Recently, Deng Hongying, a deputy to the Yunnan Provincial People's Congress, raised a problem that has attracted much attention: the rapid payment of rural medical insurance has brought huge economic pressure to farmers. Rural medical insurance premiums have become a large expenditure for farmers, and farmers' enthusiasm for paying has decreased or they have paid selectively (only for the elderly).
This phenomenon is not an isolated phenomenon, but a general trend across the country. Why, then, is it that the NCMS, which was once regarded as a blessing for farmers, has now become a burden on farmers, leading to a decline in the participation rate year by year? The answer is actually as Deng Hongying said, for many farmers, the NCMS is too expensive now, so many people choose not to pay it anymore.
First of all, we must realize that the original intention of the establishment of NCMS was to solve the problem that it is difficult and expensive for farmers to see a doctor. However, in the 17 years from 2006 to 2023, China's NCMS payment fee has risen from 10 yuan in 2006 to 380 yuan, an increase of 38. According to the relevant data of the National Bureau of Statistics, in the past 17 years, China's per capita disposable income has increased from 7,200 yuan in 2006 to 39,200 yuan in 2023, an increase of 516。Behind the huge contrast between the two, the NCMS has already unwittingly increased the economic burden on farmers, which has also led to the gradual loss of enthusiasm for people to pay fees.
Looking at the 380 yuan alone, some people may think that it is not too much, after all, paying a fee can cover one year's medical insurance reimbursement. But even if it is just a family of four, you have to pay a one-time fee of 1,520 yuan, and as of April 2023, the average monthly minimum wage in some places in China is only 1,420 yuan, which is not even enough for the cost of a family of four ** medical insurance. Moreover, the wages that can be counted are already like this, and the actual income of many peasants is probably less than the minimum wage.
In addition to the economic pressure, the reimbursement scope and reimbursement ratio of NCMS are also the focus of farmers' attention. Although the reimbursement ratio and scope of NCMS have been expanded compared with the past, there are still many restrictions in practice. Some conventional drugs or specific ** methods are not included in the reimbursement or the reimbursement ratio is low. Some farmers are difficult to get reimbursement because of the hospital level, even if the cost is high. As a result, farmers still have to bear a considerable amount of out-of-pocket expenses when seeking medical treatment, which reduces their trust and satisfaction with rural medical insurance.
In addition, the inability to accumulate NCMS payments is also a major problem. The fee is paid again every year, and if it is interrupted, it means that all previous fees paid will be reduced to zero. For those farmers who work outside the home all year round or whose income is unstable, such regulations undoubtedly increase the difficulty and cost of their insurance.
It can be said that the reason why there are fewer and fewer people in the NCMS with "little money" is that behind it is a series of complex social and economic problems. On the one hand, the economic pressure brought by the continuous medical insurance costs to farmers; On the other hand, there are the limitations and shortcomings of the medical insurance system itself. If these problems cannot be properly solved, it will be difficult to fundamentally mobilize everyone's enthusiasm for NCMS.