With the response of the National Health Insurance Administration, there seems to be good news for the medical insurance reform. Retirees aren't buying it. Why?I will delve into the causes of this phenomenon and come up with solutions.
1. The pain point of medical insurance reform: the cost of buying drugs in pharmacies.
While the cost of buying medicines from pharmacies is included in the total reimbursement, there is a deductible on the policy, which means that retirees will still have to pay part of the cost out of pocket until they reach a certain expense threshold. The restrictions on the list of medical insurance drugs and prescription drugs also bring a lot of inconvenience to retirees to buy drugs.
2.Designated pharmacies: Deductible issues.
Even at designated pharmacies, the cost of purchasing medicines is limited by out-of-pocket expenses. This means that even retirees have to bear part of the costs themselves until they reach a certain expense standard. This policy has undoubtedly increased the financial burden on retirees, and it has also made it difficult for them to develop a real sense of identity with the health care reform.
3. Remote medical care: the pain of medical insurance reform.
Out-of-town medical care has always been a pain point in medical insurance reform, and it is also a major concern for retirees. Although the National Health Insurance Agency has taken a number of measures to address this problem, the reality is still not optimistic. How to allow retirees to enjoy more convenient medical insurance services while seeking medical treatment in other places is a problem that needs to be solved urgently. Although the health insurance reform has brought some improvements to medical conditions in other places, there are still many inconveniences. For example, problems such as cumbersome reimbursement procedures and inconsistent reimbursement ratios have made it very difficult for retirees to seek medical treatment in other places. They want to simplify the reimbursement process, increase the reimbursement ratio, and truly equalize health insurance services.
In order to solve the above pain points, the Medical Insurance Office has taken extraordinary measures to rectify them. Why don't pensioners take these measures?The reason is that although the Health Insurance Bureau has made some adjustments at the policy level, there are still many problems in practice. Retirees still face many inconveniences when it comes to actually enjoying health insurance services.
In view of the problem that the purchase cost of drugs is included in the overall reimbursement but the out-of-pocket expenses are set, the health insurance bureau may consider adjusting the out-of-pocket expenses standard or increasing the out-of-pocket level to meet the needs of different groups of people. For retirees with financial difficulties, certain subsidies or exemption policies can be considered to reduce their burden.
Regarding the purchase of drugs at designated pharmacies, the medical insurance office can cooperate with large pharmacies to provide more humane services. For example, pensioners who have reached a certain age are exempt from pocket money;Or introduce a membership system that allows pensioners to enjoy more discounts on medicines. These measures not only improve the quality of life of retirees, but also increase their confidence in health insurance services.
For the problem of medical treatment in other places, the office of the medical insurance company should strengthen cooperation and communication with medical institutions in other places, and unify the reimbursement process and reimbursement ratio. The electronic reimbursement process has been introduced to make it easier for pensioners to go through the reimbursement procedures when they go to other places for medical treatment. Retirees who live in a different place for a long time may consider transferring their health insurance relationship to their place of residence in order to enjoy more favorable health insurance services there.
To solve the problem of retirees not buying medical insurance reform, the medical insurance general office must have an in-depth understanding of the needs and pain points of retirees. By adjusting policies, strengthening cooperation, and supporting humanized services, we will effectively improve the level of access and equalization of health insurance services. Only in this way can retirees truly feel the benefits and warmth of health care reform.