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    Home > Medical News > Medical World News > The "fragmentation" of medical insurance in the new era should be solved from these five aspects

    The "fragmentation" of medical insurance in the new era should be solved from these five aspects

    • Last Update: 2019-11-21
    • Source: Internet
    • Author: User
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    Source: China Medical Insurance Author: Dean of Urban Development Research Institute, Fudan University, Liang Hong With the development of reform and opening up, China's social security system has been pushed forward From the protection of all workers to the protection of all citizens, social security has become the basic way and system guarantee for all people to share the national development achievements After 40 years of reform and opening up, great changes have taken place in our country, and China's medical and health system has been breaking through waves and moving forward in the reform, with in-depth practice and exploration In the past 20 years, one of the main achievements of China's medical reform has been to realize the universal coverage of the basic medical insurance system, including the basic medical insurance system for urban employees, urban and rural residents, urban and rural residents' serious illness insurance, medical assistance, which has reduced the financial burden of people's medical treatment and effectively improved the people's sense of security and access The level of physical health has been significantly improved, which has laid a systematic foundation and created a guarantee condition for the full implementation of the healthy China strategy and the building of a moderately prosperous society in an all-round way History is a process of continuous superposition, and reform is an uninterrupted relay race Only when we do not forget our original intention can we forge ahead If we say that in the past, the construction of China's medical security system is a creative process of "from nothing to have" The task of the construction of China's medical security system in the new era is the optimization process of "from have to excellent" In the new era, the development of China's medical security system faces three basic contradictions The first is the vulnerability of the balance between high-level medical services and social and economic development At present, the level of medical technology service in China is close to or has reached the world leading level, but the overall level of social and economic development in China is still a developing country The fragility of this balance has been concealed by the rapid economic growth in the past, and is gradually emerging with the new normal of the economy today The second is the contradiction between the increasing demand for medical services and the slowing growth of financing With the increasing aging of the population and the progress of medical technology, the demand for medical services is growing day by day, and the medical expenditure is still in a rapid growth period This means that in order to meet the needs of the masses, the financing of medical security also needs to grow rapidly However, the fact is that due to the new normal of economy, the growth of medical insurance financing slows down At the same time, in order to reduce the burden on enterprises, medical insurance financing is also facing downward pressure Moreover, it is the contradiction between the new requirements of social security development and the imbalance of regional development With the further improvement of China's socialist market economy system, China will further move towards a large market, a large circulation and a large society Social security will give more play to the role of social stabilizers and safety nets, regulators and boosters of economic development, and shock absorbers that may face the risk of social unrest However, due to the imbalance of regional development, at this stage, the medical security is still based on the overall planning of the city and the city, and the medical security system has obvious "fragmentation" To cope with these contradictions, the medical security system with Chinese characteristics in the new era should focus on the four more strategic objectives, namely, a more fair, mature, stereotyped and unified medical security system, a higher quality medical security development, a more modern medical security governance and a more accessible medical security security mechanism In order to achieve this strategic goal, China's medical security in the new era needs to carry out the "five in one" strategic layout, namely, optimizing the system, adjusting the structure, controlling the cost, strengthening the supervision and consolidating the basic Excellent system: to establish and improve the long-term care insurance system, it is particularly necessary to establish a comprehensive evaluation method based on objective detection, and a long-term care service system based on mutual assistance of relatives, friends and neighbors, supplemented by community and institutional care In addition, we should gradually implement the provincial overall planning; develop commercial insurance, promote the establishment of multi-level security system; explore the integration of employee medical insurance system and urban and rural residents' insurance system; improve medical treatment in different places, promote the integration of medical insurance in the Yangtze River Delta, and provide experience and basis for the national unified medical insurance system Structural adjustment: explore the top line policy of individual self payment; implement the aid policy of "catastrophic" expenditure type poverty; explore the free policy of essential drugs for several key chronic diseases; establish the dynamic adjustment mechanism of national essential drugs catalogue; gradually implement the national essential drugs and guarantee list system; implement the preferential policy of local innovative drugs included in the medical insurance Cost control: to further improve the total budget management; to further promote the volume procurement policy; to further improve the negotiation policy of high-value drugs and consumables; to further improve the sunshine bidding procurement; to explore the establishment of public hospitals' health insurance performance evaluation.
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