1.Ethical issues in digital medical insurance governance: generation, manifestations, and countermeasures
Zengying ZHUANG ; Linlin YUE ; Yanjie JIANG ; Guiying XUAN ; Bo WANG ; Shenchao JIANG ; Jingchao HE ; Xutong LIU ; Shangwei HAN ; Xuerun TIAN ; Yongxuan LIU ; Nuo XU ; Qifan YANG
Chinese Medical Ethics 2026;39(10):1342-1348
Digital medical insurance governance, as an important component of digital transformation, improves the efficiency of medical insurance services while facing complex ethical challenges. Taking stakeholder theory as the analytical framework, this paper explored the generative mechanisms, manifestations, and countermeasures of ethical issues in digital medical insurance governance. This study uncovered that accelerated technological iteration and lagging ethical and legal norms, as well as interest conflicts among multiple participants in governance, constituted the major causes of ethical issues. These issues specifically manifested as data privacy leakage, unfair algorithmic decision-making, widening digital divide, ambiguous accountability, and other aspects. To address these issues, this paper put forward systematic countermeasures, such as establishing a dynamic ethical and legal regulatory system, balancing the demands of stakeholders, strengthening technological ethical governance, narrowing the digital divide, and enhancing accountability mechanisms. Through the implementation of multi-dimensional governance strategies, it aimed to balance technological innovation and ethical constraints, advance the inclusiveness, fairness, and sustainable development of digital medical insurance, and provide theoretical reference and practical references for improving China’s digital medical insurance governance system.

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