In the legislative plan of the Standing Committee of the 14th National People's Congress released in September 2023, the "Medical Security Law" is included in the second category of projects, that is, "draft laws that need to be put forward for consideration when the conditions are ripe", which is an important task of legislation in the field of social security in the next five years.
Why does health care need to be legislated?What problems can legislation solve?Recently, experts, scholars and professionals in the medical field have discussed the purpose, positioning, basic principles and scope of application of medical security legislation, and answered many basic and difficult questions that need to be clarified in the process of promoting medical security legislation.
01 Why does medical insurance need to be legislated?
Lou Yu
Professor, School of Civil, Commercial and Economic Law, China University of Political Science and Law
With the basic finalization of China's medical security system, a health and safety net covering the whole people has been built. However, at the same time, there is still a lot of room for improvement in the standardized operation of the rule of law, the first of which is the lack of legislation, especially the lack of high-level legislation, which leads to a strong arbitrariness in the implementation of the system, a poor sense of rights and responsibilities of all parties, and an urgent legislative task is in front of us. Speeding up the legislative process of medical security and realizing the finalization of the medical security system on the track of the rule of law has become an important task of China's medical insurance work during the "14th Five-Year Plan" period.
The Health Care Law can promote the realization of equal access to health care for citizens. Unlike the traditional right to health, which takes citizens as the first responsible person and is mainly realized through civil law, social security involves the investment of state financial funds, and needs to follow the principle of "legislation first", and only reliable legislation can realize citizens' right to medical security.
On the whole, China's basic medical security system lacks due legal norms, and only the Social Insurance Law has provisions on basic medical insurance for employees. At the same time, the legal system in the field of medical security presents a situation of "Kowloon governing water", and the laws and regulations involved are scattered in different departmental laws, which are fragmented and decentralized, and it is urgent to formulate a law that can promote the development of medical security as a whole and has a programmatic status.
02 What principles should be followed in promoting medical security legislation?
Wang Zongfan
Director and researcher of the Medical Security and Nursing Security Research Office of the Chinese Academy of Labor and Social Security
National health insurance legislation should be gradual, not overnight. First, explore through local reform pilots, reach a consensus on the basis of full pilots, form national policies and management norms to be implemented throughout the country, and then fix them in the form of legislation when the policies are more mature after implementation, so as to enhance the authority of their implementation, so as to more effectively bind relevant parties.
In the legislation of medical insurance, the first thing to consider is to protect the legitimate rights and interests of citizens, and also to stipulate the responsibilities of the management department. The management department must administer according to the law, and at the same time, the law should reflect the restraint and supervision of the management department. The law should clarify the basic policies and management mechanisms for the basic medical security (including basic medical insurance, serious illness insurance and medical assistance) for which the person is responsible. Legislation does not regulate all contents, and some content laws only give framework and directional provisions, and the specific content can be reflected through policies and normative documents.
In addition, legislation should be based on reality but need to be forward-looking, China's medical insurance system is still a long way from maturity, legislation to leave room for the reform of the medical insurance system. In general, the law should be based on realistic conditions, be multi-functional, and promote the implementation and reform of the health care system. Therefore, the medical security law should become a legal basis for comprehensively considering the interests of all parties and promote the further development of the medical insurance system.
03 What problems can the Medical Security Law solve in practice?
Hu Mu
Vice Chairman of the Medical Security Committee of the Chinese Social Security Association
The basic medical insurance system is the most important part of the legal system of medical security. The legal system of medical insurance supervision should be designed around the basic principle of the operation mechanism of medical insurance, that is, how to overcome the moral hazard caused by the asymmetry of doctor-patient information. From the perspective of the reform of the medical and health system, the basic role of medical insurance is to alleviate the problem of information asymmetry, and its core is to ensure the authenticity of information and better protect the rights of the insured.
From the perspective of medical insurance practice, it is particularly important to create a level playing field for medical institutions at the legal level. There is a big difference between medical insurance and medical insurance, the protection should be considered from the perspective of health, everyone enjoys it and is free, insurance is big or not small, and the management technology requirements are higher. In addition, ethical responsibility is one of the responsibilities of medical services, and traditional culture and innovative technologies will bring challenges to medical insurance, medical institutions and medical staff, how to encourage them to participate in good faith, improve efficiency, reduce costs, and let patients get relatively satisfactory services is one of the goals of system design.
04 What should be included in the Health Care Security Act?
Zhang Rongfang
Professor, Wuhan University Law School
From the perspective of positioning, the Medical Security Law should be an integral part of the Social Security Law and is the law of citizens' rights. As an economic security system, China's social security law system provides citizens with social risk protection in the form of social insurance in the event of old age, illness, unemployment, work-related injury, childbirth, and inability to take care of themselvesProvide survival security for the whole people in the form of social assistance. The former is the main body of social security, and the latter is the basic guarantee. As an integral part of the national social security system, medical security should mainly include basic medical insurance and medical assistance, so as to provide basic health security for the whole people.
The main content of the Medical Security Law should be defined around two parts: first, the relationship between the subject of the right to enjoy the protection and the subject providing the guarantee, including the object of protection, fund raising and management, the conditions and standards for enjoying the treatment, etc.;The second is the relationship between the subject of treatment and the subject of medical services, focusing on the access conditions and procedures of designated medical service institutions, the service code of conduct of designated medical service institutions, and the supervision and management of designated medical service institutions.
The Medical Security Law can promote the realization of citizens' equal enjoyment of the right to medical security, provide basic health security for the whole people, create a level playing field for medical institutions at the legal level, and ensure that patients receive relatively satisfactory medical services ......Legislation can provide full protection for our lives and health. We look forward to the early enactment of the Health Care Law.
Original title: Gongdao Theory |What problems can be solved by the "Medical Insurance Law" included in the legislative plan?Hear what the experts have to say
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