The medical insurance for urban and rural residents has entered the sprint phase. The "Economic Information Daily" reporter learned that as of now, Beijing, Tianjin, Hebei, Inner Mongolia, Shanghai, Zhejiang, Jiangxi, Shandong, Henan, Hubei, Hunan, Guangdong, Guangxi, Chongqing, Yunnan and other 24 provinces and municipalities have established a unified The urban and rural residents' medical insurance system has been planned or fully integrated, and the management department has been unified into the human society department.
China's basic medical insurance system has long been presented as a multi-divisional operation system. In the system division, it is characterized by employee medical insurance, urban residents' medical insurance and new rural cooperative medical operations. In the fund division, the main performance is the city and county co-ordination, and the risk apportionment is limited. Integrating the urban and rural medical insurance system and developing a more equitable medical insurance system, breaking the restriction of the urban and rural household registration system on the medical insurance system, can eliminate the urban and rural household registration factors in the policy formulation, management operation, and handling services, and remove the household registration. The medical security function carried by the system narrows the gap between urban and rural residents.
The integration of urban and rural residents' medical insurance is included in the key work of the 2017 medical reform. According to the established timetable, this work will be completed within the year, when the coverage, financing policy, guarantee treatment, medical insurance catalogue, fixed-point management, fund management will be realized. Unification policy. Due to the principle of “reducing high and not low†in the scope of reimbursement, the treatment of urban and rural residents has generally improved, and the catalogues of medicines in many regions have been greatly expanded.
Before the integration, the proportion of reimbursement within the Ningxia urban residents policy was about 57%, and the reimbursement rate within the rural residents policy was 53.59%. After the co-ordination, in 2014, the proportion of urban and rural residents reimbursed within the scope of the medical insurance policy reached 66%. Beijing's previous outpatient reimbursement policy, urban residents an annual outpatient reimbursement capping line is 2,000 yuan, while the new rural cooperative medical insurance is 3,000 yuan, according to the principle of not reducing medical insurance benefits, after the policy merger, the urban residents' outpatient reimbursement is unified to 3,000 yuan, hospitalized The top line was unified from 170,000 yuan to 180,000 yuan.
In the process of system integration, the management system has also been rationalized. Through unified arrangements, the unified management of urban and rural medical insurance has been realized, and the management and operating costs of the medical insurance system have been reduced. Specifically, in addition to the provinces of the above-mentioned 24 departments, there are also provinces that have adopted different strategies. For example, the medical insurance for urban and rural residents in Shaanxi Province is managed by the medical insurance center. The director of the medical insurance center is in principle served by the director of the same level medical reform office. Fujian Province established a unified medical insurance management system, established the Provincial Medical Insurance Management Committee, and set up a medical insurance office to undertake daily work. The medical insurance office is affiliated to the Provincial Department of Finance and operates relatively independently.
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