With the continuous development of social economy, people's demand for medical security is increasing day by day. Medical insurance, like a member of the social security family, has become a key element affecting the life and welfare of the general public. To this end, all parts of China have spontaneously implemented medical insurance reform and are committed to providing better medical services for the people. Among them, Shanxi Province has undoubtedly achieved remarkable results in this field. Recently, Tang Zhiping, vice governor of Shanxi Province, said at the provincial medical insurance reform symposium that by 2025, they plan to fully implement the "six unifications" strategy of public medical insurance, which is undoubtedly a major and very worthwhile measure. This article will provide a detailed interpretation of the policy from five aspects.
The first is to unify the scope of insurance. This policy aims to address the fragmentation and inconsistencies that exist in the current health insurance system. In the whole province, all people who have not participated in the employee medical insurance, or cannot fully enjoy other national medical insurance, should participate in the civil medical insurance in accordance with the regulations. In addition, the annual payment time for medical insurance is usually until December 31, but it can be appropriately relaxed under special circumstances.
Second, unify the standard of treatment. Shanxi will provide consistent medical benefits to all patients. Routine outpatient, chronic disease,"Two diseases"Medication support and hospitalization benefits are treated equally. Account thresholds, payment rates, and maximum limits will span all parts of the province, and will also be gradually adjusted according to local economic conditions and capital operations.
Third, to achieve unified budget management. That is, budgeting, collection and allocation should follow the same criteria to ensure that funds are used rationally and that excessive financial pressure is avoided. This is conducive to maintaining financial stability, making inflows and expenditures more decent, and further promoting social fairness and justice.
Fourth, through the provincial overall planning and adjustment management. This approach will govern the city's income and expenditure, and is expected to avoid the phenomenon that the reimbursement amount exceeds the local balance**. In the event of a similar situation, the fee will be paid in accordance with the Social Security Implementation Regulations. In addition, the provincial finance will also set up a special account management provincial overall adjustment**.
Finally, unified handling services. Streamline the responsibilities and authority of medical insurance managers at different levels, formulate clear and appropriate work processes and internal inspection mechanisms, and establish standard and standardized settlement methods. On this basis, the designated hospitals that have been determined before the provincial overall planning may be recognized as the provincial medical insurance agreement institutions after the unification. In this way, we expect the process to be more concise and clear, so that each insured person can be more aware of their rights and interests, and ensure that they can receive timely and efficient assistance when necessary.
In addition, Shanxi should also implement a unified information system. This is a key part of the New Deal, which integrates all relevant information and ensures that data is shared across all aspects. This reform is expected to improve the overall operational efficiency, reduce work errors and duplication of work, and comprehensively improve the quality of medical insurance services.
No matter what kind of policy is introduced, it is indispensable to support relevant safeguard measures. The new policy clarifies the construction of a well-equipped health service system, strict control of medical services and other safeguard measures, and wholeheartedly provides satisfactory medical and health protection for all insured people.
Looking at Shanxi's new medical insurance policy, the main goal is to comprehensively solve the problem of shortage of medical resources. While good prototypes of reform have emerged, real challenges lie ahead. But in any case, we are glad to see that Shanxi Province is moving forward tenaciously on this road and opening up a better future for the development of China's universal medical industry.