The fund should bear all or most of the personal medical expenses. This concept of requiring medical insurance to assume unlimited liability neither takes into account the principle of social medical insurance to guarantee basic medical needs nor the corresponding relationship between medical insurance rights and obligations. It will only make the new medical insurance system return to the old road of free labor insurance medical care system, and finally lead the reform to a dead end. The limited responsibility of medical insurance is to provide people with appropriate basic medical care with limited medical insurance funds and health resources. This concept adheres to the principle of corresponding rights and obligations, emphasizes that the insured should bear corresponding responsibilities for medical consumption, and defines the scope of responsibility for the insured to perform obligations and enjoy rights, so that the medical insurance system can be established on a predictable and benign track. Third, the conventional institutional arrangement of "universal health insurance" is the basic way to solve the medical security problem of college students.

The main body of the medical security system for college students should be social medical insurance, which is enforced by the state through legislation. We can make formal institutional arrangements for college students' medical security by referring to the pilot scheme of basic medical insurance for urban residents. First, the social medical insurance for college students should cover every student, and students from secondary colleges, higher vocational colleges and private colleges should be included in the system, reflecting the fairness and mutual assistance of medical insurance; Second, the medical insurance fund is financed by the state, schools and students, and the government should increase the proportion. College students are vulnerable groups, and they have no income. The government should raise the national burden standard according to the current economic consumption level; Third, the social medical insurance is mainly based on the overall planning of students' serious illness, supplemented by outpatient medical care: college students are a special group with a small age and a small chance of getting sick, but serious illness or accidental casualties are on the rise year by year, such as malignant swelling and pain, hepatitis B and tuberculosis. We can also learn from the experience of the new rural cooperative medical system and focus on the economic risks of students' serious illness; Fourth, establish a unified socialized management system: college students' medical insurance should be co-ordinated within a certain range, and it is difficult to resist the impact of serious illness medical care if the level of co-ordination is too small. Therefore, in principle, the province is the overall planning unit, and the level of overall planning can be further improved where conditions permit. The local medical insurance agency is responsible for the unified collection, use and management of the fund to ensure the full collection, rational use and timely payment of the fund.

In the total world health expenditure, China only accounts for 2%, while China's population of 654.38+0.3 billion accounts for 22% of the world population; In the proportion of total health expenditure to GDP, China only accounts for 5%, other countries, especially developed countries, such as Britain and Japan account for 8%, Canada accounts for 10%, and the United States accounts for nearly 15% [5]. Many experts and scholars have pointed out that with the rapid economic growth in China in the 2nd/Kloc-0th century, the government has the ability to increase investment in universal health insurance. "universal health insurance" is not a question of money. On April 1 2007, Shanghai officially implemented "Several Opinions on Improving the Medical Security System for College Students in Shanghai", which provided an example for solving the medical problems of college students nationwide.

Fourthly, supplementary medical security is a necessary measure to solve the medical security problem of college students.

Supplementary medical insurance for college students includes supplementary medical insurance and social medical assistance.

Supplementary medical insurance refers to different levels of commercial medical insurance to meet the different levels of medical security needs of college students. By encouraging individuals to participate in commercial medical insurance, we can solve the burden of medical expenses above the top line of basic medical insurance and make up for the shortage of basic medical care. Social medical insurance system is the main component and cornerstone of college students' medical security system, which belongs to government behavior. Commercial medical insurance belongs to college students' personal behavior and aims to meet the medical needs of college students with different economic conditions. Colleges and universities should increase publicity, strengthen college students' insurance awareness, and let students with better economic conditions buy commercial insurance; Some social pooling funds can also be reinsurance by commercial medical insurance companies, and some medical expenses above the maximum cap line can be borne by insurance companies to reduce the risk pressure of pooling funds.

Establish a social medical assistance mechanism with mutual assistance as the main body and social diversified sources of funds to solve the medical needs of poor college students and college students suffering from major diseases. Colleges and universities should set up special medical assistance funds, which can be raised from the following channels: first, local medical insurance institutions draw a certain proportion from the medical pooling fund every year; The second is the funds allocated by the government; Third, other funds donated by individuals, units or charities. The objects of social medical assistance are: first, people who can't afford medical insurance; Second, poor students suffer from serious illness, and medical expenses paid by individuals after serious illness are given assistance; In addition, some students who have been sick since childhood are not covered by insurance companies. Once the illness gets worse or worse, they have to turn to social donations. More people even have no chance to help the society because of lack of channels, so they should also receive social assistance.

Bringing college students into the "universal health insurance" system is a complex systematic work, which needs to be promoted step by step. Absorb the medical security experience and research results under the situation of "universal health insurance" and establish a medical security system for college students with China characteristics. It is a medical security system for college students based on social basic medical insurance, supplemented by commercial insurance and supplemented by relief funds. This kind of medical security can meet the medical and health needs of college students, which is conducive to the comprehensive and smooth completion of their studies, the development of schools and the construction of the country.