改革总是从基层的最原始需求开始。2009年出台的新医改方案提出:“积极提倡以政府购买医疗保障服务的方式,探索委托具有资质的商业保险机构经办各类医疗保障管理服务。”在此之前,台州、新乡、江阴、湛江等地方已经对此率先实践。就全国整体而言,政府向商保购买医疗保障经办服务甚至已小有规模。对于商业健康保险机构而言,理论上,其最大优势在于医保付费机制的设计和对医疗机构的 Reform always starts with the most primitive needs of the grassroots. The new medical reform plan introduced in 2009 put forward: “We actively advocate the government to purchase medical insurance services and explore ways to entrust qualified commercial insurance agencies to handle various types of medical insurance management services.” Prior to this, Taizhou, Xinxiang and Jiangyin Zhanjiang and other places have taken the lead in this practice. As far as the whole country is concerned, the government has even been small-scale in purchasing medical insurance from commercial insurance. For commercial health insurance agencies, in theory, its greatest strength lies in the design of medical insurance payment mechanism and the medical institutions