Why is China's health care system the world's largest poverty reduction plan?

Text . . . Wang Dongjin China Medical Insurance Research Association
whether in response to this sudden public health disaster, or in the unprecedented great ness of the great social project to overcome poverty and well-off, China's medical insurance system has played a better role in the basic support and institutional protection of the effectiveness, in order to win the "double victory" made due contributions, but also make China's health insurance system withstand the severe test. general secretary xi Jinping,
, pointed out that by current standards, the realization of poverty alleviation of the poor and the removal of the hats of poor counties does not mean that poverty alleviation is over, but the beginning of a new journey. Poverty and prosperity are deepening and developing, and are a historical process that constantly meets the growing needs of the people for a better life. The old contradictions and problems are solved, and new contradictions and problems will arise. As after the development of contradictions and problems, no less than no development of the time, but the emergence of contradictions and problems of different levels and nature of it. Therefore, as the Chinese medical insurance system and Chinese medical insurance with the effectiveness of poverty reduction and poverty prevention system, we should always take poverty reduction and poverty prevention as an important task and mission to bear, in the normal, institutionalized poverty reduction and poverty reduction in the new great journey, take the initiative to make full use of China's health insurance system to help poverty reduction and poverty prevention specific effectiveness.
under the centralized and unified leadership of the CPC Central Committee, giving full play to the remarkable advantages of the socialist system with Chinese characteristics, the people of the whole country have won the double victory in fighting the new crown epidemic and fighting poverty and comprehensively building a well-off society. The giant wheel of the socialist modernization drive with Chinese characteristics continues to chop the waves and move forward steadily and continuously, and is getting closer and closer to the grand goal of realizing the "two hundred years" of the great rejuvenation of the Chinese nation. Once again, it shows the national spirit of "difficult and difficult, Yu Yucheng" and the Chinese spirit of "the sea and the sea, showing the hero's character".
whether in dealing with this sudden public health disaster, or in participating in the unprecedented magnificent anti-poverty struggle for the well-off of the great social project, China's health insurance system has played a better role in the basic support and institutional security of the effectiveness, in order to seize the "double victory" has made due contributions, but also make China's health care system withstand a severe test. General Secretary xi Jinping,
, pointed out that by current standards, to lift the poor from poverty and remove the hats of poor counties does not mean that poverty alleviation is over, but the beginning of a new journey. Poverty and prosperity are deepening and developing, and are a historical process that constantly meets the growing needs of the people for a better life. The old contradictions and problems are solved, and new contradictions and problems will arise. As after the development of contradictions and problems, no less than no development of the time, but the emergence of contradictions and problems of different levels and nature. Therefore, as the Chinese medical insurance system and Chinese medical insurance with the effectiveness of poverty reduction and poverty prevention system, we should always take poverty reduction and poverty prevention as an important task and mission to bear, in the normal, institutionalized poverty reduction and poverty reduction in the new great journey, take the initiative to make full use of China's health insurance system to help poverty reduction and poverty prevention specific effectiveness.
(1) the original intention of establishing China's medical insurance system
, to a considerable extent, is based on the consideration of poverty reduction and poverty prevention;
the old China before liberation was poor and white, poor and weak, the people do not talk about life, the hard-working masses in the plight of poverty and disease. After the founding of New China, the party and the government are faced with the first task, is to resume economic construction as soon as possible, as soon as possible to solve the people's poverty and illness and the main contradiction of people's livelihood protection, consolidate the new red power, mobilize hundreds of millions of people to participate in socialist construction enthusiasm. Under the great attention of the Party and the government, in 1951 and 1952, the medical system of labor insurance for enterprise workers and institutions, and the public-cost medical system of state workers of organs and institutions were established, so that the two groups had basic medical security, which reversed the plight of the poor and the sick, greatly stimulated their enthusiasm for construction, which not only consolidated the new red regime, but also promoted the socialist construction.
due to the narrow coverage of labor insurance, public-funded medical system, unit (enterprise) self-insurance burden is uneven, lack of protection and fairness, insufficient security fund and serious waste of resources coexist, can not adapt to the needs of the socialist basic economic system and market economy system, especially with the deepening of the reform of state-owned enterprises, tens of millions of "shut down and turn" enterprise personnel lost the original unit of medical insurance. Enterprise employees with various economic components, hundreds of millions of rural residents and urban residents all urgently need basic medical care, to resolve the risk of disease, to solve the problem of poverty due to illness, to return to poverty due to illness, and to mention the important agenda of the Party and the government. The problem is the voice of the times, the problem is the reform. It is in this situation, in order to reduce the burden of medical expenses of the people, to resolve the risk of disease and disease-related poverty, because of disease return to poverty contradictions, opened the journey of comprehensive reform of the medical insurance system. Starting from the establishment of the basic medical insurance system for urban enterprise workers, it took about 20 years to establish the basic medical insurance system for urban and rural co-ordination, coverage for the whole people and more than 1.35 billion people (more than 95% of the total population of the country), and became the largest basic medical security network in the world.
(ii)
the universal basic health care system is essentially one of the largest poverty reduction and anti-poverty plans and institutional arrangements.
universal medical insurance system is based on basic medical insurance as the main body, enterprise supplementary medical insurance, commercial health insurance and so on as a supplement, social medical assistance for the basic urban and rural co-ordination, covering the multi-level medical security system for the whole people. The universal medical security system combines the universality, fairness, unity and preferential, flexible and targeted nature of the special group, which shows the remarkable institutional advantages. After the establishment of the universal medical insurance system, in reducing the burden of medical expenses of the masses, alleviating the problem of expensive and difficult to see a doctor, preventing poverty from illness, returning to poverty due to illness and so on have played a good role in the basic, institutional security effectiveness, and made breakthrough progress and historic achievements.
first, the central government has allocated a total of hundreds of billions of yuan to solve the "closed down bankrupt" enterprises more than 28 million people of the historical legacy of the transfer of medical care, lifting their worries. By the end of 2019, the number of people insured for workers' health insurance nationwide will reach 329.25 million. With financial support at all levels, the basic medical insurance system for new agricultural and urban residents has been established, so that more than 800 million rural residents and more than 200 million urban non-employed people (commonly known as "one old and one small") have basic medical insurance. Financial subsidies for basic medical insurance for urban and rural residents at all levels increased from an initial 40 yuan per person per year to 520 yuan in 2019. The State has also earmarked funds to establish a social medical assistance system in urban and rural areas and a system of protection for severe lying diseases, which has solved the financial difficulties of the special hardship groups such as the severely disabled, the rural "five insured households" and the urban "low-insured households" in participating in basic medical insurance, so that their basic medical care and basic life have been guaranteed by the system, effectively curbing the probability of poverty due to illness and returning to poverty due to illness.
With the deepening and development of the reform of the medical security system, the scale of the medical security fund has been expanding and the guarantee capacity has been increasing, and the level of medical security for the insured personnel has been gradually improved. By 2019, the level of reimbursement for medical expenses within the scope of the residents' health insurance policy has reached about 70%, workers' health insurance has reached more than 80%, and the cost of personal expenses will fall below 30%, the lowest level in 20 years. Effectively reduce the economic burden of the people's medical treatment, not only to help reduce poverty and prevent poverty, but also to promote the health of the whole people, but also to improve the quality of life of the people, accelerate the pace of well-off.
(3)
universal health insurance has played an important role in basic and institutional protection in the overall battle to help lift the poverty alleviation efforts, and has made an indispensable and important contribution.
China's basic national conditions are large population, wide geographical area, thin base, unbalanced economic development, inadequate. Although since the founding of New China, especially since the reform and opening-up, the economy has developed rapidly and society has made great progress, but in the countryside, especially in the "poor old and young" areas, there has long been a large number of poor groups. According to the survey, about 40% of this large group of poor people are poor or returned to poverty due to illness. General Secretary Xi Jinping said: "The well-off is not well-off, the key to look at the villagers", without the well-off of the entire rural population, there will be no overall well-off. Therefore, poverty eradication is the first important task and mission to assume. The decisive victory in 2020 and the realization of poverty alleviation and the overall construction of a well-off society is the strategic deployment of the CPC Central Committee with Comrade Xi Jinping as its core and a solemn commitment to the people of the whole country.
since about 40% of the total number of poor people are caused by illness or return to poverty due to illness, health insurance to help out poverty is a duty-bound mission to assume. In this unprecedented fight against poverty to the well-off in the overall war, people's society, health insurance and other systems, from top to bottom have consciously put poverty relief as the central task of obedience to serve the overall situation put on an important agenda, around the solution of the poor people "two not worry three guarantees" this most basic, the most urgent central task, the introduction of a series of special or package of anti-poverty preferential policies. The State Health Insurance Administration, the Ministry of Finance and the State Council's Poverty Reduction Office jointly issued the Implementation Plan for the Three-Year Action on Poverty Reduction in Health Care (2018-2020), adopted key measures to improve sustainable financing policies and achieve the protection of the poor; 80%, through the insurance of severe and extra-large diseases to solve a part of the costs, and finally to carry out bottom protection, or even all exemption, and so on;
through the implementation of the three-year action plan of medical insurance to alleviate poverty, health insurance to help poverty alleviation has achieved remarkable results. Data show that the incidence of rural poverty in China decreased from 10.2% in 2012 to 0.6% in 2019, and the rural poverty rate decreased from 98.99 million in 2012 to 5.51 million in 2019.
the development of medical security, data showing that in 2019, 87.51 million people from medical assistance and medical insurance poverty alleviation support participated in basic medical insurance, directly assisted 70.5 million people, and the central government invested 24.5 billion yuan in medical assistance grants, with a special fund of 4 billion yuan to support the improvement of medical security for the poor in deeply poor areas. By the end of 2019, the participation rate of the poor in rural areas reached more than 99.9%, the comprehensive security policy of medical insurance poverty alleviation has benefited 200 million people, helped 4.18 million people who have been affected by illness to lift themselves out of poverty precisely, greatly reduced the incidence of poverty, and accelerated the historical process of getting out of poverty and getting rich and well-off.
China's health insurance not only in helping to overcome poverty, in addition to "root" and "poor root" in the battle to make outstanding contributions, but also in the fight against the new crown epidemic test handed over the "plus test" of the qualified examination paper, fully demonstrated the adaptability, inclusiveness and flexibility of China's health insurance system. For example, the phase-down of basic medical insurance fees for workers of about 150 billion yuan, to help enterprises to reduce the difficulties caused by the epidemic, to do a good job of diagnosis of patients "two guarantees", the implementation of "triple protection" "first treatment after payment" and other special, urgent policy measures to ensure that the diagnosed patients get timely and effective treatment, reduce or even exempt the burden of medical expenses, effectively prevent the emergence of poverty-related poverty, due to the phenomenon of poverty. It is no exaggeration to say that this is in the world of any country's health care system is difficult to match.
(4)
poverty reduction and prevention are not only the initial mission of establishing the universal health insurance system, but also the important content and long-term task of deepening the reform of the medical insurance system in the new era.
poverty reduction and poverty reduction and meet the people's growing needfor a better life and health well-being are two dimensions intertwined with the same proposition, are the core tasks facing China's health insurance in the new era, are only in progress, when not completed the process of deepening development. Because the movement of contradictions is absolute, the old contradictions are resolved, and new contradictions will arise. Absolute poverty is eliminated and produces relative poverty. In other words, there will be many uncertain factors of poverty reduction and the presence of new relatively poor groups after poverty is lifted out of poverty by current standards. Anti-poverty is the long-term task of human society, but different stages of poverty reduction and poverty prevention objects, content, ways and initiatives are different.
China's medical insurance system in the long-term normal, institutionalized poverty reduction and prevention, give full play to the advantages of the system and governance effectiveness, it seems that the following eight aspects of the work should be made to grasp the ground. first,
, firmly establish the concept of long-term poverty reduction and prevention of health insurance, from the ideological preparation to fight a "long-lasting war." Data show that humans suffer from about 13,000 diseases. Who, when, what disease, often not prophetic. Therefore, the uncertainty, severity and difficulty of disease risk exist in the long run and indefinite. No matter how developed the economy is, how advanced science and technology are, the contradiction of poverty due to illness or return to poverty due to illness is always there (may be the main factor in many factors of poverty in the future), so the eradication of disease-induced poverty or return to poverty is a long-term difficult task, we must be prepared for the long-term reduction of health insurance poverty and poverty.
second, comprehensively summarize the practical experience of health insurance to help out poverty. In these years of medical insurance to help out of poverty in the actual work, there are many breakthrough, innovative practices, such as "basic health insurance and N" multiple protection, for different poverty-relief objects, and so on, have received better results. But there are also some lessons worth learning, such as "layer plus code" "stackbed frame house"-style repeated protection, excessive protection of the practice, need to sum up the reflection. After the "de-extracting, de-hypocrisy" of the identification and combing, those practical, effective, and universal, reflect the law of poverty reduction and poverty prevention successful practices, summarized and refined, to the policy level, institutional level, even the legal level, to form a long-term mechanism, so as to long-term poverty reduction and poverty prevention and prevention of a lasting role. third,
, deepen reform, focus on solving the problem of unbalanced development of multi-level medical security, and further strengthen the institutional advantages and governance effectiveness of medical insurance to reduce poverty and prevent poverty. With basic medical insurance as the main body, medical assistance (major disease protection assistance) as the bottom, a variety of forms of protection to supplement the Chinese characteristics of the medical insurance system, in a sense, "special" on the "special" in the "basic protection" and "weaving network" and social policy support, to meet the people's multi-layered multi-level protection needs of organic combination.