新国十条背景下的商业保险与社会保险的融合共赢

发布时间：2018-06-21 01:04

本文选题：新国十条 + 社会保险　；参考：《山东大学》2016年硕士论文

【摘要】：当前,我国经济社会发展面临着经济发展下行风险、社会风险因素累积、老龄化风险日益加剧、疾病风险日益凸显等问题。我国当前面临的这些问题既有周期性经济发展的问题,更有体制改革进入深水区的问题。这些问题导致了我国现阶段改革发展触及到的利益层次更深,面临的社会风险也更大。在此背景下,完善社会保障网制度,调和社会保障和商业保险制度间的功能,发挥“社会稳定器”、“社会缓冲器”的功效,显得更为必要和紧迫。当前,我国社会保障体系自身存在一定的不足,主要表现为,一是社会保障的“碎片化”致使制度稳定性较差；二是保障水平低,难以满足人们较高的保障需求；三是社保基金贬值风险使社保财务可持续性受到挑战。因此,我国社会保障体系建设仍处在一个不断健全和完善的过程中。而作为社会保障重要补充的商业保险,由于尚处在发展初级,自身发展基础还不成熟,商业保险制度还缺乏社会信用基础,民众风险意识缺乏,对商业保险还存在一定的偏见等。这些问题客观决定了我国商业保险发展,还不能完全适应当前我国全面深化改革和经济社会发展的现实需要。在商业保险与社会保障尤其是社会保险的深度融合中,发挥的作用还相对有限,其支柱作用还没有得到充分的发挥。为了进一步加快现代保险业发展,国务院出台“新国十条”,将发挥保险业职能,完善多层次社会保障体系和治理体系建设,放在突出位置,体现了国家对民生保障和社会稳定发展的重视,也是对保险行业给予的重任。因此,本文在分析了我国经济社会转型过程中面临的一些主要问题,社保体系自身不足,以及作为其重要组成的商业保险制度发展面临的困境基础上,探索商业保险与社会保险关系融合共赢,并以大病保险为例,探讨运行过程中各方利益影响因素,并提出需要解决的可持续性,经办效率和服务质量,商业保险市场化优势发挥等重点问题,并就进入机制、赔付管控机制、监管与考评机制、动态调整机制等运行机制等重点环节管控机制优化提出建议,以期共同推进我国社会保障体系健全和发展,保障人民群众生活生产稳定,促进我国社会主义和谐社会建设。
[Abstract]:At present, the economic and social development of our country is facing the downward risk of economic development, the accumulation of social risk factors, the increasing aggravation of the risk of aging, the increasing risk of disease, and so on. These problems in our country are not only periodic economic development, but also the problem of system reform entering deep water area. These problems lead to a deeper level of benefits and greater social risks. Under this background, it is more necessary and urgent to perfect the system of social security network, to reconcile the functions between social security and commercial insurance system, and to bring into play the functions of "social stabilizer" and "social buffer". At present, China's social security system itself has some shortcomings, mainly as follows: first, "fragmentation" of social security results in poor system stability, second, low level of security, difficult to meet the higher security needs of people; Third, the risk of social security fund devaluation will challenge the financial sustainability of social security. Therefore, the construction of our social security system is still in a process of continuous improvement and perfection. Commercial insurance, which is an important supplement to social security, is still in the primary stage of development, its own development foundation is not yet mature, the commercial insurance system lacks the social credit basis, and the people lack the sense of risk. There is still a certain prejudice to commercial insurance. These problems objectively determine the development of commercial insurance in China, and can not fully meet the actual needs of deepening reform and economic and social development in China. In the deep integration of commercial insurance and social security, especially the social insurance, the role played is relatively limited, and its pillar role has not been fully played. In order to further speed up the development of the modern insurance industry, the State Council has issued the "New National Ten articles", which will give full play to the functions of the insurance industry, perfect the multi-level social security system and the construction of the governance system, and put it in a prominent position. It reflects the importance that the country attaches to the livelihood of the people and the stable development of the society, and it is also an important task given to the insurance industry. Therefore, based on the analysis of some main problems in the process of economic and social transformation in China, the deficiency of social security system itself, and the difficulties faced by the development of commercial insurance system as an important part of the social security system, To explore the win-win relationship between commercial insurance and social insurance, and take the serious illness insurance as an example, to explore the factors that affect the interests of all parties in the operation process, and to put forward the sustainability, operational efficiency and service quality that need to be solved. Commercial insurance market advantages and other key issues, and put forward some suggestions on how to optimize the control mechanism of key links, such as access mechanism, compensation control mechanism, supervision and evaluation mechanism, dynamic adjustment mechanism, etc. The aim is to promote the improvement and development of our social security system, to ensure the stability of the people's life and production, and to promote the construction of a harmonious socialist society in our country.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：F842.6

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