Work together to protect the "doctor's money"
2021-11-08
From industry supervision, law enforcement inspection and severe punishment to third-party review and joint departmental supervision, from industry self-discipline and social supervision to personal trustworthiness, from rewarding social reporting to intelligent monitoring using Internet technology, take multiple measures and gather people's strength. The basic medical insurance system is used to protect citizens' right to receive material assistance from the state and society in case of disease. The safe and effective operation of medical insurance fund is related to the vital interests of citizens. After years of development, China's basic medical insurance system has covered the whole people, and has played an important role in better meeting people's medical needs and ensuring people's health. Recently, a place in Shandong falsely reported the diagnosis and treatment records and made up the false condition, resulting in "stroke" patients in the whole village. This case of fraud and insurance fraud was exposed and attracted social attention. Since the establishment of the national medical insurance administration in 2018, China has always maintained a high-pressure trend to combat medical insurance fraud, but fraud and insurance fraud cases still occur from time to time. Fund supervision must be unremitting in order to protect the people's "medical money". With the development of economy and society, the improvement of residents' income level and the acceleration of population aging, people's demand for medical treatment and health care increases. Statistics show that in 2020, the total number of people in medical and health institutions nationwide reached 7.74 billion, and residents visited medical and health institutions for an average of 5.5 times. The average outpatient cost of hospitals reached 324.4 yuan, and the average outpatient cost of township hospitals also exceeded 84 yuan. With the increase of people's demand, the number of visits and average cost are also increasing, and the medical insurance expenditure is increasing year by year. There are tens of thousands of designated medical institutions of medical insurance, which are distributed in urban and rural areas all over the country. In recent years, medical insurance payment has become more and more convenient, and remote reimbursement has become more and more convenient. Medical insurance settlement can also be carried out for Internet follow-up visits and drug purchase in designated pharmacies. Various factors make the use of medical insurance fund more and more frequent and the amount of medical insurance fund increasing. Not only to meet the basic needs of the people, but also to review and supervise each expenditure, manage the pen in the hands of doctors, and ensure that each expenditure is spent reasonably and not wasted, which has become a realistic topic of medical insurance fund supervision. The safety of medical insurance fund is related to people's vital interests. China attaches great importance to the supervision of medical insurance funds. All localities adopt various forms of fund supervision, such as full coverage inspection, flight inspection and joint supervision of departments, and implement the system of exposing typical cases and reporting rewards. The regulations on the supervision and administration of the use of the medical security fund, which came into effect on May 1 this year, stipulates that the medical security fund is earmarked for special purposes, and no organization or individual may occupy or misappropriate it, setting a "red line" for the safety of the fund. In the future, we should further improve the regulatory measures, upgrade and transform the information system, check leakage and anti-counterfeiting "without a dead corner", investigate clues, deal with them with heavy blows, completely cut off the profit chain of fraud, protect and keep the people's "medical money". It can also be seen from the exposed cases that the phenomenon of fraud and insurance fraud involves a wider range and a longer chain. Therefore, to establish and improve the supervision mechanism, we should not only rely on the medical insurance department, but also mobilize all forces of the whole society and use all kinds of advanced technologies to stop the "running, emitting, dripping and leaking", so that those who attempt to cheat and cheat insurance dare not cheat and cannot cheat. From industry supervision, law enforcement inspection and severe punishment to third-party review and joint supervision of departments, from industry self-discipline and social supervision to personal trustworthiness, from rewarding social reporting to intelligent monitoring using Internet technology, we can take multiple measures and gather people's strength to form a joint governance force. More importantly, we should also work together to promote relevant reforms in the pharmaceutical field, improve the informatization level of the pharmaceutical field and the quality of grass-roots personnel, deepen the reform of the compensation mechanism of public hospitals, improve the salary system of medical personnel, and improve the price formation mechanism of drugs and medical consumables, so as to create a good institutional environment for medical personnel to concentrate on reasonable diagnosis and treatment, Eradicate the soil of fraud and insurance fraud from the source. In addition, it is necessary to remind every insured that the medical insurance fund is the protection of citizens' health rights and interests by the state and society, and can not be lent or taken out. Everyone should be optimistic about their health insurance card, enhance legal awareness, form a "firewall" to prevent fraud and fraud in the whole society, and work together to protect the rights and interests of residents' medical security. (outlook new era)
Edit：Yuanqi Tang Responsible editor：Xiao Yu
Source：
Special statement: if the pictures and texts reproduced or quoted on this site infringe your legitimate rights and interests, please contact this site, and this site will correct and delete them in time. For copyright issues and website cooperation, please contact through outlook new era email：lwxsd@liaowanghn.com
Recommended Reading Change it 
Home
