly, fund balance from $87 billion to $48 billion.Despite spending from 2003 in 2004 to reduce a little, but the balance of payments deficit is still, and of balance of past years to $42 billion.Unemployment trust fund which spending too much, bear the large financial burden on the government.Table 1:2000-2003 federal, state, (2) the experiences from the unemployment insurance program tax principle is challenged.The United States is one of the characteristics of unemployment insurance in inhibition of unemployment in the concept of organizational system, practice the experience tax principles, namely the employer to attend unemployed insurance plan three years later, according to the records of company before laying off workers of different tax rates, the tax system can inhibit the employer fire behavior.However, experience in tax rate will cause labor turnover of labor-intensive enterprises must burden higher rates of tax than other industries.In addition, the government found that some employers spalling of the original enterprise responsibility, through illegal manipulation, to evade tax experience principle.(3) between the federal and state interests.Currently funds must be turned over to the federal Treasury collection states of fiscal revenue, by the federal unemployment trust fund for unified management, but exist in the management system of the struggle between the federal and state interests, less return states complained that the federal funds, to meet the needs of the state.(4) the presence of fund pay system.Faced by people in the United States insurance fraud phenomenon, lead to the low efficiency of capital management.As the analysis of the unemployment insurance development report, the United States the United States unemployment pay rate is 9.92% on average in 2004, and the best five states unemployment pay management of fund pay rates only at 3.77%.If in 2004 the national fund pay rate can reduce the best five states to pay rate control levels, then improve the management of funds to pay can reduce the loss of a $2.1 billion fund.Second, the main measures of the bush administration in this social context, in order to promote economic development, maintaining the social stability, the fight for re-election, President bush proposed should strengthen and protect the labor in the United States, reforming America's employment and job training programs.1. To provide the unemployed again obtain employment account in the President's economic growth plans, Mr Bush to establish account of individual employment and Re - employmentAccounts), is expected to be effective to the termination of the treatment of unemployed people actively looking for work.Reemployment subsidies standards set by the state free accounts, highest can provide $3000 in subsidies to the unemployed, encourage them to participate in job training and employment auxiliary services help to rejoin it.States, in addition to these they choose to run a service, One - Stop center will also provide them with some of the basic, free again obtain employment service, such as help to write a resume, etc.If the unemployed to enjoy unemployment insurance and find a job within 13 weeks, they can also keep the subsidies in their personal accounts, as again obtain employment.2. The reform of the unemployment insurance management system reform in this field is mainly aimed at the federal and state governments in the management of unemployment insurance benefits dispute and put forward, the purpose of the reform is to promote the state employment guarantee agencies on the unemployment insurance management and control of flexibility, strengthen the state unemployment benefits for the unemployed.(1) to reduce the federal unemployment tax employers.In 2004 the unemployment insurance tax and financial reform proposals put forward to reduce the federal unemployment tax plan, the proposal is only in the discussion of federal and state governments, are not practical.Current federal effective tax rate of 0.8%, in order to promote economic investment and job creation, in 2006 began to appropriately cut federal unemployment insurance tax.Particular way from the states of the first year after the implementation of laws and regulations on January 1st, federal unemployment rate reduced from 0.8% to 0.8%, is expected in the system implementation in the third year of implementation of the federal unemployment insurance rate was reduced to 0.4%;In choosing independently bear the unemployment insurance management fees, the tax rate to 0.4%, the first year back to 0.2% from the second year.(2) the state control of the management of funds.Management of the unemployment insurance fund from the federal government to move to the states, the fastest in fiscal year 2007 will be the main fund management gradually transferred to the state, by state control their unemployment insurance all spending, this power down actually empower states greater autonomy, fund management of the main responsibility, so as to ensure the flexibility of unemployment benefits management, improve the efficiency of management of unemployment insurance.
In fiscal year 2007 the government's fiscal budget report to President bush in the 2007 fiscal year budget for employment training agency for $9.4 billion, achieve the goal of strengthen and protect the American workforce.Reform focus mainly has the following points: (1) the construction of the changing workforce investment system concept.Employment and training department has taken measures to establish the demand driven workforce investment system, this is Mr Bush's job training plan, to get the workers in the growing economic environment to prepare working ability.Labor training programs in 2002 total financial expenditure of $12.915 billion, $2003 in 14.104 billion, for $2004 in 15.892 billion.In addition the state will provide professional development for difficult employment of the unemployed account (CareerDevelopmentAccounts), is expected to account for career development, will be three times the number of existing national each year about 800000 people will receive the account.(2) improve the efficiency of the management of the fund balance of payments.In fiscal year 2007 budget reflects the employment and training department's commitment to strengthen the management of unemployment insurance: prevention and audit will continue to pay unemployment insurance phenomenon and employers pay tax illegal act.The federal government encouraged states efforts on review the fund balance of payments, to allow the states from their tax recovered part extracted and recover the funds as funding.According to insurance fraud behavior, the implementation of individual compensation levy 15% of penalties.Against insurance fraud behavior, require employers to set up the "start working" in the new hire report date, help employment guarantee agencies to identify those who have to go back to work but continues to receive welfare benefits.Empower states hire staff enter the new directory (NationalDirectoryofNewHires) permission, this state unemployment insurance agencies in extend unemployment benefits, can query whether the unemployment benefits to get back to work, but also in receiving unemployment benefits.
Promote again obtain employment.$3 billion budget required to expand again obtain employment plans and qualification assessment (REAs), by One - Stop center interview investigation to understand the unemployed again obtain employment service requirements.Through understanding the needs of the unemployed, so as to provide effective employment service, make the unemployment insurance beneficiary will soon return to work, to reduce dependence on unemployment benefits.At the same time, the qualification for long-term unemployment benefits staff, reduce the unreasonable expense.By expanding employment plan and qualification assessment again, can have benefits to save $1.5 billion a year.
, the trend of reform policy change is in order to cooperate with President bush on strengthening and protecting the American workforce, reforming employment and training programs.The author induces the policy reform from several trends: 1. Give states even greater autonomy, improve the management system of federal, state, in the management of unemployment insurance, employers and the state government believed that now the problems in the management system, employers complain about the federal unemployment insurance tax now is too high for them.States, on the other hand, when ask federal grants to help, often encounter setbacks, federal grants are very few, almost can't meet their needs.In response, the federal is put forward to reduce the federal tax rate plan, reduce the tax burden of employers, thus promoting economic development and create jobs.According to the social security law, the state revenue must be turned in to the federal budget, under the unified management of unemployment insurance funds, but the reform trend is weakened this request, the main unemployment fund management will be from federal move down to the states.2. Strengthen again obtain employment service, the transition of the transformation of the mode of employment services to the system and the government claims that has a lot to do, think the bush administration, improve workers' employment ability, speed up the development of economy, it requires hard work for the jobs of the 21st century goal make preparations for vocational education and vocational training, strengthen and protect the labor force.In this respect, Mr Bush to establish reemployment account such as active plan and job training, career development account.Reemployment subsidies account for the long-term unemployed again obtain employment, encourage the re-employment training, career development account change by the original management mode, set up independent fund reserves in state, saving management costs, make full use of existing resources.Workforce investment system in the past ten years has not been much change, it is no longer suitable for economic and social environment full of change.In order to adapt to economic globalization, the government proposed to establish the labor market demand oriented workforce investment system, give the individual's right to control the resources, to adapt to the economic background of innovation.Through investigating the unemployed to job training and employment demand, as the main basis of the system construction, so as to provide more effective service system, suitable for the unemployed.3. Qualification strictly, improve the management efficiency of unemployment insurance for a long time to enjoy the experience of unemployment could suppress the unemployed again obtain employment, so the reform of the long-term unemployed tend to be more strict qualification regulation, designed to inspire the unemployed job as soon as possible.At the same time, the government hopes to improve the management efficiency of unemployment insurance and so on employers evasion and personal insurance fraud review is more strict.Despite the 2007 budget to $1 billion to prevent and check the insurance fraud behavior of unemployment insurance, but it is expected that in the system of the first year of the implementation can recover lost unemployment fund has $770 million.To enhance the management efficiency of system, of course, need full support from the state, the federal government is not only down unemployment insurance funds management, but also encourage the state fund income and expenses of examination work, fully arouse the enthusiasm of local management.
2015年3月7日星期六
The United States is the world's most populous country to set up the catastrophe insurance project
The United States is the world's most populous country to set up the catastrophe insurance project
The United States is the world's most populous country to set up the catastrophe insurance project, the project involves not only the natural disaster such as earthquakes, floods and hurricanes, but also man-made disasters, such as war, terrorist attack.As a result of the catastrophe risk unpredictability and its huge losses, commercial insurance companies are reluctant to provide safeguard for catastrophe risk.Therefore, the catastrophe insurance programs in the United States is established by government legislation.According to the catastrophe risk insured subject and scope is different, the catastrophe insurance project can be divided into federal catastrophe insurance program and the state catastrophe insurance programs.
Federal catastrophe Insurance Program (a) The National Flood Insurance Program (The National Flood Insurance Program, referred to as NFIP) NFIP was founded in 1968, according to The National Flood Insurance law "set up, it has established The purpose is to provide consumers with affordable Flood Insurance.Management organization for the federal emergency management agency (FEMA) consists of the federal insurance administration (FIA).The program in the community, only fully implementing the floodplain management regulations of the community of homeowners, ability is qualified to buy flood insurance, safeguard the property of the object for households and small businesses.In 1981, the FIA's proposed a plan of commercial insurance company can draw on its advantage of extensive distribution network, sales of flood insurance and a commission, but pay is still borne by NFIP.In general, NFIP enjoy duty-free treatment, funds and pay money from its premium income.But in loss more than the historical average, NFIP shall have the right to the Treasury to limit for interest-bearing loan of $1.5 billion.In addition, if you have more financing need NFIP, will also increase its lending quotas, even with earmarks.
(2) air War risk Insurance plan (The Aviation War - risk Insurance Program, referred to as AWIP) "9 · 11" incident to The Insurance industry has brought The huge impact, The Insurance company pay about $36 billion for its indemnity, also reached tens of billions of dollars of government spending.As a result, less than two weeks after the "9 · 11", the federal aviation administration has developed the plan, directly to the United States airlines because of the war and terrorism cause of third party liability insurance policy.In November 2002, the insurance liability to loss of aircraft and passengers casualty.As of October 2006, AWIP has provided the safeguard for the 75 airlines.AWIP annual premium income of about $160 million, and get the same security in the commercial insurance market need to pay the premium of about $500 million.
(3) The Terrorism Risk Insurance Act (The Terrorism Risk Insurance Act, referred to as TRIA) The bill was introduced in November 2002, mainly for The enterprise property guarantees The Terrorism Risk faced by TRIA is mainly composed of two parts: commercial Insurance company must include The Terrorism Risk Insurance policy;The ministry of finance to provide such insurance policy reinsurance.State of catastrophe insurance project (a) The California Earthquake insurance system in 1994, Northridge (of Northridge Earthquake caused serious damage to The California insurance, in The second year of The California government set up The California Earthquake insurance legislation (The California Earthquake Authority, referred to as CEA).The agency by the California's property insurance company as a member volunteered to join and become, at least 70% of the property insurance company to join legislation to conduct business.Then, in 1996 the CEA to conduct business.The CEA enjoy duty-free treatment, can extract pre-tax catastrophe reserves.CEA by members guarantees for residential, apartment, etc, but the subject-matter insured, not including swimming pool, garage, etc.The house property limited
Living costs $5000, emergency limit of $1500, with 15% franchise.Earthquake disaster compensation fund from capital, premium income, member of the apportionment of insurance company, loans, reinsurance and the composition of investment income.(2) of the Florida hurricane catastrophe insurance system of catastrophe insurance system in Florida is very rich, the government at the same time to participate in the insurance and reinsurance market directly.Florida's Catastrophe Insurance system is mainly composed of two institutions, namely The Florida Hurricane Catastrophe Fund (The Florida Hurricane Catastrophe Fund, referred to as FHCF) and Citizens Property Insurance company (The Citizens Property Insurance Corporation, referred to as CPIC).
1. The Florida hurricane catastrophe fund (FHCF) FHCF by state government was established in November 1993, legislation, mainly to alleviate the crisis caused by the hurricane Andrew to Florida insurance market.FHCF is a Florida catastrophe reinsurance project of the operation of the government the management institution to Florida management committee, the State Board of the Administration of Florida, referred to as SBA), and a tax-exempt status.FHCF regulation Florida's property insurance company must be purchased from its reinsurance, but for the overall risk exposure is less than $10 million of the insurance company not mandate.Commercial insurance company pay FHCF reinsurance rates are usually a quarter - a third of the commercial reinsurance market.FHCF provide excess reinsurance, and specifies three different levels of coverage: 45%, 75%, 90%.FHCF funding sources including insurance premium income, emergency again issued bond income and investment income.Since its inception FHCF, already pay for loss of or damage to property in Florida over billions of dollars in reparations.
2. Citizens property insurance company (CPIC) in 2002, the state government legislation set up citizens property insurance company (CPIC), it is by the Florida storm insurance association (FWUA) associated with residential property in Florida and accident insurance association (JUA) merger.CPIC established purpose, it is to those who can't get protection from business insurance market provide insurance policyholders.So far, CPIC Florida has become the largest property insurance company, its market share accounted for about a third of Florida property insurance market.CPIC consists of three different kinds of Accounts: high-risk Accounts (High Risk Accounts, HRA);Personal Line account (Personal Line Accounts, PLA);Business Line account (ltd. Line Accounts, or CLA).By 2007, CPIC the total assets of $3.7 billion, the policy number is 1.4 million, exposure to $500 billion.Catastrophe Insurance programs in addition to the above mentioned, the other states also set up the catastrophe Insurance programs, such as Hawaii Hurricane Relief Fund (Hawaii Hurricane Relief Fund, referred to as HHRF) and Texas storm Insurance organizations (Texas Windstorm Insurance Association, referred to as TWIA).These catastrophe insurance programs for America's economic development and social stability plays a very important role.
The United States is the world's most populous country to set up the catastrophe insurance project, the project involves not only the natural disaster such as earthquakes, floods and hurricanes, but also man-made disasters, such as war, terrorist attack.As a result of the catastrophe risk unpredictability and its huge losses, commercial insurance companies are reluctant to provide safeguard for catastrophe risk.Therefore, the catastrophe insurance programs in the United States is established by government legislation.According to the catastrophe risk insured subject and scope is different, the catastrophe insurance project can be divided into federal catastrophe insurance program and the state catastrophe insurance programs.
Federal catastrophe Insurance Program (a) The National Flood Insurance Program (The National Flood Insurance Program, referred to as NFIP) NFIP was founded in 1968, according to The National Flood Insurance law "set up, it has established The purpose is to provide consumers with affordable Flood Insurance.Management organization for the federal emergency management agency (FEMA) consists of the federal insurance administration (FIA).The program in the community, only fully implementing the floodplain management regulations of the community of homeowners, ability is qualified to buy flood insurance, safeguard the property of the object for households and small businesses.In 1981, the FIA's proposed a plan of commercial insurance company can draw on its advantage of extensive distribution network, sales of flood insurance and a commission, but pay is still borne by NFIP.In general, NFIP enjoy duty-free treatment, funds and pay money from its premium income.But in loss more than the historical average, NFIP shall have the right to the Treasury to limit for interest-bearing loan of $1.5 billion.In addition, if you have more financing need NFIP, will also increase its lending quotas, even with earmarks.
(2) air War risk Insurance plan (The Aviation War - risk Insurance Program, referred to as AWIP) "9 · 11" incident to The Insurance industry has brought The huge impact, The Insurance company pay about $36 billion for its indemnity, also reached tens of billions of dollars of government spending.As a result, less than two weeks after the "9 · 11", the federal aviation administration has developed the plan, directly to the United States airlines because of the war and terrorism cause of third party liability insurance policy.In November 2002, the insurance liability to loss of aircraft and passengers casualty.As of October 2006, AWIP has provided the safeguard for the 75 airlines.AWIP annual premium income of about $160 million, and get the same security in the commercial insurance market need to pay the premium of about $500 million.
(3) The Terrorism Risk Insurance Act (The Terrorism Risk Insurance Act, referred to as TRIA) The bill was introduced in November 2002, mainly for The enterprise property guarantees The Terrorism Risk faced by TRIA is mainly composed of two parts: commercial Insurance company must include The Terrorism Risk Insurance policy;The ministry of finance to provide such insurance policy reinsurance.State of catastrophe insurance project (a) The California Earthquake insurance system in 1994, Northridge (of Northridge Earthquake caused serious damage to The California insurance, in The second year of The California government set up The California Earthquake insurance legislation (The California Earthquake Authority, referred to as CEA).The agency by the California's property insurance company as a member volunteered to join and become, at least 70% of the property insurance company to join legislation to conduct business.Then, in 1996 the CEA to conduct business.The CEA enjoy duty-free treatment, can extract pre-tax catastrophe reserves.CEA by members guarantees for residential, apartment, etc, but the subject-matter insured, not including swimming pool, garage, etc.The house property limited
Living costs $5000, emergency limit of $1500, with 15% franchise.Earthquake disaster compensation fund from capital, premium income, member of the apportionment of insurance company, loans, reinsurance and the composition of investment income.(2) of the Florida hurricane catastrophe insurance system of catastrophe insurance system in Florida is very rich, the government at the same time to participate in the insurance and reinsurance market directly.Florida's Catastrophe Insurance system is mainly composed of two institutions, namely The Florida Hurricane Catastrophe Fund (The Florida Hurricane Catastrophe Fund, referred to as FHCF) and Citizens Property Insurance company (The Citizens Property Insurance Corporation, referred to as CPIC).
1. The Florida hurricane catastrophe fund (FHCF) FHCF by state government was established in November 1993, legislation, mainly to alleviate the crisis caused by the hurricane Andrew to Florida insurance market.FHCF is a Florida catastrophe reinsurance project of the operation of the government the management institution to Florida management committee, the State Board of the Administration of Florida, referred to as SBA), and a tax-exempt status.FHCF regulation Florida's property insurance company must be purchased from its reinsurance, but for the overall risk exposure is less than $10 million of the insurance company not mandate.Commercial insurance company pay FHCF reinsurance rates are usually a quarter - a third of the commercial reinsurance market.FHCF provide excess reinsurance, and specifies three different levels of coverage: 45%, 75%, 90%.FHCF funding sources including insurance premium income, emergency again issued bond income and investment income.Since its inception FHCF, already pay for loss of or damage to property in Florida over billions of dollars in reparations.
2. Citizens property insurance company (CPIC) in 2002, the state government legislation set up citizens property insurance company (CPIC), it is by the Florida storm insurance association (FWUA) associated with residential property in Florida and accident insurance association (JUA) merger.CPIC established purpose, it is to those who can't get protection from business insurance market provide insurance policyholders.So far, CPIC Florida has become the largest property insurance company, its market share accounted for about a third of Florida property insurance market.CPIC consists of three different kinds of Accounts: high-risk Accounts (High Risk Accounts, HRA);Personal Line account (Personal Line Accounts, PLA);Business Line account (ltd. Line Accounts, or CLA).By 2007, CPIC the total assets of $3.7 billion, the policy number is 1.4 million, exposure to $500 billion.Catastrophe Insurance programs in addition to the above mentioned, the other states also set up the catastrophe Insurance programs, such as Hawaii Hurricane Relief Fund (Hawaii Hurricane Relief Fund, referred to as HHRF) and Texas storm Insurance organizations (Texas Windstorm Insurance Association, referred to as TWIA).These catastrophe insurance programs for America's economic development and social stability plays a very important role.
Britain and the United States civil service pension insurance development
Britain and the United States civil service pension insurance development
Hubei social sciences 7, 2010
Period, the United Kingdom and the United States civil service pension insurance development course of civil servants pension system refers to the state and society according to the constitution and other basic legal regulations of the state, to provide civil servants after reaching the age limit of remove labor obligations stipulated by the state, the basic life after quit the labor post and establish a social insurance system.Britain and the United States civil service pension system since established, has experienced a long period of time, is a country with a civil service pension insurance system more perfect.Understanding its development process, to the current our country civil servants pension insurance reform has a good reference.1. The British civil servants endowment insurance development.In 1834, the country's law on civil servants retirement security.In 1859 the British national public officials, as the elderly pension act.In 1883, the British government set up to fund other preliminary plans the old people's old-age security, which can provide people with the post office to buy a small pension.But the plan has not been successful.Old problems in the late 19th century early 20th century is one of the main social problem in Britain.In the face of this problem, Joseph chamberlain and others urged to follow Germany implementation similar to bismarck administration issued the elderly and disabled social insurance law ".So the British liberal government in 1908 passed the old age pension act.The law is the enterprise employees for the first time included in the national pension system, the implementation of free of old age pension plan, all the cost borne by the state Treasury, and provides a very demanding enjoy pension conditions: such as enjoy pension age was 70 years old, the beneficiary shall not accept the poor law relief, applicants do not have a criminal record, etc.But as early as the end of the 19th century, Charles booth had weekly wage workers under 1 pound as the poor, so according to this method can get the pension is just a drop in the ocean, just to ease or remove part of the old man's trouble back at home.Enjoy the age of the standards set by and it is higher, therefore is called "the dead pension".1925 widows, orphans, the elderly pay pension act, the bill broke free principle, the elderly pension act of 1908 established three kinds of endowment insurance system: [1] (p49) is to has the qualifications of national health insurance (65 ~ 65 - year - old's pay pension system;2 it is to has the qualifications of national health insurance fee and more than 70 - year - old old man sex without attaching any property survey of pension system;3 it is to do not have qualified people over age 70 national health endowment insurance pension system for free, but this kind of pension provisions with the status of the property survey.Three pension scheme solves the UK pension system reasonably long free sex problem, and solved the to the problems of pension income is low or no income.The second world war, the beveridge report has great influence on the British society, the Labour government proposed to make the national common after world war ii enjoy the welfare, make shouldering the responsibility of guarantee citizens welfare country, gradually will "beveridge report" from ideal to reality, make the British on the path of the welfare state.The family allowances act passed in 1945, the national insurance law "promulgated in 1946, the industrial injury insurance law and the national health service act, passed in 1948, the national relief act the five laws take effect on July 5, 1948 at the same time, the past about all the abolition of the social security legislation, British history famous" the poor law "also came to an end after 300 years, Britain has the most complete social security law system of western countries.Among them, the national insurance law "incorporate public officials and other common all citizens enjoy the same standard of pension system.Later, in 1959 the British established a pension system that is associated with income, along with the implementation of the system, the British established three forms of the pension system, namely the pension system of the same standardAnd associated with income difference pension system and private professional pension system.
Since the 1970 s, the social security system into the predicament.During this period, the UK suffered the worst economic crisis after the war, economic malaise, America, Japan, Germany and other countries with developed countries increasingly widening gap between fiscal emptiness and implementation of public spending on social security form a sharp contradiction, the social security system in trouble.To limit spending on social security, the thatcher government since the mid - 80 - s comprehensive reform of the social security system, in the words of the British is "her welfare system for the destructive, excessive proposed the bravest challenge".In terms of endowment insurance reform, mainly manifested in the following: first, the endowment insurance fund raise aspects: before the reform, the UK is the welfare state, civil servants pension is mainly composed of the government financial burden, USES the pay-as-you-go, since the aging population, the government financial pressure increases.Reformed system in terms of funding basically reflected by the principle of responsibility sharing, by country, unit and individual is collective burden, not only conform to the principles of efficiency, also conform to the principle of fairness.Second, the multi-level old-age insurance system of public servants.Reform before the British civil servants pension system is a single country is responsible for the system, through the reform, the UK has introduced the basic endowment insurance, supplementary endowment insurance and personal savings accumulation of three levels of old-age insurance system.Third, reduce the level of pension benefits.In 1986, the UK has issued the social security act, reduced the level of pension benefits, pension based on the method associated with income pensioners throughout the life of the average income level, rather than the average 20 years the best income level, the national pension income reduced to 20% of the average income, the highest level rather than the 25% of the Labour government period
2. The United States civil service pension insurance development.As early as the end of the 19th century, America has in parts of the retirement pension system.The earliest retirement pension legislation is 1896 in New Jersey the faculty pension act.In 1920 the federal government to build system of retirement for federal workers.The original purpose is to deal with of the federal government as a result of the civil service act of 1883 and redundant labor.Civil servants pension plan is a treatment pensions system (DefinedBenefit, commonly referred to as the DB), according to the length of service of the employees by the federal government and wage levels provide a certain amount of pensions for retirees.Its funded by employee and the employer or the federal government departments jointly pay cost, skimpy share by the federal government financial burden.In the design of civil servants pension plan, employees will get higher annuities treatment for a long time, and short-term employees annuities treatment is much lower.In August 1935, the first comprehensive social security act, marked a relatively complete social security system in the United States.The reference to the European social insurance legislation and practice, to social insurance as the center, includes the content of the social assistance and social welfare.But this will only work in the commercial and industrial 65 elderly retired people over the age of retirement.The limitation of the method is then expands unceasingly.In 1950, the beneficiaries of expanding into the public service, farm workers and civil servants.In 1954, the applicable scope expanded to freelancers like lawyers and doctors.In 1956, social security coverage expanded again, including military service members and other persons own life.During this period, the civil service pension insurance or use, established in 1920, the pension system, namely civil servants and other personnel apply respectively different old-age insurance system.This is mainly because most of the federal government employees have to own their own pension plans.With the passage of time, the coverage of social security system gradually extended to government employees.In 1983, in order to expand the coverage of social security system, to strengthen the system on financial sustainability, congress amended the social insurance
Act, the federal government's new employees include all federal social security program.A change for the federal government civil servants pension system reform has provided an opportunity.New federal employee retirement plans was established in 1987, but includes all federal employees since 1984 to participate in the work.1983 years ago to participate in the work of the federal government employees are still 1920 civil servants pension plan.As a result, the United States the current endowment insurance system is a include as the first pillar of government social security pension, the second pillar of public-sector pensions and the employer pension, the third pillar of personal retirement account annuities, multi-pillar pension insurance system.
The United States civil service pension system in a certain period, to guarantee civil servants life, maintain social stability and economic development has played a positive role.But with the rapid development of economic society and the speeding up of aging population, the endowment insurance system is heavily influenced by the severe challenge and impact.Reform measures is mainly manifested in the following aspects: first, the endowment insurance system for the development of diversified;Second, raise the retirement age, inhibition of early retirement.In 1975 the United States social security advisory committee suggested that raising the retirement age, the 1977 legislation the retirement age gradually rise from 65 to 68 or 65 years old.1983 years later, the delayed rate of social security benefits for retirees also each year to 8% from 3% a year, this not only increase the insurance fund accumulation, and relatively short issue annuities fixed number of year, reduces the cost;[3] third, improve the social security taxes.The endowment insurance fund is the most important source of revenue.In December 1977, President carter signed the largest tax bill in American history, then the Reagan administration to increase the social security payroll taxes to 12.4% again.The Clinton administration to pension levy, and improved the pension contributions.The richest 20% of the pension of taxable pension percentage from 50% to 50%
Ii, the United Kingdom and the United States civil service pension insurance development course the comparative analysis of two countries civil servants endowment insurance development course from the establishment, development and reform of three process in detail, and briefly summarized in the table below, can be summed up the following laws or characteristics: first, the two countries the establishment of the civil service pension insurance usually earlier than other groups.The following table shows that the two countries established civil service pension insurance of the time before the establishment of the endowment insurance in other groups.The UK as early as 1859 to retirement system for civil servants.The United States civil service pension plan was established in 1920, and the whole society pension system set up in 1935.Two countries directly provide generous endowment security treatment for civil servants, safeguard the elderly quality of life.Other groups of old-age security are formed in a certain social environment.Such as elderly British problem in the late 19th century early 20th century to become one of the main social problems, so the government through the old age pension act, but imposes very stringent enjoy pension.The second world war, the influence of the beveridge report, has issued a "national law".The United States during 1929-1933 crisis social unrest began to consider the social security question, is the emergence of the social security act.Secondly, the two countries of civil servants endowment insurance into the unified social endowment insurance.Civil service pension insurance of the two countries is earlier than the social endowment insurance, independent civil servants pension plan in the retirement age, service period, the replacement rate, treatment rate aspects are generous, easy to cause the dissatisfaction of other departments, affect social harmony.Therefore, in the process of continuous development, one after another into the unified social endowment insurance.Such as public sector pension plans in the United States at the second level of the federal government employees' pension system in 1983, after 1984 to participate in the work of the federal employees must attend the pension system, and 1983 years ago to participate in the work of the federal government employees are still applicable, established in 1920, the pension system.
Again, the two countries civil servants endowment insurance has a perfect legal protection.Development from the two countries of civil servants, each stage of policy appears along with the promulgation of the law.The history of the civil service pension insurance system, that is, to establish and perfect the system of endowment insurance of the legislative history.As Britain established at the beginning of the elderly retired act, to the enterprise employees included, the old age pension act to benefit the national insurance law "of the nation, establish a more perfect legal system.The complete legal system for civil servants the smooth implementation of endowment insurance system has played a key role.Finally, the two countries reflect multilayered civil service pension insurance system.In Britain and the United States civil service pension insurance system before the advent of other groups are separate countries responsible for old-age pension plans.In the development and reform, in order to adapt to the needs of social and economic, the current system embodies the multilayered, namely, the basic old-age insurance, compensatory endowment insurance, individual savings accumulation of three levels of old-age insurance system of public servants.
Hubei social sciences 7, 2010
Period, the United Kingdom and the United States civil service pension insurance development course of civil servants pension system refers to the state and society according to the constitution and other basic legal regulations of the state, to provide civil servants after reaching the age limit of remove labor obligations stipulated by the state, the basic life after quit the labor post and establish a social insurance system.Britain and the United States civil service pension system since established, has experienced a long period of time, is a country with a civil service pension insurance system more perfect.Understanding its development process, to the current our country civil servants pension insurance reform has a good reference.1. The British civil servants endowment insurance development.In 1834, the country's law on civil servants retirement security.In 1859 the British national public officials, as the elderly pension act.In 1883, the British government set up to fund other preliminary plans the old people's old-age security, which can provide people with the post office to buy a small pension.But the plan has not been successful.Old problems in the late 19th century early 20th century is one of the main social problem in Britain.In the face of this problem, Joseph chamberlain and others urged to follow Germany implementation similar to bismarck administration issued the elderly and disabled social insurance law ".So the British liberal government in 1908 passed the old age pension act.The law is the enterprise employees for the first time included in the national pension system, the implementation of free of old age pension plan, all the cost borne by the state Treasury, and provides a very demanding enjoy pension conditions: such as enjoy pension age was 70 years old, the beneficiary shall not accept the poor law relief, applicants do not have a criminal record, etc.But as early as the end of the 19th century, Charles booth had weekly wage workers under 1 pound as the poor, so according to this method can get the pension is just a drop in the ocean, just to ease or remove part of the old man's trouble back at home.Enjoy the age of the standards set by and it is higher, therefore is called "the dead pension".1925 widows, orphans, the elderly pay pension act, the bill broke free principle, the elderly pension act of 1908 established three kinds of endowment insurance system: [1] (p49) is to has the qualifications of national health insurance (65 ~ 65 - year - old's pay pension system;2 it is to has the qualifications of national health insurance fee and more than 70 - year - old old man sex without attaching any property survey of pension system;3 it is to do not have qualified people over age 70 national health endowment insurance pension system for free, but this kind of pension provisions with the status of the property survey.Three pension scheme solves the UK pension system reasonably long free sex problem, and solved the to the problems of pension income is low or no income.The second world war, the beveridge report has great influence on the British society, the Labour government proposed to make the national common after world war ii enjoy the welfare, make shouldering the responsibility of guarantee citizens welfare country, gradually will "beveridge report" from ideal to reality, make the British on the path of the welfare state.The family allowances act passed in 1945, the national insurance law "promulgated in 1946, the industrial injury insurance law and the national health service act, passed in 1948, the national relief act the five laws take effect on July 5, 1948 at the same time, the past about all the abolition of the social security legislation, British history famous" the poor law "also came to an end after 300 years, Britain has the most complete social security law system of western countries.Among them, the national insurance law "incorporate public officials and other common all citizens enjoy the same standard of pension system.Later, in 1959 the British established a pension system that is associated with income, along with the implementation of the system, the British established three forms of the pension system, namely the pension system of the same standardAnd associated with income difference pension system and private professional pension system.
Since the 1970 s, the social security system into the predicament.During this period, the UK suffered the worst economic crisis after the war, economic malaise, America, Japan, Germany and other countries with developed countries increasingly widening gap between fiscal emptiness and implementation of public spending on social security form a sharp contradiction, the social security system in trouble.To limit spending on social security, the thatcher government since the mid - 80 - s comprehensive reform of the social security system, in the words of the British is "her welfare system for the destructive, excessive proposed the bravest challenge".In terms of endowment insurance reform, mainly manifested in the following: first, the endowment insurance fund raise aspects: before the reform, the UK is the welfare state, civil servants pension is mainly composed of the government financial burden, USES the pay-as-you-go, since the aging population, the government financial pressure increases.Reformed system in terms of funding basically reflected by the principle of responsibility sharing, by country, unit and individual is collective burden, not only conform to the principles of efficiency, also conform to the principle of fairness.Second, the multi-level old-age insurance system of public servants.Reform before the British civil servants pension system is a single country is responsible for the system, through the reform, the UK has introduced the basic endowment insurance, supplementary endowment insurance and personal savings accumulation of three levels of old-age insurance system.Third, reduce the level of pension benefits.In 1986, the UK has issued the social security act, reduced the level of pension benefits, pension based on the method associated with income pensioners throughout the life of the average income level, rather than the average 20 years the best income level, the national pension income reduced to 20% of the average income, the highest level rather than the 25% of the Labour government period
2. The United States civil service pension insurance development.As early as the end of the 19th century, America has in parts of the retirement pension system.The earliest retirement pension legislation is 1896 in New Jersey the faculty pension act.In 1920 the federal government to build system of retirement for federal workers.The original purpose is to deal with of the federal government as a result of the civil service act of 1883 and redundant labor.Civil servants pension plan is a treatment pensions system (DefinedBenefit, commonly referred to as the DB), according to the length of service of the employees by the federal government and wage levels provide a certain amount of pensions for retirees.Its funded by employee and the employer or the federal government departments jointly pay cost, skimpy share by the federal government financial burden.In the design of civil servants pension plan, employees will get higher annuities treatment for a long time, and short-term employees annuities treatment is much lower.In August 1935, the first comprehensive social security act, marked a relatively complete social security system in the United States.The reference to the European social insurance legislation and practice, to social insurance as the center, includes the content of the social assistance and social welfare.But this will only work in the commercial and industrial 65 elderly retired people over the age of retirement.The limitation of the method is then expands unceasingly.In 1950, the beneficiaries of expanding into the public service, farm workers and civil servants.In 1954, the applicable scope expanded to freelancers like lawyers and doctors.In 1956, social security coverage expanded again, including military service members and other persons own life.During this period, the civil service pension insurance or use, established in 1920, the pension system, namely civil servants and other personnel apply respectively different old-age insurance system.This is mainly because most of the federal government employees have to own their own pension plans.With the passage of time, the coverage of social security system gradually extended to government employees.In 1983, in order to expand the coverage of social security system, to strengthen the system on financial sustainability, congress amended the social insurance
Act, the federal government's new employees include all federal social security program.A change for the federal government civil servants pension system reform has provided an opportunity.New federal employee retirement plans was established in 1987, but includes all federal employees since 1984 to participate in the work.1983 years ago to participate in the work of the federal government employees are still 1920 civil servants pension plan.As a result, the United States the current endowment insurance system is a include as the first pillar of government social security pension, the second pillar of public-sector pensions and the employer pension, the third pillar of personal retirement account annuities, multi-pillar pension insurance system.
The United States civil service pension system in a certain period, to guarantee civil servants life, maintain social stability and economic development has played a positive role.But with the rapid development of economic society and the speeding up of aging population, the endowment insurance system is heavily influenced by the severe challenge and impact.Reform measures is mainly manifested in the following aspects: first, the endowment insurance system for the development of diversified;Second, raise the retirement age, inhibition of early retirement.In 1975 the United States social security advisory committee suggested that raising the retirement age, the 1977 legislation the retirement age gradually rise from 65 to 68 or 65 years old.1983 years later, the delayed rate of social security benefits for retirees also each year to 8% from 3% a year, this not only increase the insurance fund accumulation, and relatively short issue annuities fixed number of year, reduces the cost;[3] third, improve the social security taxes.The endowment insurance fund is the most important source of revenue.In December 1977, President carter signed the largest tax bill in American history, then the Reagan administration to increase the social security payroll taxes to 12.4% again.The Clinton administration to pension levy, and improved the pension contributions.The richest 20% of the pension of taxable pension percentage from 50% to 50%
Ii, the United Kingdom and the United States civil service pension insurance development course the comparative analysis of two countries civil servants endowment insurance development course from the establishment, development and reform of three process in detail, and briefly summarized in the table below, can be summed up the following laws or characteristics: first, the two countries the establishment of the civil service pension insurance usually earlier than other groups.The following table shows that the two countries established civil service pension insurance of the time before the establishment of the endowment insurance in other groups.The UK as early as 1859 to retirement system for civil servants.The United States civil service pension plan was established in 1920, and the whole society pension system set up in 1935.Two countries directly provide generous endowment security treatment for civil servants, safeguard the elderly quality of life.Other groups of old-age security are formed in a certain social environment.Such as elderly British problem in the late 19th century early 20th century to become one of the main social problems, so the government through the old age pension act, but imposes very stringent enjoy pension.The second world war, the influence of the beveridge report, has issued a "national law".The United States during 1929-1933 crisis social unrest began to consider the social security question, is the emergence of the social security act.Secondly, the two countries of civil servants endowment insurance into the unified social endowment insurance.Civil service pension insurance of the two countries is earlier than the social endowment insurance, independent civil servants pension plan in the retirement age, service period, the replacement rate, treatment rate aspects are generous, easy to cause the dissatisfaction of other departments, affect social harmony.Therefore, in the process of continuous development, one after another into the unified social endowment insurance.Such as public sector pension plans in the United States at the second level of the federal government employees' pension system in 1983, after 1984 to participate in the work of the federal employees must attend the pension system, and 1983 years ago to participate in the work of the federal government employees are still applicable, established in 1920, the pension system.
Again, the two countries civil servants endowment insurance has a perfect legal protection.Development from the two countries of civil servants, each stage of policy appears along with the promulgation of the law.The history of the civil service pension insurance system, that is, to establish and perfect the system of endowment insurance of the legislative history.As Britain established at the beginning of the elderly retired act, to the enterprise employees included, the old age pension act to benefit the national insurance law "of the nation, establish a more perfect legal system.The complete legal system for civil servants the smooth implementation of endowment insurance system has played a key role.Finally, the two countries reflect multilayered civil service pension insurance system.In Britain and the United States civil service pension insurance system before the advent of other groups are separate countries responsible for old-age pension plans.In the development and reform, in order to adapt to the needs of social and economic, the current system embodies the multilayered, namely, the basic old-age insurance, compensatory endowment insurance, individual savings accumulation of three levels of old-age insurance system of public servants.
The development of the social security system
The development of the social security system
Is a national social security system according to certain laws and regulations, the workers and other members of the society because of old age, illness, disability and lose labor ability or employment, or by reason of natural disasters and accidents, facing life difficulties, to ensure the basic life of its citizens and material assistance and social services.At present, our country social security system includes: social relief, social welfare, social insurance and social materials and so on four aspects.In the civilized world, the social security system has become a national security intrinsic stabilizer, the development of social and economic growth have far-reaching influence, is also a measure of a nation's progress, and one of the important yardstick of civilization.As a result, almost every country in the world have their own a system of social welfare and social security system.Every person and the social security system are inseparable.The following concrete from the following several aspects about the development of the social security system and the enlightenment to our country's social security system.
The evolution course of the social security system (a) the United States in the early days after foundation of system of Britain's 1601 "Elizabeth poor law" is the problem of the poverty relief by public attention by law.Also became the example to follow, but with the evolution of history made corresponding change.On specific poor policy, the U.S. government put the emphasis on building a batch of adoption and rehab.This has prompted the government and private relief had certain division of labor.These institutions are mainly for the "deserving" or because of the long-term unemployed in need of help, permanent disability, or some obvious poor people can't take care of yourself.And those who have a healthy body, healthy, or "not worth the benefits of" poor people rarely get rescue shelter.During this period, children's welfare homes is the earliest development of aid agency, established in 1824 the U.S. state of New York borstal, it is the first to reform school in American history.Meanwhile the other state aid agencies also arises at the historic moment, such as orphanages, designed for psychiatric patients, people with physical defects, emotional vulnerable people, deaf mute state aid agency service, etc.During that period the United States federal government also issued relevant laws.The federal parliament in 1818 promulgated the independence war pensions act is the first war pensions, it combines the present situation of the pension plan and legal principles to the revolutionary war veterans to provide help and improve their living conditions.Born in Maine Hampton dorothy ? ? Linda's silk, America in the 19th century the first man to struggle for psychiatric patients.In order to improve the poor mental patient has made unremitting efforts.Led many American middle class into the movement of spiritual enlightenment for the poor.In American history is known as the "second religious awakening" marked with the characteristics of the establishment of the thought and the social welfare system.(2) the industrialization of the era of welfare and security system of the 19th century to the 20th century, widespread attention child welfare movement in the United States, revealed a whirlwind.Across the United States in this tornado in a variety of forms.Efforts to the child from the asylum or other similar institutions out looking for family willing to adopt them, for they to make them truly care and love, enjoy the warmth of family.Meanwhile children's court is established in many places, carry out compulsory education, child Labour is forbidden, established the probation system, give the mother a certain benefits to the widow took the child and a series of measures to set up and popularized.
The first American to accept the child welfare agencies of "family love" plan is by lauren ? galbraith as a sponsor, New York children welfare association was established in 1853, then he and his organization committed to children in private "family love" of the family plan.The middle of the 19th century, chaotic, filthy, shelter evil people and practices around the city, everywhere filled with stench.The survival of the whole city is threatened.The United States launched the first national public health campaign.Efforts to build a safe and healthy place to live in the comfortable environment.(3) Roosevelt "New Deal" with the social security system including the establishment of the so-called "New Deal" relief for the poor and the unemployed, recovery industry and agriculture, reform of the banking industry and control investment business, and improve labor relations and other aspects of the policy.Roosevelt's "New Deal" in the emphasis on the role of the federal government.He think: the federal government in the national economy should play a more active role than ever before, even can assume more of the national wealth is distributed fairly and the responsibility of the national income.The Roosevelt administration in the United States for the first time in history to ensure that don't let anyone go hungry responsibility.Social security act 1935, as the cornerstone of the American welfare system.The federal government's social security department is established according to the law, and specifies the social pension insurance includes four aspects: (1) (2) (3) of elderly insurance unemployment insurance (4) for the blind, to support their children and other base of relief.According to the law, the state such as proper pension plan, the federal government can grant aid, to encourage states to establish pension law;Unemployment insurance jointly offered by the federal government and state governments.The federal government to pay wages table of enterprise to the employer to collect unemployment insurance tax, served as a relief fund, unemployment, escrow by state government.Old age insurance gold by the federal government management alone."New Deal" measures has an impact on the national each big class.Workers have the highest minimum wages and working hours legislation and the guarantee of collective bargaining.Depositors and investors for the banking and insurance law promulgated got bigger.Social insurance make old people likely to spend their twilight years.Roosevelt's "New Deal" measures and the implementation of a series of legislation, marked the modern social security system establishment.
The United States the basic content of social welfare policy of gradually improve social welfare policy in the content, formed the three big pillar, namely social security, social public welfare undertakings, and the lowest life to ensure matter.1. Social security is the first pillar of American welfare system.By those who are able to help people deal with the common risk behavior, to protect its citizens from such as disease, disability have wage income of the death of a spouse or guardian, divorce, retirement and other natural and man-made damage.The social security policy mainly refers to the social insurance scheme launched by the government.America's most important social insurance program called OASDHI, it represents the old age, survivors, disability and health insurance.Old age insurance (OAI) is specified in the revision of the social security act of 1951, is America's largest single retirement insurance plan, many americans enjoy the insurance.Survivors insurance (SI) in 1939, is for widowed and children under the age of 18 is a form of insurance.Not only time I can enjoy retirement insurance benefits, and is in after insurant death, their spouses and children can also enjoy the benefit.Disability insurance (DI) in 1956, is for severe disability and loss of working ability of adults to provide insurance;Health insurance (HI), also known as "health care plan", launched in 1968, only a kind of insurance for the elderly.The second pillar is refers to the American welfare system for the national economy to provide the most basic necessities of life and include education, health care, child care, housing and other legal services.The third pillar of American welfare system refers to all countries to the poorest and most vulnerable to damage and loss of residents set minimum material standard of living, to make sure they can live on the minimum living standard, also called "anti-poverty policy".Such as goods, services, and to treat donors to provide labor skills training, etc.However, such a series of welfare and guarantee measures and can eliminate the poverty population in the United States.The poverty of the United States is a serious social problem in the United States.In order to eliminate poverty, the United States government has adopted a series of countermeasures, according to the relief way and the beneficiary is different, this system can be broadly divided into three categories: 1, social insurance.It includes the following three (1) the old man, survivors, health insurance (OASDHI) for the disabled.This program is the certain proportion pay beneficiary's monthly salary as social security, credit funds, wait until after retirement, disability, death, lose labor ability, from the person or the beneficiary to the fund bailed out by the month.(2) the medical care program.This is 65 years old or older are designed specifically for medical care plan.The beneficiary monthly pay medical fees, little can enjoy free medical care.The doctor send the bill of them directly to the federal government cash.(3) the unemployment benefits.The beneficiary during the work, by the month pay unemployment relief credit funds.Once the unemployed can get up to six months of unemployment benefits.2. The insurance relief.As long as the income or assets to below standards can enjoy such relief.Including four: (1) minor children (AFDC) family.Aid object mainly have minor children of poor families.Usually only a parent, and parents lost their job family (common are single mothers and families with a child form).(2) the food stamp program (food m program).The project expenses shall be borne by the federal government completely, but the federal department of agriculture and state and local government common management, social welfare institutions for those earning less than a certain level of unemployment or on-the-job personnel's family.Food stamps are often used for the specified store shelves for free or at a low price to buy basic foods, such as bread, eggs, milk and so on.(3) for the elderly, the blind, etc
Lose labor ability of rescue (SST).This is the federal government to provide help for those who lose labor ability, unified fund-raising and according to the national standards issued by the federal government, states can be appropriately increase according to their own condition.(4) the general public assistance (GPA).This is for those homeless people and not eligible for the above package of assistance to the poor.By state and local government welfare agency management and implementation.3. Physical and service forms of aid.The housing condition of the poor families to donate, medicaid, provide free legal services (limited to civil litigation), free job training, adoption service and child care law procedures, for construction of housing for the elderly, to the economic difficulties of college students low-interest and interest-free loans, provide free lunch for poor children, and so on.
The social security system and social insurance institutions in the United States social security system including pension, medical, unemployment, disability, birth, survivors, security, and social relief projects.(a) endowment insurance system.Different from the traditional Chinese concept of "support", the United States in terms of pension, social security system and social endowment institutions play an important role.America's endowment insurance system is divided into national mandatory insurance, private enterprise pension plan and individual deposit insurance three levels.1. The national compulsory insurance, also known as the legal system of endowment insurance, is in August 1935, the federal government established by the elderly social welfare bill.It is a cornerstone in the multi-level old-age insurance system in the United States.Covers 96% of employment in the United States, it is oriented to the whole society to provide a basic retirement security system.2. Private enterprise pension plan, it is mainly set up by the enterprise, enterprise and worker individual regularly to specific pension management institutions to pay a certain percentage of the capital, after the worker is retired a month can according to the account of the accumulation of the forehead or enterprise pre-ordained pension payments.It belongs to the second level of endowment insurance system, has a history of nearly a century in the United States.It is a supplement to the U.S. government mandatory elderly insurance system, the worker can attend private pension plans, make them enjoy a better life after retirement.3. Individual deposit sex endowment insurance system, and it belongs to the third level of endowment insurance system.It refers to any individual with a tax revenue can have individual retirement account of an individual retirement savings plan.All this endowment insurance is paid by the individual, personal management and enjoy certain preferential tax condition of endowment insurance system.(2) of the medical insurance system.Medical insurance there are two main ways: one is the private health insurance plans, employers provide their employees and their being kucha medical insurance;The second is the government for the elderly, the disabled and some of the poor medicare and medicaid programs.These two types of plans in the funding sources, compensation levels and cost difference in such aspects as payment method.1. Private medical insurance plan.U.S. corporate health insurance until the 80 s of 20 years, basically be reimbursed with the system, the concrete by the semi-official agency orgnaization of blue cross, blue shield.Mainly for the employees by the employer to pay insurance premium, employees can participate in medical insurance depends on whether the employer willing to participate in medical insurance.2. The government sponsored health insurance plan and medical rescue plan.Only for the elderly over the age of 65 and 65, lower than the 65 - year - old disabled and kidney disease patients, divided into two parts: the first part is a mandatory hospitalization insurance, mainly pay () within a prescribed number of days in hospital treatment costs, rehabilitation services and home care after discharge fees, terminal care expenses, etc.;The second part is voluntary supplementary medical insurance, provide ginseng protect personnel to see outpatient fee payments to doctors.
. The medical aid program is jointly organized by the federal government and state governments, is the most poor and low-income families to provide medical and health-related services.(3) the unemployment insurance system.In 1935, in the establishment of a social security system in the same year, authorized states congress to pass legislation to establish the unemployment insurance system.Unemployment insurance program run by the state, the federal government is to formulate some measures to encourage states to establish unemployment insurance system.The unemployed depends on the length of time I work the period of receiving unemployment insurance compensation fixed number of year.The social security of the United States is managed by the government of social insurance agency, mainly is the social security department, the department of labor, human health and human services;Quasi-government nature of insurance institutions, such as blue cross and blue shield, and commercial insurance companies, etc. A lot of different departments.1. The endowment insurance.National mandatory insurance belongs to the first level of insurance, managed by the social security agency.2. Private enterprise pension plans belong to the second level of insurance, the companies or life insurance and asset management company management;Is done by employer units.Private enterprise pension plan reinsurance companies (i.e., regulators) by the labor department management.3. Individual deposit insurance belongs to the third level, is a personal choice such as life insurance companies, investment companies to manage.4. Unemployment insurance.By the federal department of Labour administration, state by Labour and lurking management.5. Disability insurance.Government civil servants of inductrial injury insurance by the labor department management, the enterprise staff of inductrial injury insurance is managed by state department of labor, disability pension by the social security administration management.6. Health insurance.More than 65 - year - old medical insurance by the social security administration management;Civil servants due to work-related injury medical insurance by the labor department management;Enterprise staff medical insurance is mainly composed of blue cross, blue shield two semi-official properties of an insurance company takes, is voluntary.
Life insurance companies.In the United States, the life insurance company in accordance with the social demand design the comprehensive insurance breed formed the different characteristics of the insurance company, involving people's birth, aging, illness, and death, injury and residual, health, tourism and other insurance programs.Four, the characteristics of the social security system (1) of the social security system of the United States is an important aspect of building a harmonious society in the United States.This low standard to ensure treatment coverage is very wide, embodies the principle of social justice.Make people feel the role of the social security safety net, and reduce the burden of the government and enterprises.Provides the security and stability of life for the American people, eased the American market competition class antagonisms, stabilized the capitalist social system in the United States, make the basis of the social sustainable development.(2) of the marketization, socialization of social security system in the United States.America's social security system has changed the original, the traditional way of social security, make towards marketization, socialization of social security system.Have such as the strength of large enterprises provide employees with a good pension and medical insurance treatment, not only reduce the U.S. federal government responsibility in social security, more embodies the comprehensive strength of enterprises, and stability of the staff, for the enterprise to attract talents, to enhance the enterprise cohesive force.(3) the social security program more hierarchical, mainly reflected in the protection of structure, form and type of the project, such as the United States insurance companies insurance breed all-encompassing design, a citizen of the United States no matter rich or poor, you can find suitable for their own insurance program.The multi-level security project not only makes commercial insurance company at the same time of absorbing funds, "provide good services to our customers, and promote the healthy development of the commercial insurance company.(4) the diversification of the social security system.The federal government, state and local governments bear the social security function, profit organizations and non-profit organizations also play its role in the social security system.
Is a national social security system according to certain laws and regulations, the workers and other members of the society because of old age, illness, disability and lose labor ability or employment, or by reason of natural disasters and accidents, facing life difficulties, to ensure the basic life of its citizens and material assistance and social services.At present, our country social security system includes: social relief, social welfare, social insurance and social materials and so on four aspects.In the civilized world, the social security system has become a national security intrinsic stabilizer, the development of social and economic growth have far-reaching influence, is also a measure of a nation's progress, and one of the important yardstick of civilization.As a result, almost every country in the world have their own a system of social welfare and social security system.Every person and the social security system are inseparable.The following concrete from the following several aspects about the development of the social security system and the enlightenment to our country's social security system.
The evolution course of the social security system (a) the United States in the early days after foundation of system of Britain's 1601 "Elizabeth poor law" is the problem of the poverty relief by public attention by law.Also became the example to follow, but with the evolution of history made corresponding change.On specific poor policy, the U.S. government put the emphasis on building a batch of adoption and rehab.This has prompted the government and private relief had certain division of labor.These institutions are mainly for the "deserving" or because of the long-term unemployed in need of help, permanent disability, or some obvious poor people can't take care of yourself.And those who have a healthy body, healthy, or "not worth the benefits of" poor people rarely get rescue shelter.During this period, children's welfare homes is the earliest development of aid agency, established in 1824 the U.S. state of New York borstal, it is the first to reform school in American history.Meanwhile the other state aid agencies also arises at the historic moment, such as orphanages, designed for psychiatric patients, people with physical defects, emotional vulnerable people, deaf mute state aid agency service, etc.During that period the United States federal government also issued relevant laws.The federal parliament in 1818 promulgated the independence war pensions act is the first war pensions, it combines the present situation of the pension plan and legal principles to the revolutionary war veterans to provide help and improve their living conditions.Born in Maine Hampton dorothy ? ? Linda's silk, America in the 19th century the first man to struggle for psychiatric patients.In order to improve the poor mental patient has made unremitting efforts.Led many American middle class into the movement of spiritual enlightenment for the poor.In American history is known as the "second religious awakening" marked with the characteristics of the establishment of the thought and the social welfare system.(2) the industrialization of the era of welfare and security system of the 19th century to the 20th century, widespread attention child welfare movement in the United States, revealed a whirlwind.Across the United States in this tornado in a variety of forms.Efforts to the child from the asylum or other similar institutions out looking for family willing to adopt them, for they to make them truly care and love, enjoy the warmth of family.Meanwhile children's court is established in many places, carry out compulsory education, child Labour is forbidden, established the probation system, give the mother a certain benefits to the widow took the child and a series of measures to set up and popularized.
The first American to accept the child welfare agencies of "family love" plan is by lauren ? galbraith as a sponsor, New York children welfare association was established in 1853, then he and his organization committed to children in private "family love" of the family plan.The middle of the 19th century, chaotic, filthy, shelter evil people and practices around the city, everywhere filled with stench.The survival of the whole city is threatened.The United States launched the first national public health campaign.Efforts to build a safe and healthy place to live in the comfortable environment.(3) Roosevelt "New Deal" with the social security system including the establishment of the so-called "New Deal" relief for the poor and the unemployed, recovery industry and agriculture, reform of the banking industry and control investment business, and improve labor relations and other aspects of the policy.Roosevelt's "New Deal" in the emphasis on the role of the federal government.He think: the federal government in the national economy should play a more active role than ever before, even can assume more of the national wealth is distributed fairly and the responsibility of the national income.The Roosevelt administration in the United States for the first time in history to ensure that don't let anyone go hungry responsibility.Social security act 1935, as the cornerstone of the American welfare system.The federal government's social security department is established according to the law, and specifies the social pension insurance includes four aspects: (1) (2) (3) of elderly insurance unemployment insurance (4) for the blind, to support their children and other base of relief.According to the law, the state such as proper pension plan, the federal government can grant aid, to encourage states to establish pension law;Unemployment insurance jointly offered by the federal government and state governments.The federal government to pay wages table of enterprise to the employer to collect unemployment insurance tax, served as a relief fund, unemployment, escrow by state government.Old age insurance gold by the federal government management alone."New Deal" measures has an impact on the national each big class.Workers have the highest minimum wages and working hours legislation and the guarantee of collective bargaining.Depositors and investors for the banking and insurance law promulgated got bigger.Social insurance make old people likely to spend their twilight years.Roosevelt's "New Deal" measures and the implementation of a series of legislation, marked the modern social security system establishment.
The United States the basic content of social welfare policy of gradually improve social welfare policy in the content, formed the three big pillar, namely social security, social public welfare undertakings, and the lowest life to ensure matter.1. Social security is the first pillar of American welfare system.By those who are able to help people deal with the common risk behavior, to protect its citizens from such as disease, disability have wage income of the death of a spouse or guardian, divorce, retirement and other natural and man-made damage.The social security policy mainly refers to the social insurance scheme launched by the government.America's most important social insurance program called OASDHI, it represents the old age, survivors, disability and health insurance.Old age insurance (OAI) is specified in the revision of the social security act of 1951, is America's largest single retirement insurance plan, many americans enjoy the insurance.Survivors insurance (SI) in 1939, is for widowed and children under the age of 18 is a form of insurance.Not only time I can enjoy retirement insurance benefits, and is in after insurant death, their spouses and children can also enjoy the benefit.Disability insurance (DI) in 1956, is for severe disability and loss of working ability of adults to provide insurance;Health insurance (HI), also known as "health care plan", launched in 1968, only a kind of insurance for the elderly.The second pillar is refers to the American welfare system for the national economy to provide the most basic necessities of life and include education, health care, child care, housing and other legal services.The third pillar of American welfare system refers to all countries to the poorest and most vulnerable to damage and loss of residents set minimum material standard of living, to make sure they can live on the minimum living standard, also called "anti-poverty policy".Such as goods, services, and to treat donors to provide labor skills training, etc.However, such a series of welfare and guarantee measures and can eliminate the poverty population in the United States.The poverty of the United States is a serious social problem in the United States.In order to eliminate poverty, the United States government has adopted a series of countermeasures, according to the relief way and the beneficiary is different, this system can be broadly divided into three categories: 1, social insurance.It includes the following three (1) the old man, survivors, health insurance (OASDHI) for the disabled.This program is the certain proportion pay beneficiary's monthly salary as social security, credit funds, wait until after retirement, disability, death, lose labor ability, from the person or the beneficiary to the fund bailed out by the month.(2) the medical care program.This is 65 years old or older are designed specifically for medical care plan.The beneficiary monthly pay medical fees, little can enjoy free medical care.The doctor send the bill of them directly to the federal government cash.(3) the unemployment benefits.The beneficiary during the work, by the month pay unemployment relief credit funds.Once the unemployed can get up to six months of unemployment benefits.2. The insurance relief.As long as the income or assets to below standards can enjoy such relief.Including four: (1) minor children (AFDC) family.Aid object mainly have minor children of poor families.Usually only a parent, and parents lost their job family (common are single mothers and families with a child form).(2) the food stamp program (food m program).The project expenses shall be borne by the federal government completely, but the federal department of agriculture and state and local government common management, social welfare institutions for those earning less than a certain level of unemployment or on-the-job personnel's family.Food stamps are often used for the specified store shelves for free or at a low price to buy basic foods, such as bread, eggs, milk and so on.(3) for the elderly, the blind, etc
Lose labor ability of rescue (SST).This is the federal government to provide help for those who lose labor ability, unified fund-raising and according to the national standards issued by the federal government, states can be appropriately increase according to their own condition.(4) the general public assistance (GPA).This is for those homeless people and not eligible for the above package of assistance to the poor.By state and local government welfare agency management and implementation.3. Physical and service forms of aid.The housing condition of the poor families to donate, medicaid, provide free legal services (limited to civil litigation), free job training, adoption service and child care law procedures, for construction of housing for the elderly, to the economic difficulties of college students low-interest and interest-free loans, provide free lunch for poor children, and so on.
The social security system and social insurance institutions in the United States social security system including pension, medical, unemployment, disability, birth, survivors, security, and social relief projects.(a) endowment insurance system.Different from the traditional Chinese concept of "support", the United States in terms of pension, social security system and social endowment institutions play an important role.America's endowment insurance system is divided into national mandatory insurance, private enterprise pension plan and individual deposit insurance three levels.1. The national compulsory insurance, also known as the legal system of endowment insurance, is in August 1935, the federal government established by the elderly social welfare bill.It is a cornerstone in the multi-level old-age insurance system in the United States.Covers 96% of employment in the United States, it is oriented to the whole society to provide a basic retirement security system.2. Private enterprise pension plan, it is mainly set up by the enterprise, enterprise and worker individual regularly to specific pension management institutions to pay a certain percentage of the capital, after the worker is retired a month can according to the account of the accumulation of the forehead or enterprise pre-ordained pension payments.It belongs to the second level of endowment insurance system, has a history of nearly a century in the United States.It is a supplement to the U.S. government mandatory elderly insurance system, the worker can attend private pension plans, make them enjoy a better life after retirement.3. Individual deposit sex endowment insurance system, and it belongs to the third level of endowment insurance system.It refers to any individual with a tax revenue can have individual retirement account of an individual retirement savings plan.All this endowment insurance is paid by the individual, personal management and enjoy certain preferential tax condition of endowment insurance system.(2) of the medical insurance system.Medical insurance there are two main ways: one is the private health insurance plans, employers provide their employees and their being kucha medical insurance;The second is the government for the elderly, the disabled and some of the poor medicare and medicaid programs.These two types of plans in the funding sources, compensation levels and cost difference in such aspects as payment method.1. Private medical insurance plan.U.S. corporate health insurance until the 80 s of 20 years, basically be reimbursed with the system, the concrete by the semi-official agency orgnaization of blue cross, blue shield.Mainly for the employees by the employer to pay insurance premium, employees can participate in medical insurance depends on whether the employer willing to participate in medical insurance.2. The government sponsored health insurance plan and medical rescue plan.Only for the elderly over the age of 65 and 65, lower than the 65 - year - old disabled and kidney disease patients, divided into two parts: the first part is a mandatory hospitalization insurance, mainly pay () within a prescribed number of days in hospital treatment costs, rehabilitation services and home care after discharge fees, terminal care expenses, etc.;The second part is voluntary supplementary medical insurance, provide ginseng protect personnel to see outpatient fee payments to doctors.
. The medical aid program is jointly organized by the federal government and state governments, is the most poor and low-income families to provide medical and health-related services.(3) the unemployment insurance system.In 1935, in the establishment of a social security system in the same year, authorized states congress to pass legislation to establish the unemployment insurance system.Unemployment insurance program run by the state, the federal government is to formulate some measures to encourage states to establish unemployment insurance system.The unemployed depends on the length of time I work the period of receiving unemployment insurance compensation fixed number of year.The social security of the United States is managed by the government of social insurance agency, mainly is the social security department, the department of labor, human health and human services;Quasi-government nature of insurance institutions, such as blue cross and blue shield, and commercial insurance companies, etc. A lot of different departments.1. The endowment insurance.National mandatory insurance belongs to the first level of insurance, managed by the social security agency.2. Private enterprise pension plans belong to the second level of insurance, the companies or life insurance and asset management company management;Is done by employer units.Private enterprise pension plan reinsurance companies (i.e., regulators) by the labor department management.3. Individual deposit insurance belongs to the third level, is a personal choice such as life insurance companies, investment companies to manage.4. Unemployment insurance.By the federal department of Labour administration, state by Labour and lurking management.5. Disability insurance.Government civil servants of inductrial injury insurance by the labor department management, the enterprise staff of inductrial injury insurance is managed by state department of labor, disability pension by the social security administration management.6. Health insurance.More than 65 - year - old medical insurance by the social security administration management;Civil servants due to work-related injury medical insurance by the labor department management;Enterprise staff medical insurance is mainly composed of blue cross, blue shield two semi-official properties of an insurance company takes, is voluntary.
Life insurance companies.In the United States, the life insurance company in accordance with the social demand design the comprehensive insurance breed formed the different characteristics of the insurance company, involving people's birth, aging, illness, and death, injury and residual, health, tourism and other insurance programs.Four, the characteristics of the social security system (1) of the social security system of the United States is an important aspect of building a harmonious society in the United States.This low standard to ensure treatment coverage is very wide, embodies the principle of social justice.Make people feel the role of the social security safety net, and reduce the burden of the government and enterprises.Provides the security and stability of life for the American people, eased the American market competition class antagonisms, stabilized the capitalist social system in the United States, make the basis of the social sustainable development.(2) of the marketization, socialization of social security system in the United States.America's social security system has changed the original, the traditional way of social security, make towards marketization, socialization of social security system.Have such as the strength of large enterprises provide employees with a good pension and medical insurance treatment, not only reduce the U.S. federal government responsibility in social security, more embodies the comprehensive strength of enterprises, and stability of the staff, for the enterprise to attract talents, to enhance the enterprise cohesive force.(3) the social security program more hierarchical, mainly reflected in the protection of structure, form and type of the project, such as the United States insurance companies insurance breed all-encompassing design, a citizen of the United States no matter rich or poor, you can find suitable for their own insurance program.The multi-level security project not only makes commercial insurance company at the same time of absorbing funds, "provide good services to our customers, and promote the healthy development of the commercial insurance company.(4) the diversification of the social security system.The federal government, state and local governments bear the social security function, profit organizations and non-profit organizations also play its role in the social security system.
The commercial insurance
The commercial insurance
Commercial medical insurance is the medical insurance as a special commodity, free operation of medical insurance mode according to the laws of the market.In the medical insurance market, the seller is refers to the profit or non-profit private health insurance companies or private health insurance companies;The buyer can be enterprises, social organizations, also can be the government or individuals.Commercial medical insurance personal primarily funded by participants and their employers pay of insurance premium, in general, the government fiscal investment, or subsidies.The United States is a typical representative of the implementation of commercial medical insurance mode.Although the United States government held the medical care system, medical assistance system, and minority free medical care and other social medical insurance plan, but in the whole system of medical insurance, they do not occupy the main position, the cover of people is limited.In the United States, more than 80% of the national civil servants, private enterprise employees and farmers are not protected by the social insurance, but took part in the commercial insurance system.The national commercial medical insurance fund has more than 1800.Commercial health insurance in the United States is divided into non-profit and for-profit two kinds, the former can enjoy preferential treatment in taxation, which do not enjoy the treatment of the related.Is the feature of the commercial medical insurance model, mainly by the market operation and management of medical treatment insurance, the government only responsible for the elderly and the poor health care.Insurance funds is mainly borne by individuals and enterprises, government basic no burden.The model of the outstanding problems is the social fairness is poorer, there are quite a lot of low-income employees of small businesses, individual worker and peasant family do not have medical insurance.
United States: commercial medical insurance loopholes
Around the world, by private commercial insurance as the backbone of the country medical security system, but the United States.Commercial health insurance companies is to make money.In order to make money, the company is not willing to sell insurance policies to the high risk people.Therefore, the commercial medical insurance is hard to cover the old man.Commercial health insurance is also difficult to cover the poor, because they can't afford to pay the premium.From this perspective, the commercial health insurance anyway cannot achieve universal health care, fairness is poor.However, the us government to keep the bottom line, a market economy, the government should at least do this is to use the public finance to the market fails to cover the public to provide public services.Since the commercial medical insurance to cover the elderly and the poor, the U.S. government has set the health care system designed specifically for the old man (Medicare), specially set up the medical assistance system for the poor (Medicaid).Medical care is a mandatory health insurance, the government to impose social security tax (also known as social security taxes) helping to collect the premium and medical treatment of the money comes from government fiscal, Shared by federal and state governments.These two public health care system to cover the 45% of U.S. residents.Commercial medical insurance, however, even in the elderly and the poor also cannot achieve universal coverage of the general population.The latest population statistics show that in 2005, 46.6 million people had no health insurance, 15.9% of U.S. residents.The Numbers over the years in between 14% and 20%.In other words, the private medical insurance institutions insured people about 35% to 41% of the total number of U.S. residents.Another disadvantage of commercial medical insurance is the high cost of health care.People pay insurance premiums on statistical stray into "medical expenses", in the practical part of the profits of insurance company.In addition, the professionals of high salary, high on the world's first commercial health insurance company's management fees.America's health service highly marketable.Most clinics, hospitals and other specialized medical institutions are private, many are non-profit organizations, there are many is a for-profit company.Governments at all levels and the establishment of some medical institutions in the United States, mainly in order to make up for a lack of market, in rural and remote areas to set up community health center, also set up a few public hospitals in some cities.Whether private or public, for-profit or nonprofit medical institutions compete with contract of various kinds of health care institutions.Health care institutions including government sponsored health care and medical treatment, and various private health insurance company or a non-profit organization.Medical institutions in order to attract patients, so as to win the contract more health care institutions, on the improve the level of medical services and medical technology has launched a fierce competition.
The disadvantage of the American model universally acknowledged, even the American social policy experts have no objection.The voice of the medical security system reform in the United States' larger all the time, but any strengthening government function, the implementation of mandatory social insurance scheme is due to the intense opposition from the insurance industry and medical services to become law.
Characteristics of the commercial medical insurance
Commercial health insurance is also called
Health insurance, is based on the human body the subject-matter insured, the insured due to disease or accident harm to cause of medical treatment cost and the income loss to compensate.Commercial medical insurance in China start time is not long, in the insurance consciousness, insurance depth and insurance density and coverage development, premium income, operation and management, etc, compared with western developed countries insurance, there is a larger gap.In addition due to subject to the management risk of the commercial medical insurance is higher and the technical management requirements, coupled with the lack of rich market experience, domestic insurance companies for the development of medical insurance are a cautious attitude, causes our country medical insurance coverage set up by an insurance company is single, inadequate safeguard function, and the volume is small.After China's entry into the wto, the insurance access will gradually open, our country insurance company in the fierce competition of how to don't lose the commercial medical insurance market, this article obtains from the analysis of the commercial medical insurance mechanism, product development strategy of China's commercial health insurance are discussed.
The United States commercial medical treatment
Characteristics and advantages of insurance products 1. The commercial medical insurance system introduction to the world in modern history, the emergence of the commercial health insurance only one hundred years of history, but it has been widely used all over the world provide health care services for the national health insurance way, due to the different actual situation, so he formed the different medical insurance system, basically can be divided into the following two types, one is the private commercial insurance pattern, the second is the national health insurance mode.The United States is a private commercial insurance pattern.Under the private commercial insurance pattern, the medical service is given priority to with personal consumption, the government of special crowd (old age, disability, low income, etc.) to provide cost benefits, or the use of special medical insurance.Most countries only a small part of the burden of medical insurance, transferred to the patient or enterprise.Under this model, not only the economic burden of the government, and make the maximum development of commercial medical insurance market, insurance companies under the system of loose, reasonably according to the requirements of the market for the development of insurance breed.
American commercial health insurance product development strategy under the private commercial insurance pattern, because the doctors often opened by individuals and as members of the various organizations and groups, private hospitals than state-owned public hospitals, and so on medical expenses of the private hospitals have considerable autonomy, from
To constantly improve the medical service cost, at the same time, the commercial medical insurance market is growing.In this case, the insurance company mainly on medical insurance product development strategy to expand and stable customer group, promote the main insurance products.Embodied in the following aspects: (1) pay attention to the brand strategy.Insurance companies in the United States in the process of product development, in order to strengthen the company's image, stability and expanding customer base, often pays attention to the promotion of the main risks of business, but also pays attention to the external effects of the main insurance business.To a certain extent, insurance companies in the United States at the beginning of the brand establishment often give up some interests requirement.(2) ensure that product can run long.To ensure that the product can run a long-term policy of insurance companies for long-term, comprehensive evaluation is the premise, the insurance company in the commercial medical insurance in the process of product design pays attention to the sustainability of the product characteristics.(3) pay attention to the risk.Commercial medical insurance of the risk is that the medical cost and the consumption of high-grade medical uncertainty, in the United States, because the private hospitals is more, the uncertainty is more obvious, therefore the insurance company involved in commercial health insurance products in the process, according to various medical expenses have adopted different risk assessment mechanism to determine the risk of various risks.
SAS business analysis power blue cross to participate in medical insurance reform in the United States
As U.S. President barack Obama: "America's medical insurance system reform will be related to the survival of the future."Increase the medical insurance system reform is to maximum the status of the interior, at the same time, the global focus attention on health care reform in the United States.After many years of the American medical insurance system reform by experts to analyze its difficulty lies mainly in the medical insurance organization how to control the cost, improve the health level and maximize ginseng to keep staff satisfaction.Blue cross blue shield of the United States
Using SAS (BCBS) advanced business analytics techniques successfully implement all measures to the medical insurance system reform,
Do a good try for the whole industry.The difficulties of medical insurance system reform is expected to break through.
Now almost all the blue cross blue shield of using SAS ? (BCBS) Business analysis (Business Analytics) solutions are the implementation of the medical insurance system reform measures.In the family health plans, in one of the largest and earliest 39 enterprises in addition to the four have been deployment of SAS software.Every three americans, there is a blue cross blue shield to cover health insurance, the total has more than one hundred million people.Independent business technology research institution Aite Group medical insurance division, a senior analyst at access Pandya says:
"As the reform of health care system, medical insurance agencies to reduce costs, invest in advanced technology architecture of pressure increasing. Advanced analysis technology has become an important means of cost control. This kind of advanced technology can greatly help the medical insurance company to detect fraud, through positive interaction actively manage risk, and improve the efficiency of the system in other fields and benefit level."Dialysis SAS business analysis of SAS is the world's leading supplier of business analytics software and services, and business intelligence market of the largest independent manufacturer.By including many innovative solutions in an overall framework, SAS help more than 45000 users around the world a better and faster decisions, so as to improve the performance and value.SAS Business analysis Framework (Business Analytics Framework) is a collection of data integration, analysis, and reporting features a powerful tool at an organic whole, the industry and the expansion of the solution at the grass-roots level to an unprecedented level, is advantageous for the
Enterprise solutions to the current business problems quickly, at the same time expanding the application of SAS solution to continually improve performance level.SAS technology for enterprises to build their own application laid the foundation of reliable.At the same time, SAS provides solution can fully meet the demand of the industry cost savings, improve the level of patient welfare and other aspects of the problem.
SAS solution applicable to all health insurance companies, including: l SAS ? Customer Intelligence (Customer Intelligence) improve member interaction ability and service level.L SAS ? medical Insurance fraud Framework (Faud Framework for Health Insurance) to ensure that the legitimate claims.SAS ? Disease Management (diseases Management) solutions help predict risk, optimize the interaction level, improve the health care effect.Significant advantages Excellus blue cross blue shield will SAS business analysis framework is applied to many business units, including the actuarial department, the department is responsible for the analysis of the company the risk of ginseng protect personnel to 31 in the state of New York county.Using SAS business analysis technology, Excellus now can not only check has happened in the business, but also can predict problems to come."Insurance depends on the identification and predict future risk, the company has always given prominence to this work, and after using SAS, we perform an actuarial business standard speed increased by 40% at least," Joseph Excellus actuarial manager Randazzo said, "use of save time, we can work past quite time-consuming analysis. Results are obvious: now we can better control the risk of health care plan."
Improve the level of information = improve the level of care New Jersey in the service of 3.6 million members of the horizon blue cross blue shield companies face such problems, many health care plans members of their information demands increasingly complex and comprehensive, to control the cost of the health management plan.In the deployment of SAS enterprise business intelligence
Before the Server (SAS Enterprise BI Server), and the statements
Automation dashboard growing demand become the horizon the heavy burden of the company.The insurance company in three months time achieve the return on investment.MikeOcchipinti horizon company information department manager said: "the improvement of information management and customers for horizon brought huge benefits. Ministry of information to provide business analysis results provide support for the company more than 70 important project. Only the value of a project implemented by more than 5% of millions of dollars, install the SAS solution for only three months, we will as the main customer provides automatic disease management and health report, this kind of information for improving the standard of care has very important role."
Commercial medical insurance is the medical insurance as a special commodity, free operation of medical insurance mode according to the laws of the market.In the medical insurance market, the seller is refers to the profit or non-profit private health insurance companies or private health insurance companies;The buyer can be enterprises, social organizations, also can be the government or individuals.Commercial medical insurance personal primarily funded by participants and their employers pay of insurance premium, in general, the government fiscal investment, or subsidies.The United States is a typical representative of the implementation of commercial medical insurance mode.Although the United States government held the medical care system, medical assistance system, and minority free medical care and other social medical insurance plan, but in the whole system of medical insurance, they do not occupy the main position, the cover of people is limited.In the United States, more than 80% of the national civil servants, private enterprise employees and farmers are not protected by the social insurance, but took part in the commercial insurance system.The national commercial medical insurance fund has more than 1800.Commercial health insurance in the United States is divided into non-profit and for-profit two kinds, the former can enjoy preferential treatment in taxation, which do not enjoy the treatment of the related.Is the feature of the commercial medical insurance model, mainly by the market operation and management of medical treatment insurance, the government only responsible for the elderly and the poor health care.Insurance funds is mainly borne by individuals and enterprises, government basic no burden.The model of the outstanding problems is the social fairness is poorer, there are quite a lot of low-income employees of small businesses, individual worker and peasant family do not have medical insurance.
United States: commercial medical insurance loopholes
Around the world, by private commercial insurance as the backbone of the country medical security system, but the United States.Commercial health insurance companies is to make money.In order to make money, the company is not willing to sell insurance policies to the high risk people.Therefore, the commercial medical insurance is hard to cover the old man.Commercial health insurance is also difficult to cover the poor, because they can't afford to pay the premium.From this perspective, the commercial health insurance anyway cannot achieve universal health care, fairness is poor.However, the us government to keep the bottom line, a market economy, the government should at least do this is to use the public finance to the market fails to cover the public to provide public services.Since the commercial medical insurance to cover the elderly and the poor, the U.S. government has set the health care system designed specifically for the old man (Medicare), specially set up the medical assistance system for the poor (Medicaid).Medical care is a mandatory health insurance, the government to impose social security tax (also known as social security taxes) helping to collect the premium and medical treatment of the money comes from government fiscal, Shared by federal and state governments.These two public health care system to cover the 45% of U.S. residents.Commercial medical insurance, however, even in the elderly and the poor also cannot achieve universal coverage of the general population.The latest population statistics show that in 2005, 46.6 million people had no health insurance, 15.9% of U.S. residents.The Numbers over the years in between 14% and 20%.In other words, the private medical insurance institutions insured people about 35% to 41% of the total number of U.S. residents.Another disadvantage of commercial medical insurance is the high cost of health care.People pay insurance premiums on statistical stray into "medical expenses", in the practical part of the profits of insurance company.In addition, the professionals of high salary, high on the world's first commercial health insurance company's management fees.America's health service highly marketable.Most clinics, hospitals and other specialized medical institutions are private, many are non-profit organizations, there are many is a for-profit company.Governments at all levels and the establishment of some medical institutions in the United States, mainly in order to make up for a lack of market, in rural and remote areas to set up community health center, also set up a few public hospitals in some cities.Whether private or public, for-profit or nonprofit medical institutions compete with contract of various kinds of health care institutions.Health care institutions including government sponsored health care and medical treatment, and various private health insurance company or a non-profit organization.Medical institutions in order to attract patients, so as to win the contract more health care institutions, on the improve the level of medical services and medical technology has launched a fierce competition.
The disadvantage of the American model universally acknowledged, even the American social policy experts have no objection.The voice of the medical security system reform in the United States' larger all the time, but any strengthening government function, the implementation of mandatory social insurance scheme is due to the intense opposition from the insurance industry and medical services to become law.
Characteristics of the commercial medical insurance
Commercial health insurance is also called
Health insurance, is based on the human body the subject-matter insured, the insured due to disease or accident harm to cause of medical treatment cost and the income loss to compensate.Commercial medical insurance in China start time is not long, in the insurance consciousness, insurance depth and insurance density and coverage development, premium income, operation and management, etc, compared with western developed countries insurance, there is a larger gap.In addition due to subject to the management risk of the commercial medical insurance is higher and the technical management requirements, coupled with the lack of rich market experience, domestic insurance companies for the development of medical insurance are a cautious attitude, causes our country medical insurance coverage set up by an insurance company is single, inadequate safeguard function, and the volume is small.After China's entry into the wto, the insurance access will gradually open, our country insurance company in the fierce competition of how to don't lose the commercial medical insurance market, this article obtains from the analysis of the commercial medical insurance mechanism, product development strategy of China's commercial health insurance are discussed.
The United States commercial medical treatment
Characteristics and advantages of insurance products 1. The commercial medical insurance system introduction to the world in modern history, the emergence of the commercial health insurance only one hundred years of history, but it has been widely used all over the world provide health care services for the national health insurance way, due to the different actual situation, so he formed the different medical insurance system, basically can be divided into the following two types, one is the private commercial insurance pattern, the second is the national health insurance mode.The United States is a private commercial insurance pattern.Under the private commercial insurance pattern, the medical service is given priority to with personal consumption, the government of special crowd (old age, disability, low income, etc.) to provide cost benefits, or the use of special medical insurance.Most countries only a small part of the burden of medical insurance, transferred to the patient or enterprise.Under this model, not only the economic burden of the government, and make the maximum development of commercial medical insurance market, insurance companies under the system of loose, reasonably according to the requirements of the market for the development of insurance breed.
American commercial health insurance product development strategy under the private commercial insurance pattern, because the doctors often opened by individuals and as members of the various organizations and groups, private hospitals than state-owned public hospitals, and so on medical expenses of the private hospitals have considerable autonomy, from
To constantly improve the medical service cost, at the same time, the commercial medical insurance market is growing.In this case, the insurance company mainly on medical insurance product development strategy to expand and stable customer group, promote the main insurance products.Embodied in the following aspects: (1) pay attention to the brand strategy.Insurance companies in the United States in the process of product development, in order to strengthen the company's image, stability and expanding customer base, often pays attention to the promotion of the main risks of business, but also pays attention to the external effects of the main insurance business.To a certain extent, insurance companies in the United States at the beginning of the brand establishment often give up some interests requirement.(2) ensure that product can run long.To ensure that the product can run a long-term policy of insurance companies for long-term, comprehensive evaluation is the premise, the insurance company in the commercial medical insurance in the process of product design pays attention to the sustainability of the product characteristics.(3) pay attention to the risk.Commercial medical insurance of the risk is that the medical cost and the consumption of high-grade medical uncertainty, in the United States, because the private hospitals is more, the uncertainty is more obvious, therefore the insurance company involved in commercial health insurance products in the process, according to various medical expenses have adopted different risk assessment mechanism to determine the risk of various risks.
SAS business analysis power blue cross to participate in medical insurance reform in the United States
As U.S. President barack Obama: "America's medical insurance system reform will be related to the survival of the future."Increase the medical insurance system reform is to maximum the status of the interior, at the same time, the global focus attention on health care reform in the United States.After many years of the American medical insurance system reform by experts to analyze its difficulty lies mainly in the medical insurance organization how to control the cost, improve the health level and maximize ginseng to keep staff satisfaction.Blue cross blue shield of the United States
Using SAS (BCBS) advanced business analytics techniques successfully implement all measures to the medical insurance system reform,
Do a good try for the whole industry.The difficulties of medical insurance system reform is expected to break through.
Now almost all the blue cross blue shield of using SAS ? (BCBS) Business analysis (Business Analytics) solutions are the implementation of the medical insurance system reform measures.In the family health plans, in one of the largest and earliest 39 enterprises in addition to the four have been deployment of SAS software.Every three americans, there is a blue cross blue shield to cover health insurance, the total has more than one hundred million people.Independent business technology research institution Aite Group medical insurance division, a senior analyst at access Pandya says:
"As the reform of health care system, medical insurance agencies to reduce costs, invest in advanced technology architecture of pressure increasing. Advanced analysis technology has become an important means of cost control. This kind of advanced technology can greatly help the medical insurance company to detect fraud, through positive interaction actively manage risk, and improve the efficiency of the system in other fields and benefit level."Dialysis SAS business analysis of SAS is the world's leading supplier of business analytics software and services, and business intelligence market of the largest independent manufacturer.By including many innovative solutions in an overall framework, SAS help more than 45000 users around the world a better and faster decisions, so as to improve the performance and value.SAS Business analysis Framework (Business Analytics Framework) is a collection of data integration, analysis, and reporting features a powerful tool at an organic whole, the industry and the expansion of the solution at the grass-roots level to an unprecedented level, is advantageous for the
Enterprise solutions to the current business problems quickly, at the same time expanding the application of SAS solution to continually improve performance level.SAS technology for enterprises to build their own application laid the foundation of reliable.At the same time, SAS provides solution can fully meet the demand of the industry cost savings, improve the level of patient welfare and other aspects of the problem.
SAS solution applicable to all health insurance companies, including: l SAS ? Customer Intelligence (Customer Intelligence) improve member interaction ability and service level.L SAS ? medical Insurance fraud Framework (Faud Framework for Health Insurance) to ensure that the legitimate claims.SAS ? Disease Management (diseases Management) solutions help predict risk, optimize the interaction level, improve the health care effect.Significant advantages Excellus blue cross blue shield will SAS business analysis framework is applied to many business units, including the actuarial department, the department is responsible for the analysis of the company the risk of ginseng protect personnel to 31 in the state of New York county.Using SAS business analysis technology, Excellus now can not only check has happened in the business, but also can predict problems to come."Insurance depends on the identification and predict future risk, the company has always given prominence to this work, and after using SAS, we perform an actuarial business standard speed increased by 40% at least," Joseph Excellus actuarial manager Randazzo said, "use of save time, we can work past quite time-consuming analysis. Results are obvious: now we can better control the risk of health care plan."
Improve the level of information = improve the level of care New Jersey in the service of 3.6 million members of the horizon blue cross blue shield companies face such problems, many health care plans members of their information demands increasingly complex and comprehensive, to control the cost of the health management plan.In the deployment of SAS enterprise business intelligence
Before the Server (SAS Enterprise BI Server), and the statements
Automation dashboard growing demand become the horizon the heavy burden of the company.The insurance company in three months time achieve the return on investment.MikeOcchipinti horizon company information department manager said: "the improvement of information management and customers for horizon brought huge benefits. Ministry of information to provide business analysis results provide support for the company more than 70 important project. Only the value of a project implemented by more than 5% of millions of dollars, install the SAS solution for only three months, we will as the main customer provides automatic disease management and health report, this kind of information for improving the standard of care has very important role."
With the development of the American medical insurance reform
With the development of the American medical insurance reform
A, the United States the development of medical insurance
In the United States, a common cases of inspection tests need to be beautiful
Yuan, a day of hospitalization in general also need $, medical expenses, aung
Expensive, the medical insurance from the s of this century has become an American
The most urgent need of insurance service.So far, has become a health insurance
The insurance market penetration rate is extremely high source of insurance business,
Americans are willing to pay a premium to buy all kinds of medical insurance
Risks.
Reviewing the development of the American medical insurance, can be divided into the following
Two or three, phases,
Simple folk stage of medical treatment insurance.This one phase from the s
Period until mid - way of medical treatment insurance is voluntary
, the folk organization management, the representative group medical insurance group is blue
Words, commercial medical insurance and kay from tissue.Among them, the blue cross organization
Is the regional medical insurance of American folk organization, it emphasizes the volunteer service,
Not for-profit, and use regardless of insurance is age, physical condition,
According to the unified standard particulars for payment of insurance premium, thus is advantageous to the high-risk people
Group, and not conducive to the healthy crowd commercial medical insurance organization is a nationwide
Medical organizations, it with profitability, and according to the people at high risk, low risk
Have different standard of medical treatment insurance premium, low-risk population for health fee is low,
Charging high bad to the body, thus of great appeal to healthy people
Caesar group is a form of medical insurance of the contracted in advance, it is confirmed
Insurance companies and hospitals or doctors medical contract, to carry on medical insurance is
Treatment for contracting, the condition is the guarantee insurance is effective treatment, funds
Calculate the overruns not fill, savings to return all the way to the hospital or doctor, thereby
Help to reduce the medical expenses of the hospital, the hospital or the doctor
Less spending provide effective medical care, to avoid the medical process
The waste phenomenon.
Government involvement in health insurance stage.This one phase from years away
Beginning to year marked by the U.S. congress to pass health care plan
The plan was based on the article of the social security act, the federal government
Government funding for United States citizens over the age of, patients with severe renal and disability
Patients with medical insurance, but has the specific provisions on scope of medical treatment
At the same time, the state governments according to the stipulations of article of the social security act, also
Have set up medical expenses relief and so on to participate in the national health insurance.In addition, the government
The government also provide medical aid to the poor.Days, the United States congress to vote again
Ticket by expanding the scope of medical treatment in medical care plan
Pay the insured person most of the hospitalization expenses, the insured person pays part is qualified
As the dollar.The participation of the government, the elderly and disabled people won
Have basic medical and health care in the quality of social insurance, but the vast majority of people
Treatment insurance still have to solve or employers to help solve it
With a nature of social insurance medical treatment insurance, the insured individual also should undertake
A percentage or amount of medical expenses.Therefore, years,
America's health insurance in fact includes government funding and medical insurance
People didn't get compensation, and also can return the part of the insurance benefits.
Years has changed the method of insurance rate calculation.The new rate by
Combination according to the local statistical information collected during the process of insurance work indeed
, the localization of the calculation method of premium rates, can be more accurately
Reflect the loss rate and the change of time.
The change of the insured crops.
With the development of agriculture, some of the initial agricultural insurance system
Risk of crops of wheat, barley, oats and upland rice increasingly become not important,
And other crops, especially fruit, vegetables and horticultural crops become more important
.Horticultural crops planting fruit and risk bigger, growers urgently need to be confirmed
,,
Risks.Years on a voluntary basis, therefore, implements the fruit insurance scheme,
Years on a voluntary basis for horticultural crop insurance scheme.At that time
Some people used to think that, if there is no force to participate in, small like Japan
The farmer's social practice the crop insurance is impossible, that was not the like
With this.This is because the production of fruit per cost twice or three times the rice
Of the cost of production, the production cost for the vegetable rice, farmers' right
Attend insurance demand more urgent.Of course, these new crop insurance still needs to be
Should the government provide subsidies.
Private health insurance.
Stage of reform and development.Although since years, medicine in the United States
Treatment insurance system reform, without such as premium standard, the poverty line
Adjustment, but the real start of medical insurance system reform or since
Years after President Clinton took office.Previously, the United States each year in the congress
About health insurance proposals have dozens of, but because of the parties or groups
The disagreement between, and always no result.In the year's presidential race
Selected, how to do, including medical insurance, medical and health care reform a
Straight is the hot topic of the United States, President Clinton to the White House, after the reform
The theory is incandescent.(date) (month) (year), enacted by President Clinton
Surface on reform of medical system plan, President Bill Clinton in the United States again
The senate and house of joint meeting, put forward the medical and health care
Reform scheme, although it remains to be seen how to implement, but the plan can be
As the medical insurance system into the stage of reform and development.
Second, the kind and content of the medical insurance system in the United States
America's health insurance system, more complex, according to different standards
Can make a variety of division.
According to the nature of medical treatment insurance can be divided into three categories
Free medical care.According to the relevant government rules and regulations, for not
Into medical schemes to give free treated, its scope includes only the critically ill baby
Son and HIV/AIDS patients, the medical fees are paid by the federal government.
Years, the free medical care spending $, along with HIV/AIDS
Patients are increasing, the spending has increased significantly in recent years.
Medical social insurance.Is characterized by government funding, to enforce.
It mainly includes a medicare is funded by the federal government, its
Objects are old age, disability, or citizens of the United States with severe kidney disease, about
.Ten thousand the second is funded by the federal and state governments of low-income family
Court medicaid, enjoy the qualification for low-income home below the poverty line
Court, but the poverty line have different states, such as a family of New York state,
In the year is only enough to qualify for family income less than $
The subsidy, such beneficiary three is about more than ten thousand people across the United States army
Medical social insurance of people and their families, about ten thousand people across the United States is four
Belongs to "a minor children family allowances" plan funded health insurance
, and enjoy other medicaid, around the country..Ten thousand people.
Personal medical insurance.It is mainly refers to employers or federal
The government plans to provide health insurance, and insurance is covered by individual freedom, the right
As for all the citizens of the United States, under the age of about one hundred million people, there is
..More than americans have no health insurance.
According to the scope of insurance, medical social insurance in the United States can be divided into the
One of the hospitalization insurance and supplementary medical insurance.The former belongs to the mandatory
Insurance, funding including hospitalization, hospital treatment, and family members
Beneficiaries care and outpatient expenses compensation, but still have to take
Amount or proportion of the cost of the latter belongs to the voluntary insurance, the insured person per month
Must pay the insurance premium monthly pay $s
Yuan, the safeguard scope includes ZhenDuanFei and uniersity, dental treatment and medicine
Goods, inspection, care, etc.
According to the medical insurance organization can be divided into two kinds of work
Enterprise mainly is the group of large and medium-sized, office worker, with confirmed by the employer
Insurance health insurance contracts, according to certain conditions for all employees
And their families to provide health insurance, this kind of business is equivalent to our country's enterprises
Welfare cangue degrees, but no unified standard citizens for personal medical insurance
Risks, namely, individual or family separate medical insurance contract with the insurance company.
According to the content of medical treatment insurance can be divided into five kinds of hospitalization medical treatment
With insurance.To pay the hospital clinical, laboratory and patient food, special equipment
Use, care, certain drugs and the material cost, most of the sick in the hospital
Number of days and the bed the highest expenses have specific provision standard general medical care
The cost of insurance.Pay outpatient visits, drugs and general and health care costs, but the hand
Except surgery insurance cost.Payment of the surgical operation
Use, but there is every time limit stipulated individual medical highest operation cost
Insurance.Undertake such as dental, eye care, oral health, cancer care
Such as fee, the specialized large or major medical expenses insurance.bearing
The medical expenses of the general, namely to lower health care costs irresponsible,
But only responsible for the high medical costs, sometimes even the highest paid not limit
Well, but have a franchise and the proportion of the presenter.
Three main problems of medical insurance system, the United States
Medical costs jumped sharply on led to the medical treatment insurance premium
L.From year to year, medical treatment charge of surge make single worker
The rising cost of health insurance and health insurance fees of the family
Rose by years, America's health care costs.
Dollars, accounting for the gross national product (GNP), medical insurance of insurance
Gold rose index is normal price.
The lack of a unified medical insurance system.In the United States, people are divided
Into classes or groups, some enjoy free or social medical insurance, there are
Enjoy employer-sponsored health insurance, some can only be as free
State standard of poverty line, and furthermore, led to the medical insurance system
Not unified, benefit the middle class is more, instead, poor benefit,
To become the United States an important cause of social contradictions.
Inadequate protection.Due to the expensive medical costs and government funding
Co., LTD., together with the commercial insurance is covered by insurance institutions will some shut out of the United States
In medical insurance is developed at the same time, inadequate protection of the deposit has asked
The topic.On the one hand, the insurance is covered by a year with one month's salary payment
Treatment insurance fee, but only a third of insurance can be compensated, d
Most of treatment costs still shall be borne by the individual, on the other hand, in a medical
Insurance people, there are also a significant number of people belong to the insurance, namely to
Limited a few insurance, either guarantee amount is low.
The national also have no health insurance.Across the United States about some
People enjoy government funding or employer funded or individuals to participate in medical insurance,
But people are still unable to bear insurance premium or due to the employer
This does not provide any medical insurance fund and their income is slightly higher than the poor
Stranded wire, cannot enjoy medicaid or lost due to unemployment or conversion work
To the original medical insurance or is thought to be due to suffering from chronic diseases
Do not conform to the insured object, was shut out in medical insurance.
Fourth, the medical insurance system reform
The Clinton administration on medical and health care system reform scheme is in grams
Under the leadership of Mrs Linton, after more than a year of brewing and listen to all parties
After issued.Reform is the slogan of the if you don't have medicine now
Insurance, then you will get if you have health insurance, then you
Will not be lost.The ultimate aim is to provide every American with
Health insurance.
According to the administration of President Bill Clinton announced reforms, its main content
To sum up as the
a
Next time
Comprehensive protection.The medical insurance will be involved in every family, and a
People, to ensure that every person in need when receive appropriate medical service system at the same time
Book a standard range of medical services as content of basic health care, including
Outpatient, hospital, laboratory examination, diagnosis, inspection, psychiatric and beforehand
The project of the health care and so on.Every American will be as a club
Will be as the health insurance card, security card once you need to use, any hospital
Or doctors all patients can not be rejected.But because America's economy in recent years
Well, can guarantee as planned implementation within a year
To conclude.
Simplified procedures.Due to the private insurance industry developed in the United States, the relevant regulations
A dime a dozen, is used to process documents, form each year than the average
Higher than that of countries, many medical units hired personnel dealing with these things
Services, and the expenses and has nothing to do with medical services, therefore, by Jane
Formalities, can save a lot of cost and is used to health career
Into the.
Improve the employers and the government funding standards.The new reform
Employers must pay each employee medical insurance, the rest of the department
Points shall be borne by the employee himself.If belong to small businesses or low-income individuals
Or family, the government can also offer certain subsidy, to ensure that there is no cure
People can get medical treatment insurance insurance.
The freedom to choose.That determine the three reforms, everyone can
Choose a suitable for their own health insurance plan, and give the change
Get the freedom of choice, in order to create a free competition of the medical insurance
The market.
Emphasis on the responsibility.Reform requires to every person, group
Responsible for health, especially in the insurance industry, medical personnel, such as the pharmaceutical industry is heavy
Big responsibility.At the same time, is appealing to everyone to change unhealthy behavior, and requirements
Hospitals in the compression of health funds at the same time guarantee the quality of medical services.
In the state of the crowd.This allows a state
Everyone in, makes the ability of the medical risk greatly strengthen,
And the alliance with the trade unions and the insurance company can make medical price
On the negotiations.
At present, the reform is discussed in congress, though many group
Body, the opposition parties, but according to the poll, most people said praise
With Clinton's reform.The medical insurance system reform in the United States
Smoothly and realize the goal of its reform, remains to be seen
A, the United States the development of medical insurance
In the United States, a common cases of inspection tests need to be beautiful
Yuan, a day of hospitalization in general also need $, medical expenses, aung
Expensive, the medical insurance from the s of this century has become an American
The most urgent need of insurance service.So far, has become a health insurance
The insurance market penetration rate is extremely high source of insurance business,
Americans are willing to pay a premium to buy all kinds of medical insurance
Risks.
Reviewing the development of the American medical insurance, can be divided into the following
Two or three, phases,
Simple folk stage of medical treatment insurance.This one phase from the s
Period until mid - way of medical treatment insurance is voluntary
, the folk organization management, the representative group medical insurance group is blue
Words, commercial medical insurance and kay from tissue.Among them, the blue cross organization
Is the regional medical insurance of American folk organization, it emphasizes the volunteer service,
Not for-profit, and use regardless of insurance is age, physical condition,
According to the unified standard particulars for payment of insurance premium, thus is advantageous to the high-risk people
Group, and not conducive to the healthy crowd commercial medical insurance organization is a nationwide
Medical organizations, it with profitability, and according to the people at high risk, low risk
Have different standard of medical treatment insurance premium, low-risk population for health fee is low,
Charging high bad to the body, thus of great appeal to healthy people
Caesar group is a form of medical insurance of the contracted in advance, it is confirmed
Insurance companies and hospitals or doctors medical contract, to carry on medical insurance is
Treatment for contracting, the condition is the guarantee insurance is effective treatment, funds
Calculate the overruns not fill, savings to return all the way to the hospital or doctor, thereby
Help to reduce the medical expenses of the hospital, the hospital or the doctor
Less spending provide effective medical care, to avoid the medical process
The waste phenomenon.
Government involvement in health insurance stage.This one phase from years away
Beginning to year marked by the U.S. congress to pass health care plan
The plan was based on the article of the social security act, the federal government
Government funding for United States citizens over the age of, patients with severe renal and disability
Patients with medical insurance, but has the specific provisions on scope of medical treatment
At the same time, the state governments according to the stipulations of article of the social security act, also
Have set up medical expenses relief and so on to participate in the national health insurance.In addition, the government
The government also provide medical aid to the poor.Days, the United States congress to vote again
Ticket by expanding the scope of medical treatment in medical care plan
Pay the insured person most of the hospitalization expenses, the insured person pays part is qualified
As the dollar.The participation of the government, the elderly and disabled people won
Have basic medical and health care in the quality of social insurance, but the vast majority of people
Treatment insurance still have to solve or employers to help solve it
With a nature of social insurance medical treatment insurance, the insured individual also should undertake
A percentage or amount of medical expenses.Therefore, years,
America's health insurance in fact includes government funding and medical insurance
People didn't get compensation, and also can return the part of the insurance benefits.
Years has changed the method of insurance rate calculation.The new rate by
Combination according to the local statistical information collected during the process of insurance work indeed
, the localization of the calculation method of premium rates, can be more accurately
Reflect the loss rate and the change of time.
The change of the insured crops.
With the development of agriculture, some of the initial agricultural insurance system
Risk of crops of wheat, barley, oats and upland rice increasingly become not important,
And other crops, especially fruit, vegetables and horticultural crops become more important
.Horticultural crops planting fruit and risk bigger, growers urgently need to be confirmed
,,
Risks.Years on a voluntary basis, therefore, implements the fruit insurance scheme,
Years on a voluntary basis for horticultural crop insurance scheme.At that time
Some people used to think that, if there is no force to participate in, small like Japan
The farmer's social practice the crop insurance is impossible, that was not the like
With this.This is because the production of fruit per cost twice or three times the rice
Of the cost of production, the production cost for the vegetable rice, farmers' right
Attend insurance demand more urgent.Of course, these new crop insurance still needs to be
Should the government provide subsidies.
Private health insurance.
Stage of reform and development.Although since years, medicine in the United States
Treatment insurance system reform, without such as premium standard, the poverty line
Adjustment, but the real start of medical insurance system reform or since
Years after President Clinton took office.Previously, the United States each year in the congress
About health insurance proposals have dozens of, but because of the parties or groups
The disagreement between, and always no result.In the year's presidential race
Selected, how to do, including medical insurance, medical and health care reform a
Straight is the hot topic of the United States, President Clinton to the White House, after the reform
The theory is incandescent.(date) (month) (year), enacted by President Clinton
Surface on reform of medical system plan, President Bill Clinton in the United States again
The senate and house of joint meeting, put forward the medical and health care
Reform scheme, although it remains to be seen how to implement, but the plan can be
As the medical insurance system into the stage of reform and development.
Second, the kind and content of the medical insurance system in the United States
America's health insurance system, more complex, according to different standards
Can make a variety of division.
According to the nature of medical treatment insurance can be divided into three categories
Free medical care.According to the relevant government rules and regulations, for not
Into medical schemes to give free treated, its scope includes only the critically ill baby
Son and HIV/AIDS patients, the medical fees are paid by the federal government.
Years, the free medical care spending $, along with HIV/AIDS
Patients are increasing, the spending has increased significantly in recent years.
Medical social insurance.Is characterized by government funding, to enforce.
It mainly includes a medicare is funded by the federal government, its
Objects are old age, disability, or citizens of the United States with severe kidney disease, about
.Ten thousand the second is funded by the federal and state governments of low-income family
Court medicaid, enjoy the qualification for low-income home below the poverty line
Court, but the poverty line have different states, such as a family of New York state,
In the year is only enough to qualify for family income less than $
The subsidy, such beneficiary three is about more than ten thousand people across the United States army
Medical social insurance of people and their families, about ten thousand people across the United States is four
Belongs to "a minor children family allowances" plan funded health insurance
, and enjoy other medicaid, around the country..Ten thousand people.
Personal medical insurance.It is mainly refers to employers or federal
The government plans to provide health insurance, and insurance is covered by individual freedom, the right
As for all the citizens of the United States, under the age of about one hundred million people, there is
..More than americans have no health insurance.
According to the scope of insurance, medical social insurance in the United States can be divided into the
One of the hospitalization insurance and supplementary medical insurance.The former belongs to the mandatory
Insurance, funding including hospitalization, hospital treatment, and family members
Beneficiaries care and outpatient expenses compensation, but still have to take
Amount or proportion of the cost of the latter belongs to the voluntary insurance, the insured person per month
Must pay the insurance premium monthly pay $s
Yuan, the safeguard scope includes ZhenDuanFei and uniersity, dental treatment and medicine
Goods, inspection, care, etc.
According to the medical insurance organization can be divided into two kinds of work
Enterprise mainly is the group of large and medium-sized, office worker, with confirmed by the employer
Insurance health insurance contracts, according to certain conditions for all employees
And their families to provide health insurance, this kind of business is equivalent to our country's enterprises
Welfare cangue degrees, but no unified standard citizens for personal medical insurance
Risks, namely, individual or family separate medical insurance contract with the insurance company.
According to the content of medical treatment insurance can be divided into five kinds of hospitalization medical treatment
With insurance.To pay the hospital clinical, laboratory and patient food, special equipment
Use, care, certain drugs and the material cost, most of the sick in the hospital
Number of days and the bed the highest expenses have specific provision standard general medical care
The cost of insurance.Pay outpatient visits, drugs and general and health care costs, but the hand
Except surgery insurance cost.Payment of the surgical operation
Use, but there is every time limit stipulated individual medical highest operation cost
Insurance.Undertake such as dental, eye care, oral health, cancer care
Such as fee, the specialized large or major medical expenses insurance.bearing
The medical expenses of the general, namely to lower health care costs irresponsible,
But only responsible for the high medical costs, sometimes even the highest paid not limit
Well, but have a franchise and the proportion of the presenter.
Three main problems of medical insurance system, the United States
Medical costs jumped sharply on led to the medical treatment insurance premium
L.From year to year, medical treatment charge of surge make single worker
The rising cost of health insurance and health insurance fees of the family
Rose by years, America's health care costs.
Dollars, accounting for the gross national product (GNP), medical insurance of insurance
Gold rose index is normal price.
The lack of a unified medical insurance system.In the United States, people are divided
Into classes or groups, some enjoy free or social medical insurance, there are
Enjoy employer-sponsored health insurance, some can only be as free
State standard of poverty line, and furthermore, led to the medical insurance system
Not unified, benefit the middle class is more, instead, poor benefit,
To become the United States an important cause of social contradictions.
Inadequate protection.Due to the expensive medical costs and government funding
Co., LTD., together with the commercial insurance is covered by insurance institutions will some shut out of the United States
In medical insurance is developed at the same time, inadequate protection of the deposit has asked
The topic.On the one hand, the insurance is covered by a year with one month's salary payment
Treatment insurance fee, but only a third of insurance can be compensated, d
Most of treatment costs still shall be borne by the individual, on the other hand, in a medical
Insurance people, there are also a significant number of people belong to the insurance, namely to
Limited a few insurance, either guarantee amount is low.
The national also have no health insurance.Across the United States about some
People enjoy government funding or employer funded or individuals to participate in medical insurance,
But people are still unable to bear insurance premium or due to the employer
This does not provide any medical insurance fund and their income is slightly higher than the poor
Stranded wire, cannot enjoy medicaid or lost due to unemployment or conversion work
To the original medical insurance or is thought to be due to suffering from chronic diseases
Do not conform to the insured object, was shut out in medical insurance.
Fourth, the medical insurance system reform
The Clinton administration on medical and health care system reform scheme is in grams
Under the leadership of Mrs Linton, after more than a year of brewing and listen to all parties
After issued.Reform is the slogan of the if you don't have medicine now
Insurance, then you will get if you have health insurance, then you
Will not be lost.The ultimate aim is to provide every American with
Health insurance.
According to the administration of President Bill Clinton announced reforms, its main content
To sum up as the
a
Next time
Comprehensive protection.The medical insurance will be involved in every family, and a
People, to ensure that every person in need when receive appropriate medical service system at the same time
Book a standard range of medical services as content of basic health care, including
Outpatient, hospital, laboratory examination, diagnosis, inspection, psychiatric and beforehand
The project of the health care and so on.Every American will be as a club
Will be as the health insurance card, security card once you need to use, any hospital
Or doctors all patients can not be rejected.But because America's economy in recent years
Well, can guarantee as planned implementation within a year
To conclude.
Simplified procedures.Due to the private insurance industry developed in the United States, the relevant regulations
A dime a dozen, is used to process documents, form each year than the average
Higher than that of countries, many medical units hired personnel dealing with these things
Services, and the expenses and has nothing to do with medical services, therefore, by Jane
Formalities, can save a lot of cost and is used to health career
Into the.
Improve the employers and the government funding standards.The new reform
Employers must pay each employee medical insurance, the rest of the department
Points shall be borne by the employee himself.If belong to small businesses or low-income individuals
Or family, the government can also offer certain subsidy, to ensure that there is no cure
People can get medical treatment insurance insurance.
The freedom to choose.That determine the three reforms, everyone can
Choose a suitable for their own health insurance plan, and give the change
Get the freedom of choice, in order to create a free competition of the medical insurance
The market.
Emphasis on the responsibility.Reform requires to every person, group
Responsible for health, especially in the insurance industry, medical personnel, such as the pharmaceutical industry is heavy
Big responsibility.At the same time, is appealing to everyone to change unhealthy behavior, and requirements
Hospitals in the compression of health funds at the same time guarantee the quality of medical services.
In the state of the crowd.This allows a state
Everyone in, makes the ability of the medical risk greatly strengthen,
And the alliance with the trade unions and the insurance company can make medical price
On the negotiations.
At present, the reform is discussed in congress, though many group
Body, the opposition parties, but according to the poll, most people said praise
With Clinton's reform.The medical insurance system reform in the United States
Smoothly and realize the goal of its reform, remains to be seen
The veterans health care system reform
The veterans health care system reform
American Veterans health Care System (the Veterans Affairs health Care System) is the only directly by the government to provide services in the United States health Care System, the government by congress to approve tax of its funding, facilities of the state, medical institutions personnel for government employees, from the Department of Veterans Affairs (Department of Veterans Affairs) of the Veterans Affairs medical Affairs management.In the 1980 s and early ninety s, it's bureaucracy, such as low efficiency and treatment level of general, privatization of veterans health care system.Launched in 1995, the veterans health care system reconstruction plan, began to reform in an all-round way.More than a decade, the United States veterans health care system has become the largest integrated health care system, centered on patients, high quality, high value of the characteristics of medical services, make it become the world's most effective public hospital system, is other learning model for the health care system.
American veterans health care system functions play four main functions: the veterans health care system to provide medical and health services, teaching, scientific research, and to assume the government's medical emergency task.(a) at the beginning of the health service set up, veterans health care system is only for the war wound disabled veterans provide medical services.In 1990, less than 10% of injuries disabled veterans medical service system, 90% of the veterans have other health insurance.But its service gradually expand to other veterans, mostly low-income and displaced persons.In 1995, only 12% of the patients was disabled in the war wounded veterans, but there are also 28%
Patients was disabled in the war wounded veterans, but they are not for the disabled in the hospital, the remaining 59% of the patients did not wound disabled in the war, mainly low-income veterans.So the system became an important part of health care network, and undertake the responsibilities of a social safety net, actually.After the reform, the qualification for veterans hospital services determined from strict authentication system to the registration system.Because of budget constraints, not provide all the required services for all registered person, so according to the degree of disability disease associated with serving, severity of the disease, registrant of economic conditions, such as standard, the registered person is divided into eight priority group, under the constraint of the budget in accordance with the priority to provide medical and health services, priorities of the need to pay higher co-payments.
(2) medical education and training of veterans health care system to accept every year 34000 residents and 22000 medical students in internship, 125 medical college in 107 and 131 by veterans affairs medical center has the teaching agreement, an estimated 65% of the doctors are trained veterans health care system.Medical research, 1958 (3) veterans health care system in accordance with the requirements of the U.S. congress, began to conduct medical research work, including research in all directions, the government invests a lot of money to support, at the same time, the participation of private funds have contributed to the veterans health care system of medical research.(4) the government's health emergency treatment in 1982, the veterans health care system in accordance with the requirements of the U.S. congress began and undertake processing and other emergency system of emergent public health events, natural disasters and other events of emergency medical and health care.
American veterans health care system reconstruction scheme in 1995, the veterans affairs medical affairs bureau began to reconstruct veterans health care system reform.Reform is on the one hand due to bureaucratic phenomenon is serious, such as inefficient, treatment level of general performance make it criticized;On the other hand is financial pressure.Health care spending is increasing, while the government finances can't keep up.Although the decrease in the total number of veterans, but because of an ageing population, medical expenditures rise quickly;In reducing the federal government spending, reduce the fiscal deficit, under the macro policy of veterans health care system of the government budget in 1977 accounted for 5% of the federal budget down to 2.5% in 1996.Congress did not veterans health care system reform to the American public debate on health reform, but to make its independence to reform.The director Kenneth w. Kizer proposed "from hospital system to medical systems (from a hospital system to a health care system)".Major reforms
Features are: change the organizational structure and governance structure, optimize the allocation of resources, management, assessment of the quality and effect, and provide support for the patients, medical staff and regulators of the information system.
A) organizational structure adjustment, realize the regional integration in 1995, the veterans health care system contains about 173 hospitals, 600 outpatient clinics, 133 nursing institutions, 40 206 rehabilitation institutions and consultation center.After the reform, 173 veterans hospital merger to 22 regional integration service network (VISN), its internal resources can be Shared human and equipment (two network has also been merged, so the existing 21 network).Through regional integration, regional medical services can be more flexibility and operability, timely reflect the different needs of patients with local area network, adopting reasonable solution.For example, post-traumatic stress disorder (PTSD), veterans health care system area network can be adjusted timely to this kind of special disease diagnosis and treatment process.
(2) governance structure adjustment, the management and supervision of the separation reform, veterans affairs medical affairs bureau is responsible for the overall planning and policy making, and direct management of the hospital, so the management team.Veterans health care system of employees ranked third in the federal government agencies, streamlining staff is a strong demand from the outside.After the reform, from to is mainly responsible for policy making, the long-term goal of the system planning and to develop guidance, responsible for the supervision and examination of various regional integration service network, and shall be responsible for congress.At the same time, simplify the management of the affairs personnel, 25% attrition.Area network, director of the national network of responsibility for the operation, budget and decision-making.
(3) budget mode, mode of payment change before the reform, the government report of the previous year's spending budget according to the hospital, the veterans health bureau to grant 173 hospitals.For hospitals, the more spending, after is, the more money, have no incentive to control costs.After reform, according to the past no longer spending on the budget, but according to the budget estimate of the cost of every veterans, grants follow patients, and capitation payment, this incentive hospital service more people, and must control the cost.Veterans affairs medical affairs bureau under the supervision of the congress, funding for 22 area network.1997 veterans demand resources after the construction of the distribution system (VERA), through the data analysis, categorizing the crowd of different requirements, main need of basic medical services and the main difference between two groups the special medical services, for a better budget.
(4) medical pattern adjustment, service content reform
Before the reform, veterans health care system mainly provide service in hospital.Under the trend of the development of the management of health care in the United States is a strong, veterans health care system to provide preventive health care, more basic medical service and health management, moving in the compound of community-based mutual medical network development.Through the establishment of more outpatient clinics and mobile clinics, make its service people can be more convenient access to medical services.At the same time, the veterans health care system able to persuade the government expands services to more veterans groups, and the health of the community as a standard of performance appraisal.After the reform, the outpatient service toll, a decline in the hospital, the reason is that the proportion of the chronic diseases and nursing rehabilitation increased, at the same time supporting services: including nursing station, counseling centers and number of institutions in the rehabilitation center.
(5) the quality and value as a development strategy, establish assessment and accountability system due to the public nature of veterans health care system, this system is also the most critical departments, in the ninety s, the veterans health care system by many critics, even made in Hollywood movies.So after reform will have on the quality and value as a development strategy, take the objective evaluation of the quality and value as a means of internal performance improvement, and as the basis of internal and external accountability.Made the measure of quality and value in the reform, and to evaluate.Value with the technology level of medical services, service convenience, treatment effect, the patients' satisfaction, the overall health of the community five output index and medical costs the input index to measure and analyze the effect of the input and output.Veterans affairs medical affairs department responsible for the congress, veterans health care system between various levels also have signed an agreement of the quality of accountability, such as each part of the veterans affairs medical treatment and the director of the network accountability agreement.
(6) the construction of information sharing system of veterans health care system successfully implemented to improve the way of management model, reform the budget, optimizing the allocation of resources and improving the service quality and value is the important basis of a Shared information system is established.The department of veterans affairs (VA) since 1985, for the convenience of medical management and automated information system is established, first hospital computer program system for decentralized, has a wide range of clinical and management performance.In 1997 began using electronic medical record system (CPRS), greatly improved the function of the original system.Reform set up after the veterans health information system and the technical architecture (VistA) to realize the information sharing, not only help the doctor make reasonable medical decisions, but also provide support to improve the performance and implementation of health management.Veterans health information system and the continuous improvement, toward the more perfect sharing information platform development, including 1) patient centered health records system;2) services for the center with your health care provider and evaluation system;3) with the modern enterprise financial management system as the core of financial management system.
Fourth, the American legion the effect of the medical system reform
Veterans health care system reform has achieved remarkable success after, become one of America's most dynamic medical system, caused the wide concern policy circles and academia.In recent years, the system is evaluated both efficiency and cost of medical services in the best group.After reform, veterans health care system with relatively fewer resources to treat more patients, more than 77% of the patients get effective basic medical treatment service.The more veterans willing to sign up.In recent years, the American legion in reducing population, from 26.5 million to 23.5 million in 2000, but the veterans health care system in the registration number is on the increase, from $1999 in 4.3 million to 7.9 million, actually obtains the number of medical and health services will increase, from $1995 in 2.9 million to 2006 in 5 million.But the veterans health care system to sort out the medical expenses of flat growth rate, up from $1996 in 17 billion to $2006 in 32 billion, compared with other American medical system, the system cost control is the best.At the same time, the veterans health care system to become industry leaders, medical information, performance improvement in its patient satisfaction and 18 on disease prevention and treatment of indicators as the national standards.
Five, the American veterans medical system reform of our country's enlightenment American veterans effective health care system reform scheme and process of medical and health system reform in our country, especially the reform of public medical service system in China has great reference significance.1, the public medical system not only provides medical and health services, but also an important force in medical education, scientific research, and more of the functions of the medical treatment, is an important guarantee of national emergency event handling.2, unified integrated public medical system, not only has economies of scale and scope economy effect, able to provide cost effective management and control, and for the use of modern information and management provides the basis.3, public medical institutions need to refactor, but also the public medical system can through the adjustment of organizational structure and management system, such as resource allocation way of improving the value of the reform, improve the efficiency and service.4, medical service should be toward to patients as the center, in the direction of health as the center, so the organization form of the content of the medical service, medical institutions should be in this direction.5, the establishment and perfection of the information system is the important guarantee of successful reform.
American Veterans health Care System (the Veterans Affairs health Care System) is the only directly by the government to provide services in the United States health Care System, the government by congress to approve tax of its funding, facilities of the state, medical institutions personnel for government employees, from the Department of Veterans Affairs (Department of Veterans Affairs) of the Veterans Affairs medical Affairs management.In the 1980 s and early ninety s, it's bureaucracy, such as low efficiency and treatment level of general, privatization of veterans health care system.Launched in 1995, the veterans health care system reconstruction plan, began to reform in an all-round way.More than a decade, the United States veterans health care system has become the largest integrated health care system, centered on patients, high quality, high value of the characteristics of medical services, make it become the world's most effective public hospital system, is other learning model for the health care system.
American veterans health care system functions play four main functions: the veterans health care system to provide medical and health services, teaching, scientific research, and to assume the government's medical emergency task.(a) at the beginning of the health service set up, veterans health care system is only for the war wound disabled veterans provide medical services.In 1990, less than 10% of injuries disabled veterans medical service system, 90% of the veterans have other health insurance.But its service gradually expand to other veterans, mostly low-income and displaced persons.In 1995, only 12% of the patients was disabled in the war wounded veterans, but there are also 28%
Patients was disabled in the war wounded veterans, but they are not for the disabled in the hospital, the remaining 59% of the patients did not wound disabled in the war, mainly low-income veterans.So the system became an important part of health care network, and undertake the responsibilities of a social safety net, actually.After the reform, the qualification for veterans hospital services determined from strict authentication system to the registration system.Because of budget constraints, not provide all the required services for all registered person, so according to the degree of disability disease associated with serving, severity of the disease, registrant of economic conditions, such as standard, the registered person is divided into eight priority group, under the constraint of the budget in accordance with the priority to provide medical and health services, priorities of the need to pay higher co-payments.
(2) medical education and training of veterans health care system to accept every year 34000 residents and 22000 medical students in internship, 125 medical college in 107 and 131 by veterans affairs medical center has the teaching agreement, an estimated 65% of the doctors are trained veterans health care system.Medical research, 1958 (3) veterans health care system in accordance with the requirements of the U.S. congress, began to conduct medical research work, including research in all directions, the government invests a lot of money to support, at the same time, the participation of private funds have contributed to the veterans health care system of medical research.(4) the government's health emergency treatment in 1982, the veterans health care system in accordance with the requirements of the U.S. congress began and undertake processing and other emergency system of emergent public health events, natural disasters and other events of emergency medical and health care.
American veterans health care system reconstruction scheme in 1995, the veterans affairs medical affairs bureau began to reconstruct veterans health care system reform.Reform is on the one hand due to bureaucratic phenomenon is serious, such as inefficient, treatment level of general performance make it criticized;On the other hand is financial pressure.Health care spending is increasing, while the government finances can't keep up.Although the decrease in the total number of veterans, but because of an ageing population, medical expenditures rise quickly;In reducing the federal government spending, reduce the fiscal deficit, under the macro policy of veterans health care system of the government budget in 1977 accounted for 5% of the federal budget down to 2.5% in 1996.Congress did not veterans health care system reform to the American public debate on health reform, but to make its independence to reform.The director Kenneth w. Kizer proposed "from hospital system to medical systems (from a hospital system to a health care system)".Major reforms
Features are: change the organizational structure and governance structure, optimize the allocation of resources, management, assessment of the quality and effect, and provide support for the patients, medical staff and regulators of the information system.
A) organizational structure adjustment, realize the regional integration in 1995, the veterans health care system contains about 173 hospitals, 600 outpatient clinics, 133 nursing institutions, 40 206 rehabilitation institutions and consultation center.After the reform, 173 veterans hospital merger to 22 regional integration service network (VISN), its internal resources can be Shared human and equipment (two network has also been merged, so the existing 21 network).Through regional integration, regional medical services can be more flexibility and operability, timely reflect the different needs of patients with local area network, adopting reasonable solution.For example, post-traumatic stress disorder (PTSD), veterans health care system area network can be adjusted timely to this kind of special disease diagnosis and treatment process.
(2) governance structure adjustment, the management and supervision of the separation reform, veterans affairs medical affairs bureau is responsible for the overall planning and policy making, and direct management of the hospital, so the management team.Veterans health care system of employees ranked third in the federal government agencies, streamlining staff is a strong demand from the outside.After the reform, from to is mainly responsible for policy making, the long-term goal of the system planning and to develop guidance, responsible for the supervision and examination of various regional integration service network, and shall be responsible for congress.At the same time, simplify the management of the affairs personnel, 25% attrition.Area network, director of the national network of responsibility for the operation, budget and decision-making.
(3) budget mode, mode of payment change before the reform, the government report of the previous year's spending budget according to the hospital, the veterans health bureau to grant 173 hospitals.For hospitals, the more spending, after is, the more money, have no incentive to control costs.After reform, according to the past no longer spending on the budget, but according to the budget estimate of the cost of every veterans, grants follow patients, and capitation payment, this incentive hospital service more people, and must control the cost.Veterans affairs medical affairs bureau under the supervision of the congress, funding for 22 area network.1997 veterans demand resources after the construction of the distribution system (VERA), through the data analysis, categorizing the crowd of different requirements, main need of basic medical services and the main difference between two groups the special medical services, for a better budget.
(4) medical pattern adjustment, service content reform
Before the reform, veterans health care system mainly provide service in hospital.Under the trend of the development of the management of health care in the United States is a strong, veterans health care system to provide preventive health care, more basic medical service and health management, moving in the compound of community-based mutual medical network development.Through the establishment of more outpatient clinics and mobile clinics, make its service people can be more convenient access to medical services.At the same time, the veterans health care system able to persuade the government expands services to more veterans groups, and the health of the community as a standard of performance appraisal.After the reform, the outpatient service toll, a decline in the hospital, the reason is that the proportion of the chronic diseases and nursing rehabilitation increased, at the same time supporting services: including nursing station, counseling centers and number of institutions in the rehabilitation center.
(5) the quality and value as a development strategy, establish assessment and accountability system due to the public nature of veterans health care system, this system is also the most critical departments, in the ninety s, the veterans health care system by many critics, even made in Hollywood movies.So after reform will have on the quality and value as a development strategy, take the objective evaluation of the quality and value as a means of internal performance improvement, and as the basis of internal and external accountability.Made the measure of quality and value in the reform, and to evaluate.Value with the technology level of medical services, service convenience, treatment effect, the patients' satisfaction, the overall health of the community five output index and medical costs the input index to measure and analyze the effect of the input and output.Veterans affairs medical affairs department responsible for the congress, veterans health care system between various levels also have signed an agreement of the quality of accountability, such as each part of the veterans affairs medical treatment and the director of the network accountability agreement.
(6) the construction of information sharing system of veterans health care system successfully implemented to improve the way of management model, reform the budget, optimizing the allocation of resources and improving the service quality and value is the important basis of a Shared information system is established.The department of veterans affairs (VA) since 1985, for the convenience of medical management and automated information system is established, first hospital computer program system for decentralized, has a wide range of clinical and management performance.In 1997 began using electronic medical record system (CPRS), greatly improved the function of the original system.Reform set up after the veterans health information system and the technical architecture (VistA) to realize the information sharing, not only help the doctor make reasonable medical decisions, but also provide support to improve the performance and implementation of health management.Veterans health information system and the continuous improvement, toward the more perfect sharing information platform development, including 1) patient centered health records system;2) services for the center with your health care provider and evaluation system;3) with the modern enterprise financial management system as the core of financial management system.
Fourth, the American legion the effect of the medical system reform
Veterans health care system reform has achieved remarkable success after, become one of America's most dynamic medical system, caused the wide concern policy circles and academia.In recent years, the system is evaluated both efficiency and cost of medical services in the best group.After reform, veterans health care system with relatively fewer resources to treat more patients, more than 77% of the patients get effective basic medical treatment service.The more veterans willing to sign up.In recent years, the American legion in reducing population, from 26.5 million to 23.5 million in 2000, but the veterans health care system in the registration number is on the increase, from $1999 in 4.3 million to 7.9 million, actually obtains the number of medical and health services will increase, from $1995 in 2.9 million to 2006 in 5 million.But the veterans health care system to sort out the medical expenses of flat growth rate, up from $1996 in 17 billion to $2006 in 32 billion, compared with other American medical system, the system cost control is the best.At the same time, the veterans health care system to become industry leaders, medical information, performance improvement in its patient satisfaction and 18 on disease prevention and treatment of indicators as the national standards.
Five, the American veterans medical system reform of our country's enlightenment American veterans effective health care system reform scheme and process of medical and health system reform in our country, especially the reform of public medical service system in China has great reference significance.1, the public medical system not only provides medical and health services, but also an important force in medical education, scientific research, and more of the functions of the medical treatment, is an important guarantee of national emergency event handling.2, unified integrated public medical system, not only has economies of scale and scope economy effect, able to provide cost effective management and control, and for the use of modern information and management provides the basis.3, public medical institutions need to refactor, but also the public medical system can through the adjustment of organizational structure and management system, such as resource allocation way of improving the value of the reform, improve the efficiency and service.4, medical service should be toward to patients as the center, in the direction of health as the center, so the organization form of the content of the medical service, medical institutions should be in this direction.5, the establishment and perfection of the information system is the important guarantee of successful reform.
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