Tang Wei: The new benefits of people's livelihood protection brought about by medical insurance for major diseases

　　According to media reports: At the recent executive meeting of the State Council, "it is determined to accelerate the development of commercial health insurance, help medical reform, improve the level of of public medical security." "One of the most important measures is: to comprehensively promote commercial insurance institutions entrusted with the insurance for urban and rural residents major diseases, and to increase the proportion of medical reimbursements for patients with of major diseases in The above measures can be regarded as the State Council's new "National Ten" support for the development of the insurance industry Related practices: from the urban residents' medical insurance fund, the new agricultural joint fund to draw a certain proportion or quota as insurance funds, the establishment of urban and rural residents of the insurance system It should be noted that, in fact, the above-mentioned policy programme was piloted as early as the end of 2012.　　The original intention of promoting commercial insurance to help medical reform policy is to change the status quo of medical and needs of new agricultural insurance, urban residents' medical insurance and urban and rural residents' medical insurance that are difficult to meet the related "basic medical insurance object" concerned In 2011, the state finance invested a total of 219.7 billion yuan in the three "out-of-system basic medical insurance", accounting for 82% of the income of the new agricultural insurance, urban residents' health insurance and urban and rural residents' health insurance fund Among them, the central and local governments each invested 94.9 billion yuan and 124.8 billion yuan, accounting for 43% and 57% respectively, accounting for 2% of the state's fiscal revenue But even so, the actual reimbursement ratio of urban residents' medical insurance is only 52.28 percent, the actual reimbursement ratio of new farmers is only 49.20 percent, the actual reimbursement ratio of urban and rural residents' medical insurance is only 44.87 percent, which means that "out-of-system" urban and rural residents still have to pay half of their own medical expenses when they get sick, and the problem of "expensive to see a doctor" has not been completely solved.　　However, on the other hand, by the end of 2011, the cumulative balance of the three "out-of-system basic medical insurance" funds was 136.4 billion yuan, of which the cumulative balance of the New Agricultural Fund was 82.4 billion yuan, the cumulative balance of the urban residents' health insurance fund was 41.4 billion yuan, and the cumulative balance of the urban and rural residents' health insurance fund was 12.6 billion yuan.　　In view of the above two policy consequences, the policy design at that time was: from the "basic health insurance" considerable cumulative balance of funds to draw a portion of the funds to insurance companies to insure "big disease health insurance." This has two advantages: first, through medical insurance for major diseases, the proportion of medical expenses reimbursed can be increased to 70 per cent for those insured for medical insurance for urban residents, new farmers' and urban and rural residents' health insurance Specifically, when the insured (participation) is born and sick, half of the medical expenses are reimbursed from the basic medical system, and the remaining half can be reimbursed for half through major illness insurance, so that the total reimbursement ratio can reach about 70% Second, since the cost of insurance is set out from the cumulative balance of the three funds mentioned above, there will be no additional increase in the personal contribution burden of the insured (participation).　　Since 2012, according to circumstascany, the insurance industry has managed major disease insurance services in 26 provinces and 260 co-ordination areas, with 470 million beneficiaries, an average increase of 10-15 percentage points in the level of protection, and a ratio of more than 70% reimbursement for major diseases That is to say, from the pilot situation, fully achieved the purpose of policy design.　　In the decision of the executive meeting of the State Council, there seems to be a reference that is different from that of the year: "A certain proportion or quota from the urban residents' health insurance fund and the new agricultural joint fund shall be allocated as insurance funds to establish the insurance system for urban and rural residents." There is no reference here to "cumulative balance funds" Does this mean a change in policy? Because in recent years, has been plagued by the pilot development of the difficulty is: the fund balance is very little or no fund balance of the place how to do? What should be done when the existing fund balance is running out? ——— have these two problems been solved? It would be better if there was a definite answer.　　(The author is a researcher at the Chinese Academy of Social Sciences)