There was an incident that received widespread attention from the Chinese people before, that is, an elderly person spent 30,000 yuan before and after surgery.
But when he was ready to use NCMS for reimbursement, he was only reimbursed 972 yuan. This made the sick old man feel very puzzled.
According to common sense, normal medical insurance should reimburse more than 40% even if it is impossible to reimburse it in full.
So why is NCMS only able to reimburse close to 1 30? There are many reasons for this.
In fact, the fact that the elderly man was reimbursed so little for surgery and ended up being reimbursed through NCMS is mainly due to the disparity in regional reimbursement.
Different regions and different types of medical expenses can be reimbursed at different rates.
If the elderly person uses all domestic devices in the process of **, and does not use any too precious drugs, then this reimbursement ratio is relatively high.
But if this elderly person listened to the advice of experts or doctors when he was sick, used the best medical equipment, and used imported drugs.
Then the reimbursement ratio will be relatively low.
Because compared with domestic drugs, the cost of imported drugs is difficult to control, many imported drugs are extremely expensive.
If all the costs of using these imported drugs and imported equipment are included in the reimbursement ratio, it is likely to cause bad consequences.
That is, some people will abuse these drugs, which will eventually lead to the rapid loss of insurance funds, so that many people who really need insurance cannot afford to take drugs and cure diseases.
Therefore, the old man spent 30,000 yuan for the operation, but only reimbursed less than 1,000 yuan, and it is very likely that in the process of **, he used some instruments or drugs that were not covered by the reimbursement.
But in fact, the patient himself has the right to choose the best way.
If you want to avoid this kind of thing, then the patient should do so before treating the diseaseYou should have a full understanding of the way you want to receive and the drugs you want to receive.
Then check in advance whether these ** methods and drugs are covered by the insurance.
If you are not there, rashly accept **, sometimes not only can you not cure the disease, but you will also ruin your family.
Therefore, the elderly should consider more when choosing hospitals and programs.
There are also some places where the reimbursement ratio of NCMS is relatively lowIt is directly related to the level of local economic development.
Essentially, the NCMS insurance benefits used by the elderly when they see a doctor.
It is the insurance money paid by other people and some insurance money allocated by the state every year, so as to help these elderly people solve the problem of difficulty in seeing a doctor.
However, in some places, the level of economic development is relatively low, and the local per capita income is low, so the insurance premiums paid are also low.
Then the reimbursement ratio of the local NCMS is naturally not much higher.
In the same way, if it is a relatively economically developed place such as Shanghai, Beijing and Tianjin.
Then there are more people who pay insurance premiums, and the total amount of insurance premiums goes up, and the reimbursement ratio will also rise.
So this old man spent so much money when he saw a doctor, but the insurance only reported a littleIt's caused by a variety of factors, which is not to say that insurance isn't useful.
In fact, the existence of NCMS is indeed a benefit for the elderly.
What we can see is that some people are using this example to attack NCMS, feeling that there is no need for NCMS to exist.
But this statement itself has ulterior motives and is also misleading.
The full name of NCMS is called the new rural cooperative medical system, which is essentially a medical welfare policy provided by the state for the elderly in rural areas, which also starts from the current special national conditions of our country.
Now China has entered the aging stageMany elderly people will develop various underlying diseases when they get older.
However, because the development level of medical technology in China is relatively limited, the current treatment is relatively high.
Many of the medical devices and drugs used in China's hospitals need to be imported from foreign countriesAnd foreign countries will stuck China's neck in the upper layer of medical devices.
As a result, the cost of these foreign medical devices flowing into China is quite high, which directly raises the cost of using these medical devices.
This is good for those urban families, because urban families often have some assets with years of accumulation.
After getting sick, as long as it is not a particularly serious disease, I am not afraid that I will not be able to cure it.
However, for most rural families, they have no fixed assets themselves, and in this era of low agricultural products, they cannot earn much money by farming alone.
Therefore, in the past 20 years, there have been many rural elderly people who have not been able to get effective ** after getting sick.
Their own family circumstances dictate that they can't afford to go to a good hospitalAnd these old people don't have retirement health insurance for the elderly in the city.
In such a situation, the state has launched a new agricultural cooperative cooperative strategy. The NCMS strategy is also one of the basic national policies that the state has been working on.
The Social Insurance Law of the People's Republic of China, promulgated in October 2010, clearly states that the NCMS system is one of the three major basic medical insurance systems in China.
After more than ten years of development,The number of NCMS participants is now the largest of all insurance companies in China.
The number of participants in NCMS exceeds 2500 million, almost the vast majority of the elderly have NCMS insurance.
Although NCMS insurance cannot solve all problems, objectively speaking, many rural elderly people have physiological diseases.
At the very least, the existence of NCMS will ensure that these elderly people have access to basic medical care.
This can be regarded as solving the problem of starting from scratch, which is better than many old people after getting sickI can't even afford to go to the hospital, so I can only be tormented by illness at home, which is much better.
However, from an objective point of view, it is obvious that the current NCMS system is not perfect.
After many elderly people get sick, the medical equipment and drugs that can be covered by NCMS are too few, and many elderly people still can't afford to cure their diseases.
So what kind of way should the state solve the problem in the future?
In fact, if you want to completely avoid this kind of old man who spends more than 30,000 yuan to see a doctor and only reimburse 1,000 yuan, there are two methods.
One is to increase the number of insured people, as long as the number of insured people increases, the total amount of insurance money goes up, then the proportion of insurance money will also be **.
In the process of seeing a doctor, the amount of money that the elderly need to spend on themselves will decrease.
But from an objective point of view, this is something that cannot be done at all now, because China has entered an aging society, the population growth rate has been declining year after year, and the labor force population has been declining.
That is, in the foreseeable future,The number of people enrolled in various health insurance and retirement insurance will decline further, while the number of insured people will increase
Under this general trend, even if the state promotes these insurances through policy, not too many people will buy them in the short term, because everyone is profit-oriented.
Then, what the state can do is to provide more subsidies for NCMS through the first financial means, which is the only means that can be taken now.
Of course, directly from ** can indeed make NCMS have sufficient funds, but this will also cause a new problem. That is, it will put considerable pressure on the finances.
Although many of the elderly in China now have commercial medical insurance or other insurance, it is unlikely that they can not afford to see a doctor at all.
But the problem is that with the continuous development of aging, the number of elderly people is increasingThe state's financial investment in the new rural cooperative medical system and other old-age insurance will also rise.
At present, the state can afford to spend 200 million or 300 million yuan on medical security for the elderly.
If the number of people who need the New Rural Cooperative Medical System, pension insurance, and old-age medical insurance reaches 400 million in the future, this will bring a mountain of pressure on the national finances.
Therefore, the state finance can only solve the problem in the short term, and in order to fundamentally solve the problem of the difficulty of the elderly in seeing a doctor and the low reimbursement ratio of medical insurance, it is still necessary to increase the number of insured people.
And in the current situation of an imbalance in the ratio of supply and demand for insurance.
For patients, especially for those in rural areas who are involved in NCMSWhat you need to do is to refer to the advice and experience of people around you when you see a doctor.
Understand the situation and precautions when using NCMS for reimbursement, and give full play to the role of NCMS to the greatest extent possible, so as to avoid some economic losses that could have been avoided.
Then, the future reform of the medical insurance system is related to everyone's vital interests, so the Chinese people should have a deeper concern for the national policy and understand the changes and updates of the national policy.
Only by maintaining enough sensitivity to this can we better use the reimbursement system of NCMS to see a doctor for ourselves.
Therefore, although the reimbursement system of NCMS has been criticized by some people.
However, from a long-term perspective, NCMS is still the most important and main part of China's farmers' medical security system, and we should not criticize NCMS.
Instead, we should support the NCMS strategy and actively pay insurance premiums.
In addition, the state should also invest more funds in the pension and medical care of the elderly and the elderly in rural areas to further improve the security system of the NCMS.
For ordinary people, we should also always pay attention to policies and put forward reasonable suggestions when necessary to help the country improve the new agricultural cooperative system.
Of course, we should have enough confidence in the country, with the continuous development of society and economy, all kinds of social insurance will be further improved in the future, and social welfare will also increase, which is the inevitable development trend of any country. Most of the social problems that we are experiencing now are due to the fact that development is not yet in place.