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上海市基本医疗保障体系相对健全,总体来看覆盖范围广、筹资水平高,但同时存在个人医疗负担较重、基金使用效率不高和医院普遍反映医保指标不足等问题,且不能保障各层次医疗服务需求。目前,上海市商业医疗保险发展空间相对受限,主要服务于高端客户群体,其专业性未得到充分发挥。发挥商业医疗保险的补充作用有助于完善基本医疗保障制度,同时可依托基本医疗保险的广覆盖来促进商业医疗保险的发展。
Shanghai’s basic medical insurance system is relatively sound, covering a wide range of areas with a high level of fund-raising. However, there are also problems such as heavy personal medical burdens, inefficient fund utilization and generally inadequate health care indicators in hospitals, etc., and can not guarantee medical services at all levels service requirements. At present, the space for commercial medical insurance development in Shanghai is relatively limited, mainly serving the high-end customer base and its professionalism has not been fully realized. The complementarization of commercial medical insurance helps improve the basic medical insurance system and at the same time, it can promote the development of commercial medical insurance based on the broad coverage of basic medical insurance.