The medical security system is more perfect
2022-06-06
Since the 18th National Congress of the Communist Party of China, the development of medical security has entered a new stage, and the reform of universal medical insurance has been advanced in depth. China has established a basic medical security system covering the whole people, established a supplementary medical insurance system such as serious illness insurance, fully implemented medical assistance for major and serious diseases, developed various forms of commercial health insurance, and built a multi-level, wide-ranging and universal medical security system, The goal of universal access to basic medical care has been initially achieved, laying the institutional foundation for the people to have access to medical care. —— We will strengthen the bottom line of people's livelihood, emphasize universal benefit and fairness, and make the medical security network more compact. At the beginning of last year, Mr. Xu from Haikou City, Hainan Province, was hospitalized due to multiple organ dysfunction syndrome and sepsis. His medical expenses totaled 450000 yuan, including 260000 yuan for basic medical insurance reimbursement, 159000 yuan for large medical expenses, and 31000 yuan for personal payment. "Good policies have helped us to lighten our burden." Mr. Xu's family said. In recent years, China has started from reforming the medical insurance for employees, comprehensively integrating the medical insurance for urban residents and the new rural cooperative medical system, unifying the medical insurance system for urban and rural residents, comprehensively implementing the serious illness insurance for urban and rural residents, and improving the medical insurance and assistance system for major and serious diseases... The basic medical insurance, serious illness insurance and medical assistance complement each other, effectively improving fairness and universal benefits, and effectively maintaining the people's "medical care" security needs. At present, China has established the largest basic medical insurance network in the world, with 1.36 billion people participating in the national basic medical insurance, and the coverage rate is stable at more than 95%; The proportion of hospitalization expenses paid within the scope of medical insurance policies for employees and urban and rural residents is about 80% and 70% respectively; The proportion of personal health expenditure in total health expenditure decreased from 29.27% in 2015 to 27.7% in 2020; The annual revenue and expenditure of the fund exceeded 2trillion yuan, benefiting more than 4billion people to seek medical treatment, greatly alleviating the problem that it is difficult and expensive for people to see a doctor. —— We will improve the quality of medical security, effectively reduce the burden, and make medical security more effective. The reform of the medical insurance system has been deepened. It has not only realized the "full coverage" of the whole people, but also provided more refined and high-quality medical security for the people. More drugs are available, and the burden of medical treatment is further reduced. By promoting the reform of centralized procurement of national drugs and consumables, dynamically adjusting and optimizing the list of Medicare drugs, and exploring the establishment of a drug security mechanism for rare diseases, we have not only included more life-saving and emergency drugs in the scope of Medicare, but also significantly reduced the burden of medical treatment for the masses. Since 2018, the state has collected 234 drugs in 6 batches, with an average price reduction of 53%; 2 batches of consumables, with an average price reduction of more than 80%. The varieties in the 2021 version of the drug catalogue were increased to 2860, and the average price of 67 negotiated drugs was reduced by 62%. By March, 2022, 167000 pharmaceutical institutions had supplied negotiated drugs. More balanced, long-term, and significantly enhanced sustainability. Deepen the reform of medical insurance payment mode and improve the efficiency of medical insurance fund; Improve the financing operation mechanism and strengthen the supervision of medical insurance funds... Since the 18th National Congress of the Communist Party of China, the construction of various medical insurance systems has been strengthened to ensure the steady and sustainable operation of medical insurance funds as a whole, laying a solid foundation for further improving the guarantee ability. —— Accelerate information construction, improve service efficiency, and make medical insurance services more convenient for the people. "A few years ago, it was not so convenient to get medical reimbursement in different places." In Qingdao, Shandong Province, Li Hai was very convenient when handling the settlement of medical treatment and discharge for his mother. In recent years, Shandong has built a unified medical security information platform across the province, optimized the settlement mechanism for medical treatment in different places, and realized the full coverage of "one card (code) access". Nowadays, the insured only needs to hold a medical insurance card or scan the code through the medical insurance electronic voucher to pay across the province. In 2019, the pilot work of nationwide unified cross provincial and off-site medical online filing service was launched. On the basis of realizing the direct settlement of hospitalization expenses across provinces in 2017, the direct settlement of general outpatient expenses across provinces in 2021 will also realize the full coverage of overall planning regions. By the end of April 2022, it has accessed 205300 designated medical institutions in total, benefiting 32.4219 million people. All provinces have launched the pilot of direct inter provincial settlement of five outpatient chronic diseases, including hypertension, diabetes, outpatient radiotherapy and chemotherapy for malignant tumors, uremia dialysis, and anti rejection treatment after organ transplantation; In 2020, the National Medical Insurance Bureau printed and issued the list of administrative service items of national medical security, requiring that the handling of service items involving the masses should not exceed 4 kinds of handling materials, which should be listed one by one. The vague expressions such as "other materials" and "relevant materials" have been eliminated, 9 service items can be handled with one certificate, and 4 service items implement the commitment system. Let data run more and let people run less. One stop service, one window handling, one order settlement, and medical insurance service items can be handled online. At present, China's medical security has initially realized the "online", "handheld", "nearby" and "integrated" handling services. The service efficiency has been continuously improved, and the people's sense of gain, happiness and security has been continuously enhanced. (outlook new era)
Edit：Yuanqi Tang Responsible editor：Xiao Yu
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