The coverage of China's medical security system continues to expand, and the medical insurance system that will be implemented mainly includes three systems: medical insurance for urban workers, basic medical insurance for urban and rural residents, and serious illness insurance.Secondly, with the gradual increase in the payment method of medical insurance, after the change from capitation payment to payment according to the type of disease, the urban staff medical insurance mainly adopts the capitation payment method, which has led to the problem of excessive opening of doctors in China and bias towards large hospitals, in order to solve this problem, the first implementation of the payment method according to the type of disease, that is, the unified fixed payment of medical expenses according to the type of disease, so that doctors no longer take the number of drugs prescribed as an indicator of economic interests, and the implementation of this method has effectively improved the problem of excessive use of medical resources.
Although the coverage of the medical insurance system is expanding, the quality of medical services in China still needs to be further improved, so the National Health Insurance Administration responded:The problem of medical reform has been solved, why do people still choose to refuse to buy it in the future?
The purpose of medical reform is to establish a fairer and more reasonable medical insurance system, but in the process of implementation in real life, many problems have emerged, such as the limited economic income of retirees, their high sensitivity to medical insurance reform, etc., and the unreasonable design of its secondary policies have become their financial burden.
For example,The threshold is too highMany of them need long-term medication, but the scope and category of drug reimbursement restrictions have led to them having to bear a high proportion of out-of-pocket expenses, which directly reflects the disconnect between China's medical reform policy and the actual needs of retirees.
Reimbursement for out-of-town medical treatmentAlthough the policy supports reimbursement for medical treatment in other places, in reality, retirees often feel at a loss because they are not familiar with the complexity of the reimbursement process due to the medical insurance policies in different places, which not only consumes a lot of their time and energy, but also reduces their confidence and satisfaction with medical insurance reform.
MoreoverThe reimbursement ratio of medical insurance is not uniformRetirees usually want to be able to enjoy medical services close to their place of residence, but the current health insurance system does not provide sufficient convenience and support, which will undoubtedly exacerbate retirees' dissatisfaction with the reform.
Therefore, when formulating new countermeasures, the National Health Insurance Administration should pay more attention to the humanization and details of the reform to meet the special needs of retireesAdjust the threshold standardA more reasonable level can be considered for retirees who are in financial difficultyProvide more subsidies or develop relief measures.
And againstThe reimbursement process for medical treatment in other places should be simplified, try to eliminate policy differences between regions, and achieve a uniform reimbursement ratio, in additionThe promotion of electronic reimbursement systems is also necessaryIt can effectively reduce the processing time of retireesImprove reimbursement efficiencyAt the same time, considering the current situation of many retirees living in different places, the transfer service of medical insurance relationship will also become more flexible and convenient to adapt to their residence changes.
The education department has clearly stipulated that in 2024, a unified national medical insurance information sharing platform will be established, which can ensure that retirees enjoy the medical reimbursement system in China and even the whole country, and the reform of the medical security system has always been a very complex and challenging task to provide more fair, convenient and efficient medical services for the general public, especially the retired group.