龙江人寿补充医疗保险业务管办分离模式研究
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摘要
随着保险市场的竞争日益激烈,龙江人寿的发展前景变得越来越复杂,特别是健康险业务面临越来越严峻的考验,其中补充医疗保险业务既是社会福利保障制度的重要组成部分,也是黑龙江省各寿险公司,特别是平安养老保险公司与龙江人寿互相争抢的一块大“蛋糕”。面对如此的竞争环境,龙江人寿提出加大与政府合作,通过发展补充医疗保险业务,促进健康险业务发展的战略。现在正是黑龙江省寿险市场全新竞争格局形成的关键时期,是龙江人寿实施结构调整,转变发展模式、站在新起点上的全面发展的时期。如何利用医疗改革的契机,谋求补充医疗保险业务的发展,成为龙江人寿需要解决的课题。
本文首先对龙江人寿补充医疗保险业务经营进行分析,介绍了补充医疗保险业务的内容及特点,分析龙江人寿补充医疗保险业务经营的现状及存在的问题,说明发展补充医疗保险业务需要创新手段。
其次论述了运用管办分离模式发展补充医疗保险业务,通过对补充医疗保险运行模式的比较及借鉴,管办分离典型案件的分析,结合龙江人寿补充医疗保险业务的现状,分析龙江人寿运用管办分离的可操作性,确定龙江人寿管办分离模式的运行内容。
最后,提出了保障管办分离模式运行的具体举措及方法,即调整组织结构、打造专业化经营模式、加强风险控制、创新服务手段,确保管办分离模式在龙江人寿充分发挥其优势,促进补充医疗保险业务发展。
With the increasingly competition in insurance market, LongJiang life facing the development become more and more complex and severe. Supplementary medical insurance as health insurance business in life insurance company, it is not only an important component in social welfare and security system, but also a big "cake" for various life insurance companies vying in our province. Facing such a competitive environment, LongJiang life puts forward to intensify the cooperation with the Government, through developing the supplementary medical insurance, and promoting the health insurance development.
Now it is a crucial period for formation of competitive pattern, it is also a comprehensive development period for LongJiang life to progress steadily in the implementation of structural adjustment, and to change the development model at a new starting point. LongJiang life will continue to maintain industry leadership to ensure that the market share is first in the industry, and to complete health insurance premiums. How to size the opportunity for medical care reform to seek the development of supplementary medical insurance has become a subject of LongJiang life need to be resolved.
First of all, supplemenrary medical insurance on LongJiang life besiness analysis describes the contents of the supplemenrary medical insurance and characteristics of LongJiang life supplemenrary medical insurance status and management problems,indicating the development of innovative means of supplementary medical insurance needs.
Secondly, this article discusses the model of management separation of supplementary develop supplementary medical insurance, through compare the model of supplementary medical insurance, analyses cases of management separation,link current situation in supplementary medical insurance of longLiang life, analyses the model of management separation is feasible.
Finally, point out the measure that ensure the model of management separation, adjusting the organizational structure, creating a professional business model, reinforce management of danger, innovate method of service, the model of management separation bring all advantage into play, advance development model to determine the direction of supplementary medical insurance.
本文首先对龙江人寿补充医疗保险业务经营进行分析,介绍了补充医疗保险业务的内容及特点,分析龙江人寿补充医疗保险业务经营的现状及存在的问题,说明发展补充医疗保险业务需要创新手段。
其次论述了运用管办分离模式发展补充医疗保险业务,通过对补充医疗保险运行模式的比较及借鉴,管办分离典型案件的分析,结合龙江人寿补充医疗保险业务的现状,分析龙江人寿运用管办分离的可操作性,确定龙江人寿管办分离模式的运行内容。
最后,提出了保障管办分离模式运行的具体举措及方法,即调整组织结构、打造专业化经营模式、加强风险控制、创新服务手段,确保管办分离模式在龙江人寿充分发挥其优势,促进补充医疗保险业务发展。
With the increasingly competition in insurance market, LongJiang life facing the development become more and more complex and severe. Supplementary medical insurance as health insurance business in life insurance company, it is not only an important component in social welfare and security system, but also a big "cake" for various life insurance companies vying in our province. Facing such a competitive environment, LongJiang life puts forward to intensify the cooperation with the Government, through developing the supplementary medical insurance, and promoting the health insurance development.
Now it is a crucial period for formation of competitive pattern, it is also a comprehensive development period for LongJiang life to progress steadily in the implementation of structural adjustment, and to change the development model at a new starting point. LongJiang life will continue to maintain industry leadership to ensure that the market share is first in the industry, and to complete health insurance premiums. How to size the opportunity for medical care reform to seek the development of supplementary medical insurance has become a subject of LongJiang life need to be resolved.
First of all, supplemenrary medical insurance on LongJiang life besiness analysis describes the contents of the supplemenrary medical insurance and characteristics of LongJiang life supplemenrary medical insurance status and management problems,indicating the development of innovative means of supplementary medical insurance needs.
Secondly, this article discusses the model of management separation of supplementary develop supplementary medical insurance, through compare the model of supplementary medical insurance, analyses cases of management separation,link current situation in supplementary medical insurance of longLiang life, analyses the model of management separation is feasible.
Finally, point out the measure that ensure the model of management separation, adjusting the organizational structure, creating a professional business model, reinforce management of danger, innovate method of service, the model of management separation bring all advantage into play, advance development model to determine the direction of supplementary medical insurance.
引文
[1]徐兆铭.金融企业人力资源管理.北京大学出版社,2008：45-148页
[2]刘永安.企业人力资源管理经典案例.第三版.清华大学出版社,2007：1-85页
[3]贝纳德·L.威布(BenrardL. Wbeb)等.商业保险.于小东.英勇总译校.北京：北京大学.2003
[4]徐美芳.中国健康保险需求决定因素分析——以2006年上海保险市场为例.世界经济文汇.2007,(5)：30-40页
[5]付伟华.加快发展补充医疗保险业务完善多层次社会保障体系.证券与保险.2007,(10)：48-49页
[6]姜华.对商业保险参与医保的调查思考.中国保险.2004,11：42-45页
[7]陈英.企业社会责任理论与实践.经济管理出版社,2009：137-237页
[8]马永伟.保险知识读本.中国金融出版社,2000：10-100页
[9]唐金成,苏英蔷.论我国大额医疗保险的商业化运作.保险职业学院学报.2008,(4)：36-41页
[10]周绿林,刘石柱.我国商业医疗保险发展前战略研究.中国卫生经济).2002,(12)：15-16页
[11]吴建卫.论商业医疗保险的风险管控保险研究.2003,03：45-46页
[12]杨博.中国商业健康保险的发展研究.天津财经大学硕士学位论文.2009,5：34-44页
[13]赵丹竹.我国城镇社会医疗保险与商业保险的融合对接问题研究.首都经济贸易大学硕士学位论文.2006,3：7-14页
[14]张冬平.我国补充医疗保险业务制度研究.首都经济贸易大学硕士学位论文.2004,3：28-41页
[15]邓芳.商业保险是社会保险的必要补充.经济工作.2009,(2)：94-95页
[16]韩德.商业保险参与社会医疗体制改革所面临的问题和对策.经济论坛.2002,(5)：42-43页
[17]林春梅.我国团体保险业务发展问题探讨.首都经济贸易大学硕士学位论文.2006,3：5-29页
[18]杨絮.我国城镇职工医疗保险改革研究.东北师范大学硕士学位论文.2006,5：8-18页
[19]崔晓华.我国保险业竞争力问题探讨.首都经济贸易大学硕士学位论文.2005,3：8-43页
[20]张帆,孙涛等.黑龙江省城镇职工补充医疗保险业务需求调查与影响因素分析.中国卫生经济.2009,28卷(2)：20-21页
[21]Jeromey B temple. Health insurance reform and older Australians. Demography mad Sociology Program, ResearchSchool of Seoeial sciences, Institute of Advanced studies, TheAustalian National Uneiversity, Canberra, Austalia.2006,25(2):63-68P
[22]XUE Xiao-he. (2002). Gradual establishment of rural basic medical security system:An interview with WANG Yan-zhongThe Deputy Chief of China Social Science Scientific Institution. Economy Times
[23]ZHU Ling. (2002). Rural health education and illness prevention. China Population Science
[24]ZHU Ling. (2000). Government and rural areas:The selection of basic medical security system. China Social Science
[25]Pescosolido, Bernice A. (1992). Beyond rational choice:The social dynamics of how people seek help. American Journal of Sociology,1997:1096-1138P
[26]侯文若,孔泾源.社会保险.中国人民大学出版社.第二版,2008.201-212页
[27]张阳,周海炜,李明芳.战略管理.科学出版社,2009：159-199页
[28]魏华林,李金辉.人寿保险需求研究.中国财政经济出版社,2009-318-370页
[29]尚汉冀,李荣敏,黄云敏.健康保险与医学统计.复旦大学出版社,2007： 3-113页
[30]张洪涛.社会保险案例分析.中国人民出版社,2008：143-255页
[31]邹平,刘虹.中国保险改革发展启示录.中国社会科学出版社,2003：21-102页
[32]北京大学中国保险与社会保障研究中心.变革中的稳健保险、社会保障与经济可持续发展.北京大学出版社,2005：139-362页
[33]傅安平.中国寿险业与资本市场的互动发展.经济科学出版社,2004：75-147页
[34]郭金龙.我国保险业发展的实证分析和国际经验.经济管理出版社,2006：153-195页
[35]汪生忠.中国保险业改革与发展前沿问题.机械工业出版社,2006：214-331页
[36]柳承滨.中国人寿团体业务发展战略研究.哈尔滨工程大学硕士论文.2003：25-55页
[37]李莹.商业健康保险医疗费用控制机制研究.吉林大学硕士论文.2009：12-27页
[2]刘永安.企业人力资源管理经典案例.第三版.清华大学出版社,2007：1-85页
[3]贝纳德·L.威布(BenrardL. Wbeb)等.商业保险.于小东.英勇总译校.北京：北京大学.2003
[4]徐美芳.中国健康保险需求决定因素分析——以2006年上海保险市场为例.世界经济文汇.2007,(5)：30-40页
[5]付伟华.加快发展补充医疗保险业务完善多层次社会保障体系.证券与保险.2007,(10)：48-49页
[6]姜华.对商业保险参与医保的调查思考.中国保险.2004,11：42-45页
[7]陈英.企业社会责任理论与实践.经济管理出版社,2009：137-237页
[8]马永伟.保险知识读本.中国金融出版社,2000：10-100页
[9]唐金成,苏英蔷.论我国大额医疗保险的商业化运作.保险职业学院学报.2008,(4)：36-41页
[10]周绿林,刘石柱.我国商业医疗保险发展前战略研究.中国卫生经济).2002,(12)：15-16页
[11]吴建卫.论商业医疗保险的风险管控保险研究.2003,03：45-46页
[12]杨博.中国商业健康保险的发展研究.天津财经大学硕士学位论文.2009,5：34-44页
[13]赵丹竹.我国城镇社会医疗保险与商业保险的融合对接问题研究.首都经济贸易大学硕士学位论文.2006,3：7-14页
[14]张冬平.我国补充医疗保险业务制度研究.首都经济贸易大学硕士学位论文.2004,3：28-41页
[15]邓芳.商业保险是社会保险的必要补充.经济工作.2009,(2)：94-95页
[16]韩德.商业保险参与社会医疗体制改革所面临的问题和对策.经济论坛.2002,(5)：42-43页
[17]林春梅.我国团体保险业务发展问题探讨.首都经济贸易大学硕士学位论文.2006,3：5-29页
[18]杨絮.我国城镇职工医疗保险改革研究.东北师范大学硕士学位论文.2006,5：8-18页
[19]崔晓华.我国保险业竞争力问题探讨.首都经济贸易大学硕士学位论文.2005,3：8-43页
[20]张帆,孙涛等.黑龙江省城镇职工补充医疗保险业务需求调查与影响因素分析.中国卫生经济.2009,28卷(2)：20-21页
[21]Jeromey B temple. Health insurance reform and older Australians. Demography mad Sociology Program, ResearchSchool of Seoeial sciences, Institute of Advanced studies, TheAustalian National Uneiversity, Canberra, Austalia.2006,25(2):63-68P
[22]XUE Xiao-he. (2002). Gradual establishment of rural basic medical security system:An interview with WANG Yan-zhongThe Deputy Chief of China Social Science Scientific Institution. Economy Times
[23]ZHU Ling. (2002). Rural health education and illness prevention. China Population Science
[24]ZHU Ling. (2000). Government and rural areas:The selection of basic medical security system. China Social Science
[25]Pescosolido, Bernice A. (1992). Beyond rational choice:The social dynamics of how people seek help. American Journal of Sociology,1997:1096-1138P
[26]侯文若,孔泾源.社会保险.中国人民大学出版社.第二版,2008.201-212页
[27]张阳,周海炜,李明芳.战略管理.科学出版社,2009：159-199页
[28]魏华林,李金辉.人寿保险需求研究.中国财政经济出版社,2009-318-370页
[29]尚汉冀,李荣敏,黄云敏.健康保险与医学统计.复旦大学出版社,2007： 3-113页
[30]张洪涛.社会保险案例分析.中国人民出版社,2008：143-255页
[31]邹平,刘虹.中国保险改革发展启示录.中国社会科学出版社,2003：21-102页
[32]北京大学中国保险与社会保障研究中心.变革中的稳健保险、社会保障与经济可持续发展.北京大学出版社,2005：139-362页
[33]傅安平.中国寿险业与资本市场的互动发展.经济科学出版社,2004：75-147页
[34]郭金龙.我国保险业发展的实证分析和国际经验.经济管理出版社,2006：153-195页
[35]汪生忠.中国保险业改革与发展前沿问题.机械工业出版社,2006：214-331页
[36]柳承滨.中国人寿团体业务发展战略研究.哈尔滨工程大学硕士论文.2003：25-55页
[37]李莹.商业健康保险医疗费用控制机制研究.吉林大学硕士论文.2009：12-27页