Medical insurance dividends should be covered with universal benefits and provided with precise benefits

2023-09-26

According to the National Medical Insurance Bureau, as of August this year, 99% of the employee medical insurance coordinated areas in China have established general outpatient treatment, and 320900 designated medical institutions have opened general outpatient settlement services, with a total settlement of 1.314 billion people. According to statistics, from March to August this year, a total of 123 million people were reimbursed for negotiated drugs during the 346 agreement periods, with medical insurance fund expenses of 49.17 billion yuan. The average actual reimbursement ratio reached 69.7%, combined with price reductions and medical insurance reimbursement. The 346 negotiated drugs have already reduced the burden on patients by 109.7 billion yuan. These seemingly abstract data all have more practical support for people's livelihood experiences. With the help of a medical insurance card, medical treatment can be carried out at designated hospitals, and reimbursement can be achieved simultaneously. Purchasing drugs listed on the medical insurance drug list at designated pharmacies, and the payment list also lists self funded and coordinated expenses, is equivalent to achieving "buy and report". The list of medical insurance drugs is also "getting longer and longer", and the prices are also becoming more reasonable. Especially for some key drugs, they have also been negotiated to enter the list, which not only solves the urgent need for medical treatment among the public, but also to some extent solves the problem of difficult and expensive medical treatment. Dynamically adjusting the drug catalog should not only take into account the income and expenditure of the medical insurance fund, but also pay attention to the increasing demand for medical insurance from the public, which is closely related to the emergence of new specialty drugs in the market. Because of this, the basic principle of this year's national medical insurance drug catalog adjustment is to adhere to the positioning of basic insurance, adhere to doing our best and acting according to our abilities, and establish the improvement of drug security level on the basis of sustainable economic and financial growth. On the premise of maintaining overall stability of varieties, access conditions, and workflow, the review method and specific rules of this year's catalog adjustment have been further optimized and improved, Fully reflecting the value of medical insurance purchase and supporting pharmaceutical innovation, the scientific, standardized, and refined level of catalog adjustment will be further improved. The medical insurance department has also released a list of declared drugs that have passed the formal review, including 224 out of catalog drugs and 164 in catalog drugs, with a total of 388 drugs passing the formal review. These drugs will be reviewed, calculated, and negotiated according to the plan. It is expected that the adjustment results of the catalog will be announced in early December of this year, and the new version of the medical insurance drug catalog will be officially implemented from January 1 next year. This also means that the new catalog will have more new specialty drugs that can be reimbursed to meet public demand. The adjustment of the medical insurance catalog is increasingly in line with public expectations in achieving inclusive benefits and releasing more dividends. In the context of the medical insurance inclusive system, the public is more concerned about the precise benefits of medical insurance dividends. For example, incorporating more expensive "life-saving drugs" into the medical insurance catalog to enable more patients to use affordable drugs; For example, lowering the price of high-value medical consumables, and so on. It is worth mentioning that some "life-saving drugs" have been included in medical insurance, and it is believed that more new and specialized drugs will be included in the future. The Chinese medical insurance system is supported by a strong population base, and there is also a relatively abundant pool of medical insurance funds to support it. This is the basis for the medical insurance department to conduct bidding negotiations with various pharmaceutical companies through the market. With the inclusion of "life-saving drugs" in the medical insurance catalog

Edit:GuoGuo    Responsible editor:FangZhiYou

Source:people.cn

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