Strengthening social insurance work on the track of rule of law-瞭望新时代网-瞭望时代，放眼世界

Strengthening social insurance work on the track of rule of law

2024-06-25

From June 12th to 15th, Zheng Jianbang, Vice Chairman of the Standing Committee of the National People's Congress, led the Social Insurance Law Enforcement Inspection Team of the Standing Committee of the National People's Congress to conduct law enforcement inspections in Sichuan Province. The law enforcement inspection team pointed out that Sichuan Province attaches great importance to social insurance work and the implementation of the Social Insurance Law, adheres to the people-centered approach, and has initially established a multi-level social security system that covers the whole population, coordinates urban and rural areas, is fair and unified, safe and standardized, and sustainable. Zheng Jianbang emphasized that implementing the Social Insurance Law is a concrete manifestation of adhering to the principle of putting the people first and an important measure to weave and strengthen the social security safety net. To enhance the awareness of the rule of law, highlight the construction of the rule of law, and strengthen social insurance work on the track of rule of law. A pot of clear tea tells the story of the rule of law. "There are five types of social insurance, including pension, work-related injury and unemployment insurance, medical insurance, and maternity insurance, all of which are different." "Urban and rural housing insurance is a good insurance type, with wide coverage and subsidies, low selection threshold, and comfort." On June 13th, in the Dahong Rice Shop in Yaoba Town, Hejiang County, Luzhou City, Sichuan Province, there were crisp gong sounds, and the relevant knowledge of social insurance law was integrated into the humorous "three sentences and a half" to promote to the tea guests below. A pot of clear tea talks about the rule of law. The more you drink the tea, the lighter it becomes, and the more it enters your mind and heart. Since 2012, Yaoba Town has built a "Rule of Law Tea House" in Dahong Rice Shop, regularly inviting various functional departments, legal professionals, etc. to tell stories about the rule of law and promote legal knowledge. At the same time, regular rule of law lectures will be conducted, using popular performance methods such as situational dramas, three and a half sentences, and fast-paced storyboards, to convert French into vernacular Chinese that the people can understand, remember, and remember, and promote. Vice Governor of Sichuan Province, Pu Budunzhu, introduced that the Sichuan Provincial Party Committee and Government have always attached great importance to promoting the rule of law. Through closely combining special activities such as the Constitution Propaganda Week, the Medical Insurance Fund Supervision Concentrated Propaganda Month, the Private Enterprise Recruitment Week, and the College Graduates Employment Service Month, they have deeply carried out the "Seven Improvements to the Law" of the Social Insurance Law, carried out regular interpretation of social security policies, and vigorously created a social atmosphere of respecting the law and abiding by its usage. Various relevant departments will also prioritize the promotion of regulations and policies through various forms and channels. Taking the Sichuan Provincial Medical Security Bureau as an example, in addition to promoting laws and regulations such as the Social Insurance Law and the Regulations on the Supervision and Management of the Use of Medical Security Funds, a military training competition for the provincial medical insurance handling system was held in 2023, with 19000 participants. This not only improved the ability to handle business, but also educated the public on medical insurance policies and regulations. Under various forms of promotion, the awareness of universal participation in insurance has been enhanced. As of the end of 2023, the number of elderly insurance participants in Sichuan Province reached 65.764 million, with a coverage rate of 95%; The number of insured individuals in unemployment insurance reached 11.913 million; The number of insured persons in work-related injury insurance reached 15.848 million; The number of insured persons in maternity insurance reached 12.189 million; The number of participants in basic medical insurance reached 81.328 million, and the participation rate has remained stable at over 97% since 2019. One stop service promotes convenience. Simply swipe your social security card on the self-service terminal and you can immediately enjoy various services such as social security inquiry, certificate printing, and urban and rural resident insurance payment. Not only that, there is also a policy inquiry column on the machine, allowing the public to check and know about relevant social security policies at any time... On June 12th, the law enforcement inspection team arrived at the Citizen Center in Yibin City, Sichuan Province, and found that many citizens were operating independently in front of the self-service terminal placed in the human resources and social security comprehensive service hall. The clear service classification on the machine is not only convenient for everyone to use, but also saves the time cost of queuing at the manual window. The tedious procedures during medical treatment have caused many patients to complain incessantly. In the Affiliated Hospital of Southwest Medical University located in Luzhou City, Sichuan Province, many patients enjoy the convenience brought by informatization. On the self-service terminal of the hospital, patients and their families can not only conveniently handle admission procedures, medical insurance registration, discharge settlement and other businesses, but also check the daily list of medical treatment at any time. This not only facilitates patients to grasp the medical situation, but also to some extent avoids problems such as excessive medical treatment. The relevant person in charge of the Affiliated Hospital of Southwest Medical University introduced that the hospital is currently implementing "smart+medical insurance", moving medical insurance services to "codes", mobile phones, and wards, achieving "handheld" and "facial recognition" services such as medical insurance registration and settlement. At the same time, emphasis is placed on "online+offline" linkage, by establishing a "medical insurance liaison officer" system in clinical departments, assisting in supervising the implementation of medical insurance policies, and providing professional services for "one elderly, one young" and remote medical personnel. Sichuan Province is committed to improving the quality and efficiency of social security services as an important means of implementing the Social Insurance Law, and promoting information technology construction is an important part. Pubutonzhu introduced that currently, Sichuan Province has established a unified social security and medical insurance information system throughout the province, achieving centralized management of data at the provincial level, effectively connecting with national social security and medical insurance services platforms, expanding online service channels, improving social security relationship registration and transfer continuity measures, promoting "one-stop" social security business, and achieving digital transformation of social security handling. Relying on the unified social security information system throughout the province, the Department of Human Resources and Social Security of Sichuan Province promotes an integrated service model of "one door guidance, one window acceptance, one station service, and one completion", promoting "certificate reduction and convenience", "one matter one handling, notification and commitment system", and age appropriate services and extension services. Currently, 28 social security services have been implemented throughout the province, 20 cross provincial services have been implemented, and 17 have been extended to 3101 townships (streets) and villages (communities). "No meeting, nearby services, and online services" have become the norm. A network crackdown on fraudulent insurance and safeguarding the security of social security funds is of great significance for safeguarding the basic rights and interests of the people, maintaining social stability, and promoting economic development. In recent years, Sichuan Province has continuously increased its efforts to crack down on fraudulent insurance practices. Since 2016, courts at all levels in Sichuan Province have concluded a total of 583 cases of social security fraud, including 250 cases of medical insurance fraud. Qin Hai, Executive Vice President of the Higher People's Court of Sichuan Province, reported that currently, in judicial practice, it is difficult to combat the crime of insurance fraud. On the one hand, due to the involvement of multiple subjects and links in the operation of the social insurance system, it has strong professionalism, and the concealment of fraudulent insurance crimes is strong, making it difficult to identify fraudulent insurance violations. On the other hand, there are difficulties in determining the trial of insurance fraud cases. Taking medical insurance fraud cases as an example, the examination of drug sources, determination of personal fraud amounts, and collection of relevant evidence are relatively complex, making it difficult to determine the amount of fraud. Qin Hai suggests further improving the regular communication and coordination mechanism between courts and human resources and social security departments, jointly cracking down on illegal and criminal activities such as insurance fraud, unifying the jurisdiction's adjudication standards and legal application standards, and ensuring the safe and healthy operation of social security funds. Medical insurance fraud has always been a major criminal case of social insurance fraud. In order to protect the "life-saving money" of the people, the Sichuan Provincial Medical Insurance Bureau has always made cracking down on fraudulent insurance practices a key task, establishing a joint rectification network of multiple departments such as medical insurance, disciplinary inspection, procuratorial work, public security, and health, and cracking down on various fraudulent and fraudulent behaviors of obtaining medical insurance funds. Although a high-pressure situation has been formed to combat fraud and insurance fraud, Deng Zhengquan, Director of the Sichuan Provincial Medical Security Bureau, pointed out that the current trend of fraud and insurance fraud is becoming more professional and specialized, leading to increasing regulatory difficulties. There are currently no independent supervision and law enforcement agencies for the use of medical insurance funds at the city and county levels. There are only over 100 full-time personnel engaged in the supervision of medical insurance funds in the province, and more than 50000 designated medical institutions need to be supervised, managed, and inspected. The regulatory force is weak. In this regard, he suggested increasing the construction of administrative law enforcement teams for medical insurance fund supervision, establishing specialized institutions for medical insurance fund supervision and law enforcement at the municipal level, and implementing vertical management below the municipal level, effectively integrating the forces of the city and county levels, and better coordinating and arranging administrative law enforcement inspections. Suggest the introduction of detailed implementation rules for the Supervision and Management of the Use of Medical Security Funds to better guide and solve the difficulties encountered in law enforcement practices in various regions. (Lai Xin She)

Edit：Ying Ying Responsible editor：Shen Chen

Source：http://www.legaldaily.com.cn

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