There are obvious differences between the medical insurance paid in rural areas and the medical insurance paid at work in many aspects. Here's a detailed comparison of the two health care systems:
Insured Objects and Coverage:
Rural health insurance, often referred to as the New Rural Cooperative Medical System (NCMS), is primarily for residents of rural areas, especially those who depend on agriculture for their livelihoods.
Its coverage is relatively small and is mainly concentrated in rural areas.
The medical insurance paid at work, namely the basic medical insurance for urban employees (UBMI), mainly covers urban employees and some urban residents. Its coverage is wide-ranging, covering almost all workers working in cities.
Payment Mechanism and Fee Bearing:
The payment mechanism of rural medical insurance is usually voluntarily participated by farmers, and individual, collective and multi-party joint financing.
The individual contribution standard is relatively low, and a certain subsidy will also be provided.
The payment of basic medical insurance for urban employees is jointly borne by the employer and the employee, and a certain percentage of the insurance cost is deducted from the monthly salary. The payment standard is relatively high, but the corresponding level of protection is also higher.
Coverage level and reimbursement ratio:
The level of protection of rural medical insurance is relatively low, mainly for serious diseases, and the reimbursement ratio and limit are relatively low. It was originally designed to address the financial burden of farmers due to serious illnesses.
The basic medical insurance for urban workers has a relatively high level of protection, covering more medical services, and the reimbursement ratio and limit are relatively high.
Its purpose is to ensure the basic medical needs of urban workers.
Governing Bodies and Operational Methods:
The management agency of rural medical insurance is usually the local health department or the rural cooperative medical management institution, and its operation mode is relatively simple, mainly based on primary medical institutions.
The management of basic medical insurance for urban employees is more complex, involving multiple departments and institutions, including the social security department and the medical insurance bureau. Its operation mode is also more standardized, and it has formed a close cooperative relationship with medical institutions, pharmacies, etc.
Institutional cohesion and interoperability:
There is a certain problem of convergence between rural medical insurance and basic medical insurance for urban employees.
With the advancement of urban-rural integration, some regions have begun to try to merge or integrate the two to improve the fairness and efficiency of the medical insurance system.
In terms of interoperability, there are certain differences between the two medical insurance systems in terms of medical service provision and cost settlement, which may lead to some difficulties faced by some insured persons when seeking medical treatment across regions.
Policy Orientation and Development Trends:
As a basic medical security system in rural areas, rural medical insurance has been strongly supported and promoted in recent years.
With the implementation of the rural revitalization strategy, rural medical insurance is expected to receive more policy support and investment.
As the basic medical security system for urban workers, the basic medical insurance for urban workers is also constantly improving and developing. With the advancement of medical technology and the growth of demand for medical services, the basic medical insurance for urban workers is facing higher protection requirements and greater financial pressure.
To sum up, there are obvious differences between the medical insurance paid in rural areas and the medical insurance paid by work in terms of insurance objects, payment mechanisms, security levels, management institutions, system convergence and policy orientation. These differences reflect the differences in the level of economic and social development between urban and rural areas, as well as the different policy orientations in the field of medical security. With the advancement of urban-rural integration and the continuous improvement of the medical security system, the difference between the two medical insurance systems is expected to gradually narrow and achieve a more equitable and sustainable medical security system.