China News Service, March 25. According to the website of the State Medical Insurance Bureau, recently, most parts of the country have completed the centralized collection of medical insurance expenses in urban and rural residents, and the people participating in the insurance have enjoyed medical security services.What is the national basic medical insurance participation?Is it reasonable for residents’ medical insurance payment standards?Is the unsatisfied residents who participated in the basic medical insurance “suffered losses”?The person in charge of the State Medical Insurance Bureau accepted an interview with reporters on the issue of social concern.
Question: Some people say that the number of medical insurance participants in urban and rural residents in my country has continued to decline in recent years.Others said that medical insurance “surrender” in rural areas in some areas.Is the relevant statement true?
Answer: This statement is inaccurate.The coverage of basic medical insurance insurance in my country is more than 95%, and the quality of participation has continued to improve.
From a macro perspective, the number of residents’ medical insurance insurers remain stable.Related data has fluctuated slightly in recent years, mainly caused by two reasons.The first is the governance of insurance data.Since 2022, the medical insurance department has taken the national unified medical insurance information platform as an opportunity to clean up the inter -province and province for two consecutive years for two consecutive years.This is the main reason why residents’ medical insurance participation data fluctuates.The second is the optimization of the insurance structure.Due to new employment factors such as graduation and employment of college students, some of the people who originally participated in the medical insurance of residents turned to participate in employee medical insurance. From 2020-2023, 5-8 million biders are converted from the residents’ medical insurance to participating in employee medical insurance each year.The number of residents ‘medical insurance and the number of employees’ medical insurance have disappeared.
From a micro perspective, the State Medical Insurance Bureau recently sent a special person to go to 8 villages in Inner Mongolia, Heilongjiang, Henan, Hubei, Hunan, Sichuan, Gansu and other 8 provinces.The survey shows that of 5 of these eight villages, the number of people participating in residents’ medical insurance in 2023 increased compared with 2022. The number of insureds in 3 villages decreased slightly. The overall number of participants in 8 villages increased by 151 compared with 2022.Taking a village in Macheng City, Hubei Province, which is circulated on the Internet as an example, found on the spot, 97.4%of the residents of the village participated in medical insurance in 2023, and actually added 30 people to the insurance.It’s just an example.Many villagers said that fortunately, with medical insurance, they really solved their worries about seeing a doctor.
However, we must also see that with the continuous development of my country’s population aging and declining childization, especially with the decline in the total population of our country, the number of people in the future of residents may decrease steadily. It may be reduced.
Question: In 2023, the personal payment standard for urban and rural residents in my country was 380 yuan.Some people think that the cost standard is high and the growth rate is fast.What to look at this view?
Answer: Some public opinion believes that compared with the 10 yuan/person payment standards at the time of the establishment of the “New Rural Cooperation” in 2003, the current 380 yuan/person’s medical insurance fee payment standards have increased too fast.However, we should not just look at the increase in payment standards, but we should see what this increased 370 yuan brings to the general public.In fact, behind the rise in medical insurance funding standards, the level of medical insurance services has increased significantly.
First, the scope of protection of the masses has expanded significantly.In the early days of the establishment of the “Xinnonghe” in 2003, there were only more than 300 kinds of medicines that could be reimbursed. Drugs for treating cancer and rare diseases could hardly be reimbursed. Patients with major illnesses were very limited.At present, there are 3,088 drugs in my country’s medical insurance category, covering a variety with more than 90%of public medical institutions, including 74 tumor targeting drugs and more than 80 rare medicines.In particular, many new drugs can be included in the medical insurance directory shortly after the domestic listing.Taking the drug “Emantinib”, which treats leukemia, as an example, the drug’s annual payment fee of nearly 300,000 yuan when the drug was just listed in China.There is a difficult choice between the fragile life; since the establishment of the State Medical Insurance Bureau in 2018, after the drug collection and reimbursement by medical insurance, the annual payment fee for patients to take medicine is reduced to about 6,000 yuan. The continuous medical insurance system has allowed countless patients and families toReload the hope of life.
The second is that the diagnosis and treatment technologies of various modern medical examinations are even more available.In the past 20 years, with the strong support of medical insurance policies, medical service capabilities have achieved leapfrog development, major disease diagnosis and treatment capabilities are compared with international advanced levels, and some areas lead the world.The medical examination and diagnosis and treatment methods enjoyed by the patients are sharply moving towards digital, intelligent, and precise directions. High -tech equipment such as color Doppler ultrasound, CT, nuclear magnetic resonance is rapidly popularized.Technology is increasingly popularized and included in the scope of medical insurance reimbursement, and the majority of patients participating in the insurance have enjoyed more high -quality medical services.
Third, the proportion of medical reimbursement of the masses has increased significantly.In 2003, at the beginning of the establishment of the “Xinnonghe” system, the proportion of reimbursement in hospitalization expenses within the scope of policy was generally about 30%-40%.At present, the proportion of reimbursement for hospitalization expenses within the scope of medical insurance in my country has remained at about 70%, and the burden of medical treatment is significantly reduced, and this will inevitably bring improvement of medical insurance funding standards.At the same time, with the deepening of my country’s population aging, the improvement of the medical needs of the masses, and the improvement of the level of medical consumption, the medical insurance fund is also needed to be raised to provide a stable and sustainable guarantee for the masses.
Fourth, the level of service capabilities of the masses is improved.In 2003, the participating people of the “Xinnonghe” could be convenient for reimbursement in the county (district) hospital, and the proportion of reimbursement for medical treatment in different places was reduced, and they could not be settled directly.At present, the people of residents’ medical insurance can not only enjoy medical reimbursement in the county (district), the city (state), and the province.The masses living, traveling, and work in other places provide a solid guarantee.In addition, the guarantee mechanism for hypertension and diabetes outpatient medication from scratch allows the masses to stop worrying about buying medicine and help about 180 million urban and rural residents “two diseases” patients reduce the burden of medication by 79.9 billion yuan; the “triple protection system” is only 2023 only 2023One year, it benefited more than 180 million in the low -income population in rural areas, helping reduce the burden of medical expenses exceeding 180 billion yuan.
In the past 20 years, although the per capita fundraising standards of residents have increased by 370 yuan, the income of the level of medical security and the promotion of services to the masses is far from the measurement of 370 yuan.In fact, in order to support the substantial improvement of medical insurance services and levels, while the state adjusts the annual insurance payment standards for individual residents, the financial subsidy of residents’ participation in the insurance has been raised significantly.From 2003 to 2023, the national finance’s subsidy for the participation of residents’ participation from less than 10 yuan increased to no less than 640 yuan.If a resident continuously participated in the insurance from 2003 to 2023, the total medical insurance premiums were at least 8,660 yuan; of which the financial subsidy was at least 6020 yuan, accounting for about 70%of the total premiums.About 30%of the total.
With the strong support of the continuous medical insurance system, the demand for medical treatment across the country was quickly released, and the health level was significantly improved.According to statistics, from 2003 to 2022, the total number of diagnosis and treatment of medical institutions in my country increased from 2.096 billion to 8.42 billion; the average life expectancy of residents in the country increased from 72.95 in 2005 to 77.93 in 2020.At the same time, the proportion of personal health expenditures accounted for the total health expenses of the country, from 55.8%in 2003 to 27.0%in 2022.Nearly 1.4 billion medical insurance insurers enjoy higher -level medical conditions, larger scope of medical security, higher proportion of medical insurance reimbursement, and more convenient medical insurance services. It is the protection of the Chinese medical insurance system for the health of the people’s lives and health.
Question: Are the medical insurance reimbursement enjoyed by urban and rural residents from individual residents’ payment?
Answer: The premiums of urban and rural residents’ medical insurance are paid year -on -year. The fundraising standard in 2023 is 1020 yuan/person, of which fiscal subsidies are not less than 640 yuan/person.Small heads, and for difficulty personnel such as low guarantee households, finance will also give full or partial subsidies.
The medical insurance premiums paid by residents jointly form a basic medical insurance fund pool jointly for urban and rural residents in my country, which brings the continuous improvement of the basic medical insurance guarantee level of the masses.Here, we will add several data in 2023: First, the total amount of personal payment of medical insurance for urban and rural residents across the country is 349.7 billion yuan, and the second is that the financial payment subsidy for residents will be 697.759 billion yuan.1042.3 billion yuan.The total annual expenditure of residents ‘medical insurance funds is 2.98 times the total amount of residents’ payment.
Question: How do you think of “not getting sick after paying the medical insurance, suffering from losing” and other remarks?
Answer: The occurrence of diseases is often uncertain.In modern society, in the face of the sudden arrival of major illnesses, individuals and families are difficult to withstand high treatment costs alone.The essence of insurance is the risk of helping individuals and families who unfortunately suffer from serious illness after gathered the strength of all parties.Therefore, participating in medical insurance is “guarantee when sick, and benefit others when they are not ill.” It should be a rational choice when every crowd faces the uncertainty of disease risks.
In 2022, there were 8.42 billion people in outpatient diagnosis of medical and health institutions across the country. On average, each person went to the medical institution 6 times a year.The national medical and health institutions were admitted to the hospital of 247 million, with an annual hospital hospitalization rate of 17.5%. That is to say, one of each of each of them was a hospital in one year.The probability of residents’ illness and serious illness is not as low as expected.During the previous period of poverty alleviation, 40%of poverty was poverty due to illness and returning to poverty due to illness, which also showed a great impact on the economic conditions of the disease.
Data show that in 2022, the average hospitalization cost of the medical insurance participants in my country was 8,129 yuan, calculated at a reimbursement ratio of 70%, and the average reimbursement of medical insurance for hospitals was 5690 yuan. The premium is saved, and the compound interest is calculated at a annual interest rate of 5%. By 2023, the principal and interest have a total of 3343.1 yuan.In other words, the amount of medical insurance reimbursement after residents who live in a hospital will be far more than the savings of individual total premiums for 20 consecutive years.
Therefore, the saying that “after paying medical insurance is not sick, it suffers” is wrong, and it is not cost -effective from the accounting account.
Question: Some netizens said, “Young people can not participate in insurance, just give the elderly and children to insurance.”What do you think of this view?
Answer: This view is representative in some people.However, if you consider all factors in comprehensive consideration, you will find that this is actually “calculating a small account and suffering a lot.”
The first is that the spectrum of diseases in my country is changing.With the development of modern science and technology, more and more diseases have achieved early discovery and early diagnosis, especially with the acceleration of the rhythm of modern life, increasing work pressure, and living habits.Primary aging trends such as malignant tumors, etc., the health risks faced by young people should not be underestimated.
Second, the tolerance of young adults on disease risks is more fragile.There are old -age and small young people. It is the “top pillar” of the family. Once suffering from major illnesses, if there is no medical insurance, it will not only mean that the family will bear huge amounts of treatment costs, but also means that the family will lose important economic sources.This double blow not only has a catastrophic impact on the family, but also further affects the education and growth of children.Therefore, the family’s “top beam column” requires a key protection for medical security.
In summary, young adults should participate in insurance.This is not only for yourself, but also to provide protection for parents, children and families.