This article is transferred from [Guangming.com- “Guangming Daily”];
A total of more than 180 million people with low -income population in rural areas ——
The 3rd medical insurance system is escorted by “Healthy China”
Guangming Daily reporter Qiu Yan
In order to help hundreds of millions of families cope with the economic risks brought by medical expenses for medical expenses, since 2015, the state has fully implemented the triple system for basic medical insurance, major illness insurance, and medical assistance to reduce the burden on the medical expenses of the masses.According to the recently released “2023 Medical Security Development Statistics Express” released by the State Medical Insurance Bureau, in 2023, the triple system of basic medical insurance, major illness insurance, and medical assistance has accumulated a total of 186.498 million people with low -income people in rural areas, reducing the burden of medical expenses by 188.35 billion yuanEssence
Basic medical insurance, keep the “basic disk”
Basic medical insurance includes employee medical insurance and residents’ medical insurance.Pilot medical insurance has been piloted in 1994 and officially established in 1998, mainly covering employment groups.The “Xinnonghe” established by residents’ medical insurance in 2003 and the basic medical insurance of urban residents established in 2007, which were established in 2007, mainly covered non -employed people.
“My father, myself, and my sister have high blood pressure and high blood sugar.” When talking about medical insurance, Mr. Ma, who lives in Qinhuangdao, Hebei Province, feels deeply.Just save a lot of money for our family. “
For ordinary residents and patients with chronic diseases, medical insurance is a “required option” in daily life whether it is hospitalized or medication.Through medical insurance, thousands of families have reduced their worries and improved the happiness index.
For more than 20 years, the scope of the basic medical insurance guarantee has been established from more than 300 kinds of medicines in the early days of the establishment of “New Rural Cooperation”, expanded to the current 3088 drugs, covering a variety of more than 90%of the amount of drugs for public medical institutions, and contains 74 speciesTumor targeting drugs, more than 80 rare medicines.
The continuous expansion of the “basic disk” has supported the “one sky” of the common people’s medical medicine.
At the same time, in order to allow ordinary people to enjoy more convenience and benefits, medical insurance is also advancing with the times.New methods such as electronic medical insurance cards, Internet settlement, and medical treatment have continued to emerge.Doppler ultrasound, CT, nuclear magnetic resonance and other inspections, painless, minimally invasive surgery, successively included in reimbursement.
“Over the years, Chinese medicine has continued to be guided by the needs of the masses, is committed to improving the ability of security, and providing the people with a more intelligent and refined service experience.” The relevant person in charge of the National Medical Insurance Bureau said.
Disease insurance, building a high “firewall”
On the basis of residents’ medical insurance, the Insurance Insurance Insurance Insurance, the institutional arrangement of high medical expenses of major illnesses who participated in the insurance participating in the insurance was launched in 2012, and it was fully implemented in 2015.This system does not need to apply for insurance separately. All the people participating in the medical insurance of the residents are insurers who participated in major illness insurance and do not need to pay alone.
“The medical insurance policy has greatly reduced the economic burden of my family.” Said Mr. He, an insured resident from Dazhou City, Sichuan Province.
At the age of his adults, he has been working with his father in a foreign country. Although he is not rich, his life is stable.However, there was an unexpected situation. He checked the bronchial pleural fistula, and the medical expenses were expected to cost more than 1 million yuan.
Under the guarantee of the reimbursement policy of major illness, he eventually reimbursed about 180,000 yuan through residents’ medical insurance, reimbursed about 570,000 yuan, and reimbursed about 750,000 yuan, successfully spent the difficulties.
At present, the proportion of major illness insurance payment in urban and rural residents is no less than 60%. The maximum payment limit of residents’ medical insurance overlapped the per capita disposable income of local residents can be reached about 6 times.For the subsistence allowances, the puzzled personnel, and the poor to return to the poor, the payment ratio will increase by 5 percentage points, and further increase the maximum payment limit.
In 2023, the reimbursement of the major illness insurance in urban and rural residents in my country benefited 11.56 million, and the per capita burden was reduced by 8,000 yuan.The major illness insurance corresponds to higher reimbursement quotas and greater guarantee.
Medical assistance, weaving “Dian Dian.com”
Medical assistance is based on the basic medical insurance and major illness insurance. In the institutional arrangement of the maintenance effect, pilots began in rural and cities in 2003 and 2005, and the system was fully established in 2009.Objects obtain basic medical and health services, which reflects human care of medical insurance policies.
Medical rescue targets cover members with special difficulties, subjects, and subsistence allowances, and subsistence allowances, and are incorporated into the rural areas that are prone to poor people and rigid expenditures in rural areas.Medical assistance will be rescued on its medical expenses in accordance with regulations.
Taking Mr. Qiu, the subject of subsistence allowance, he incuted a total of 118,000 yuan in medical expenses from January to June 2023.Among them, residents’ medical insurance reimbursement is 58,000 yuan, major illness insurance reimbursement is 35,000 yuan, medical assistance payment is 15,000 yuan, and eventually reimbursement is 108,000 yuan.Mr. Qiu’s personal burden was only 10,000 yuan, which greatly reduced the cost of expenses.
“In the next step, we will continue to reform and improve the medical assistance system, promote the establishment of a diversified medical assistance system, and coordinate the level of rescue of patients with major illnesses in difficult families; support social forces such as charity organizations to participate in rescue guarantees, better play the protection joint effort, meet low income difficulties,The demand for diversification of the masses.
“Guangming Daily” (10th edition 1024, April 22, 2024)
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