From system coverage to all people**

â–¡ Our reporter Sun Meng Wang Dan â–¡

The draft "12th Five-Year Plan" outline proposes that "the basic medical insurance system covering urban and rural residents must be improved in the next five years." What barriers to universal health coverage need to be removed? This question has caused heated discussions among members.

■ Policy orientation needs to be adjusted “So far, the number of people participating in China’s basic medical insurance has reached 1.267 billion.” On March 9th, the chairman of Hubei Provincial Federation of Industry and Commerce Zhao Xiaoyong made a contribution at the third plenary session of the Fourth Session of the Eleventh National People's Political Consultative Conference. The conference stated that after 13 years of development, the time for full coverage of basic medical insurance has matured.

Zhao Xiaoyong said that the people who have lost health care today are broadly divided into three types: poor people without payment capacity, healthy people who do not feel sick, and affluent people who do not have to pay for medical expenses. For this purpose, the current policy of “health insurance for employees and participation of residents” and “government subsidies support” and “government subsidies support” should be adjusted to “national co-ordination guarantees and citizens’ participation in the law” so that basic medical insurance can be guaranteed in terms of the system. Benefit all people.

Li Yufeng, vice president of the First People's Hospital of Huai'an City, Jiangsu Province, proposed that a long-term mechanism for long-term participation should be established. He suggested formulating a preferential policy for continuous enrollment, and set up a calculation system to urge urban and rural residents who have stopped participating in the insurance, and urge them to pay for the renewal fee, and gradually transform the urban and rural residents from voluntary participation to conscious participation, so that new The transition of rural cooperative households under the coverage of households is covered by personal insurance. At the same time, the government should also establish a long-term subsidy mechanism to solve the problem of overdue participation of insured persons.

■ The “major unification” still needs time. The medical security system and management methods of “urban-rural dual structure, separate three-system operation, and separate management of two systems” have long been criticized. A CPPCC member suggested that medical reforms should be used to gradually realize the nationwide co-ordination of medical insurance.

In terms of insurance financing mechanism, Zhao Xiaoyong proposed that the central government can reform the method of funding and allow the country to provide a unified national basic insurance fund for the common people. Established a mechanism that “the state provides basic premiums, individuals and employers pay basic premiums, individuals and employers choose to pay supplementary premiums, local governments provide subsidized premiums, and central and local governments jointly provide relief premiums”, and we share the burden on each A national enjoys basic medical protection.

Gong Jianming, deputy director of the Central Standing Committee of the Agriculture and Industry Party and deputy director of the Hunan Provincial Labor and Social Security Department, called for the social medical insurance of all groups to be managed by a unified department and unified organization. “In Changsha and some other regions, we have already done so. The actual operation has indeed reduced costs and improved efficiency, he said.

Gong Jianming also proposed to set up a national unified and unique life insurance account for each common citizen so that an insurance card can be used throughout the country to change the relative closed operating mode of different types of basic medical insurance funds. The transition will gradually proceed from the overall planning at the municipal level to the overall planning at the provincial level, and will be coordinated throughout the country. At the same time, he admits that it will take time for the realization of "general unification", but it can be piloted in some areas and gradually expanded after gaining experience.

■ to meet the diversified needs "Currently, medical insurance can only afford 50% to 60% of the costs for major illnesses. For cancer patients, it costs hundreds of thousands of yuan. The people have to bear nearly half of the cost. The burden is still very heavy." Tianjin Medical Sun Shengzhu, director of pathology department at the University Affiliated Cancer Hospital, said that now China’s commercial insurance can only cover less than 5% of the population. If 30% to 50% of the people have commercial insurance, then the anti-risk ability will be strong. Many can truly reflect the value of commercial insurance. He suggested that according to the people's income level and affordability, commercial insurance should be divided into 3 to 5 grades. The key is to make the low- and middle-income people have commercial insurance, which will be a useful supplement to basic medical insurance.

Chairman Wu Yan, President of China People's Insurance Group Co., Ltd., proposed to further eliminate the institutional constraints on commercial insurance participation in medical insurance management services, relax access restrictions, and increase effective supply. Support and encourage insurance agencies to expand supplementary medical insurance business on the basis of basic medical protection to meet the needs of multi-level and diversified social medical security. Encourage insurance institutions to give full play to the advantages of specialized risk control and capital management, participate in the management of medical reform funds, and form an operational mechanism for the separation, mutual supervision and control of “registration, management, and supervision”.

Some of the people living below the Dibao line can’t afford commercial insurance. If they are sick, they may not even have enough money to borrow. The Sun’s preservation holds that, first, the civil affairs department needs to form a salvage mechanism, and there are donations from the charity department. It is also necessary to form a national level rescue fund to ensure that they can see the disease. At the same time, hospitals also need to reduce or exempt part of the medical expenses incurred for high-end technical services after the necessary review procedures according to the specific conditions of the patients.