大陸醫療保障與健康保險的發展與需求The Development of Health Insurance Requirement in China

摘要
　　大陸保險市場的發展潛力持續吸引國際目光，隨著醫療保障與健康保險需求，未來預期保險公司將會更積極參與政府部門的補充醫療管道，擴大商業健康險的發展空間。本研究收集大陸醫療保障體系的法律規範、整理商業健康險發展歷程文獻、以及與兩岸健康險專家及學者面談，對於大陸健康險的發展特色及面臨問題，進行系統性歸納。進而建議未來商業健康險的發展過程中，需要提升社會形象、改進資訊不對稱、強化資訊公開度、重視醫療資源壟斷、追求健康險的專業化經營效率、重視中低所得消費者健康險的需求、提升被保險人優勢、消彌消費者道德風險、完善醫療數據等方向。
關鍵詞：全國醫療系統、商業健康險、資訊不對稱、道德風險、消費者保護
Abstract
　　The potential development of Insurance market in China attained world. According to the coming of aging society, the national insurance system will be increased significantly, which is an indicator of the industry’s raising contribution to the society. The frequency communication of insurance industry between Taiwan and China due to culture and living habit of both sides of Taiwan Strait are the same origination. Considered the potential business since the required of health insurance in the future, the insurer in Taiwan should be aware to the insurance market development and the status of health insurance. In this report, we summary characteristics and problems facing in development of health insurance in China by collecting the national insurance system in China, understanding the development of the health insurance, and interviewing scholars and professional actuaries. In the development of health insurance in China, insurers should make efforts in terms of claim data collection, public information strengthen, information asymmetry improvement, competitive and attractive products development, more professional and efficient in actuarial study, moral hazard reduction and consumer protection.
Keywords: National health system, Health insurance, Information asymmetry, Moral hazard, Consumer protection