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第2期 总第103期 南京医科大学学报（社会科学版）
2021年4月 Journal of Nanjing Medical University（Social Sciences） · 127 ·

金机制研究［J］. 社会建设研究，2018（1）：55-68 ［14］ 郑功成. 多层次社会保障体系建设：现状评估与政策
［13］ 申曙光. 关于医疗保障发展的三点思考［J］. 中国医疗 思路［J］. 社会保障评论，2019，3（1）：5-31
保险，2020（3）：6-7 （本文编辑：姜 鑫）

Reflections on improving the medical insurance and medical assistance
mechanisms for major diseases

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LUO Meng ，TANG Zhiru ，YAN Lilun ，ZHANG Xiujun ，LI Shaohua 1
1. School of Health Management，2. School of Public Health，Anhui Medical University，Hefei 230032，China
Abstract：This manuscript found out the main problems and potential risks in medical insurance and
medical assistance by sorting out the emergency measures for medical insurance and medical assistance during
the outbreak of COVID ⁃ 19. The study analyzed the characteristics of the epidemic risk，and their special
requirements of the system normalization，fairness，public character，and positive externality of medical
insurance so as to improve the medical insurance and medical assistance mechanisms for major diseases. This
study further analyzed the reform and improvement on seven aspects，including the fund ⁃ raising，object
confirmation，fee payment，service provision，fee settlement，guarantee coordination and the supplementary
security mechanism，which provided countermeasures and suggestions for improving the medical insurance and
medical assistance systems of major diseases，and provided reference for improving the modernization level of
the medical security governance system and governance capacity.
Key words：major disease；medical insurance；medical assistance