Medical insurance is a basic guarantee for citizens and an important welfare for migrant workers. However, the latest data shows that in 2022, the number of residents participating in medical insurance nationwide will be 25.38 million fewer than the previous year, and the vast majority of them are older migrant workers who stay in rural areas. Why did these migrant workers choose to give up health insurance?What is their employment status?What difficulties and challenges do they face?
Reasons for the decrease in medical insurance: declining income, payment burden, and awareness of participation
According to the explanation of the National Health Insurance Administration, the decline in the number of residents participating in medical insurance in 2022 is mainly due to the decline in the income of migrant workers and free self-employed people, the weakening of personal payment ability, and the reduction of financial subsidies in individual regions, resulting in a phased decline in residents' willingness to participate in insurance. Affected by factors such as the new crown epidemic, the financial crisis, and environmental protection policies, some traditional employment fields for migrant workers, such as manufacturing, construction, accommodation and catering, have experienced difficulties in production and operation, factory shutdowns or holidays, and wage arrears or reductions, resulting in a significant decline in the income level of migrant workers.
There are great differences in the payment standards and financial subsidy levels of residents' medical insurance in different regions, and the payment burden in some areas is heavier, while the subsidy is weaker, making the payment of migrant workers less cost-effective. In addition, some migrant workers do not have enough awareness and attention to medical insurance, lack long-term health planning and risk prevention awareness, and think that they are in good health and do not need to pay medical insurance, or think that the level of protection and service quality of medical insurance is not high, and it is not worth paying.
The impact of the reduction of medical insurance: increase medical risks, reduce social security, and affect employment stability
Migrant workers who give up medical insurance means that they lose the basic protection of their health from the state, and in the event of illness or accident, they will face high medical costs and living difficulties, and may even lead to family poverty or return to poverty.
The reduction in the number of migrant workers in medical insurance will also affect the balance and sustainable development of medical insurance**, reduce the coverage and fairness of the medical insurance system, and weaken the function and role of the social security system6.
The reduction of the number of migrant workers with medical insurance will also affect the employment stability and mobility of migrant workers, reduce the employment competitiveness and market demand of migrant workers, and increase the employment pressure and insecurity of migrant workers.
Countermeasures to reduce medical insurance: increase income levels, reduce the burden of contributions, and enhance the awareness of participation
In order to solve the problem of the reduction of the number of migrant workers with medical insurance, it is first necessary to increase the income level of migrant workers, stabilize the employment of migrant workers, and promote the employment and entrepreneurship of migrant workers. It is necessary to increase support for the employment of migrant workers, implement policies such as tax and fee reductions, return of stable posts, and deferred payment of social security, so as to help enterprises tide over difficulties and ensure the wage income of migrant workers.
Improve the employment skills and quality of migrant workers, broaden the employment channels of migrant workers, and encourage migrant workers to transfer to emerging industries and service industries. Promote local and nearby employment of migrant workers, and reduce the cost and risk of migrant workers' mobility. Secondly, it is necessary to reduce the burden of medical insurance payment on migrant workers, improve their sense of access to medical insurance, and increase their willingness to participate in insurance.
It is necessary to unify and standardize the payment standards and financial subsidy levels for residents' medical insurance, reduce the proportion of individual contributions for migrant workers, and increase the payment preferences and subsidies for migrant workers. It is necessary to improve and improve the level of protection and service quality of residents' medical insurance, expand the scope and proportion of reimbursement for migrant workers, simplify the reimbursement process and procedures for migrant workers, and speed up the reimbursement speed and efficiency of migrant workers.
It is necessary to strengthen the direct settlement of medical treatment in other places and the online verification of medical treatment in other provinces and other places, so as to facilitate migrant workers to seek medical treatment and reimbursement in other places. Finally, it is necessary to enhance the awareness and attention of migrant workers to medical insurance, improve their awareness and sense of responsibility for participating in insurance, and cultivate their health concept and risk prevention awareness. It is necessary to strengthen the publicity and education of medical insurance for migrant workers, so that migrant workers can understand the importance and necessity of medical insurance, understand the policies and regulations of medical insurance, and master the operation and methods of medical insurance. It is necessary to guide migrant workers to establish long-term health planning and risk prevention awareness, so that migrant workers can realize that medical insurance is not only a welfare, but also a responsibility, and that paying medical insurance is not only for themselves, but also for their families and society.
Conclusion:
Medical insurance is a basic guarantee for citizens and an important welfare for migrant workers. The reduction in the number of migrant workers under medical insurance not only affects the health and life of migrant workers, but also affects the operation of the medical insurance system and social stability. Therefore, we should take effective countermeasures and suggestions from many aspects to improve the income level of migrant workers, reduce the burden of migrant workers' contributions, and enhance their awareness of participating in insurance. Medicare