Jurisprudential examination and normative reconstruction of the “ensuring the basics” principle in basic medical insurance

The jurisprudential connotation of the “ensuring the basics” principle in basic medical insurance is to safeguard people’s “economic security” in the diagnosis and treatment of illness. This principle is grounded in the legal system of basic medical insurance benefits, which defines the scope of insured events, medical services and cost-sharing, and is dynamically adjusted in line with socioeconomic development, so as to clarify the specific limits of people’s right to claim basic medical insurance benefits. Based on the jurisprudential connotation of “ensuring the basics” and its legal logic, under the objective of “ensuring basic survival”, the policy scope of “prioritizing major illnesses while also covering minor illnesses” established in China’s current policy documents on basic medical insurance within the limit of “moderate medical security” still shows a certain deviation from this principle. With the Medical Security Law on the legislative agenda, it is necessary to reconstruct and optimize the benefit norms of basic medical insurance through legal integration, legal reservation, and rule-of-law decision-making, so as to promote the maturity and regularization of the basic medical insurance legal system.

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Publication Details

Journal
Zhongguo ruankexue
Published
2025-12-01
DOI
https://doi.org/10.3724/1005-0566.20251206
Primary Topic
Healthcare Systems and Reforms
Type
article
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article

Jurisprudential examination and normative reconstruction of the “ensuring the basics” principle in basic medical insurance

Shuyun Sun, Zhen Zhao
Zhongguo ruankexue
Healthcare Systems and Reforms
article

Jurisprudential examination and normative reconstruction of the “ensuring the basics” principle in basic medical insurance

Shuyun Sun, Zhen Zhao
article en

Abstract

The jurisprudential connotation of the “ensuring the basics” principle in basic medical insurance is to safeguard people’s “economic security” in the diagnosis and treatment of illness. This principle is grounded in the legal system of basic medical insurance benefits, which defines the scope of insured events, medical services and cost-sharing, and is dynamically adjusted in line with socioeconomic development, so as to clarify the specific limits of people’s right to claim basic medical insurance benefits. Based on the jurisprudential connotation of “ensuring the basics” and its legal logic, under the objective of “ensuring basic survival”, the policy scope of “prioritizing major illnesses while also covering minor illnesses” established in China’s current policy documents on basic medical insurance within the limit of “moderate medical security” still shows a certain deviation from this principle. With the Medical Security Law on the legislative agenda, it is necessary to reconstruct and optimize the benefit norms of basic medical insurance through legal integration, legal reservation, and rule-of-law decision-making, so as to promote the maturity and regularization of the basic medical insurance legal system.

Zhongguo ruankexueVol. 40(12)
Peace, Justice and strong institutions
Openalex Percentile: Top 20%
Healthcare Systems and Reforms
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