Accurate, multiple and standardized, alleviate the burden of medical expenses for major diseases

The high medical expenses of major diseases are undoubtedly a risk factor for patients and their families to become poor due to illness and return to poverty due to illness.
It is also a huge stone on our road to common prosperity
.

In order to effectively reduce the burden of the medical expenses of the people in need of serious and serious diseases, the General Office of the State Council has issued the "Opinions on Improving the Medical Insurance and Relief System for Serious and Serious Diseases" (hereinafter referred to as the "Opinions")

While the "Opinions" emphasizes the main guarantee function of the triple system of basic medical insurance, it clearly requires the coordinated development and effective connection with charity assistance and commercial health insurance, reflecting the characteristics of the "precision, multiple, and standardized" system
.

——Accurate

——Accurate

Although the incidence of major diseases is low, the medical expenses are high.
Some patients and their families fall into poverty because they cannot afford the high medical expenses.
Therefore, timely medical assistance and social charity assistance are provided, and comprehensive support is provided.
Can effectively help them get out of trouble
.

The question is: how to improve the quality of assistance and the efficiency of fund use, so that the limited funds can be used to the maximum effect? Accurate positioning and targeted assistance of the target of assistance are undoubtedly the key link

One is the accuracy of the rescue target
.

Comprehensive consideration of family economic status, medical expenses, medical insurance payment, etc.

One is the accuracy of the rescue target

Second, the rescue cost is accurate

The third is precision in the rescue link

——Multiple

Judging from the current reality in China, it is impossible to solve the problem of medical insurance for serious and serious diseases by relying on a single system, but to choose a triple system of basic medical insurance as the main body, and the coordinated development and effective connection of commercial health insurance and charity assistance.
Government-led, multi-participation, multi-management, and multi-guarantee system model
.

The first is to strengthen the comprehensive protection of the triple system
.

Basic medical insurance strictly implements basic medical insurance payment scope and standards, implements fair and appropriate protection; enhances the burden reduction function of serious illness insurance, explores and perfects the preferential payment policy for subsistence allowances, extremely poor people and the poor who return to poverty, to play a supplementary role in basic medical insurance, Rescue recipients whose personal medical expenses burden is still heavier after payment such as critical illness insurance shall be assisted in accordance with regulations; for recipients who have been referred for standardized referrals and seek medical treatment in the province, after the comprehensive protection of the triple system, the personal burden is still heavier within the scope of the policy.

The first is to strengthen the comprehensive protection of the triple system

The second is to encourage the development of mutual medical assistance and commercial health insurance

The third is to develop and expand charity assistance

--specification

--specification

The standardization and unification of policies is an important foundation for ensuring the fairness and accessibility of the system, and it is also a necessary condition for enhancing the people's sense of access, happiness, and security of medical insurance
.

Therefore, the "Opinions" clearly requires:

The first is to standardize institutional arrangements
.

Standardize the positioning of the triple system, basic medical insurance adheres to the main protection function, implements fair and appropriate protection; critical illness insurance plays a supplementary protection function, enhances the burden reduction function, and implements inclined payment for the needy; medical assistance plays the bottom protection function, according to the "insurance first, then rescue" In accordance with the principle of providing assistance to the recipients of assistance, they shall be rescued in accordance with the regulations
.

The first is to standardize institutional arrangements
.

The second is to standardize the scope of protection
.
Adhere to basic protection and focus on solving basic medical protection needs
.
It is clarified that the medicines, medical consumables, and diagnosis and treatment items paid by the medical assistance fund shall, in principle, comply with the state's regulations on the payment scope of the basic medical insurance fund
.
Personal out-of-pocket expenses within the scope of the policy below the threshold of basic medical insurance and critical illness insurance shall be included in the scope of assistance according to regulations
.
Except as otherwise provided by the state, all localities shall not formulate or use flexible methods to expand the scope of medical assistance coverage without authorization
.

The second is to standardize the scope of protection
.

The third is to standardize rescue standards
.
Adhere to classified assistance and clarify specific assistance standards
.
In principle, the minimum payment standard is cancelled for the subsistence allowance recipients and the extremely poor.
If the conditions are not met, the minimum payment standard can be determined at about 5% of the per capita disposable income of the residents in the previous year.
The annual minimum payment standard for the marginal family members of the subsistence allowance is based on the overall planning area.
About 10% is determined, and patients who are poor and severely ill due to illness are determined at about 25%; the medical expenses that meet the requirements of the subsistence allowances and the extremely poor shall be rescued at a rate of not less than 70%.
In principle, the proportion of other rescue objects is slightly lower than that of the subsistence allowance.
Target: Set a reasonable annual medical aid limit
.

The third is to standardize rescue standards
.

The fourth is to standardize handling and management
.
Insist on seeking benefits from management and make up for shortcomings in rescue services
.
There are mainly three aspects, namely: accelerating the promotion of integrated management, optimizing the procedures for reviewing assistance applications, and improving the level of comprehensive service management
.
The purpose is to improve the efficiency and management level of medical assistance services, so that the people in need can enjoy the convenient and efficient medical assistance services while deeply feeling the warmth of the party and the people's government
.

The fourth is to standardize handling and management
.

We firmly believe that with the full implementation of the "Opinions", the medical security work for major diseases will be further carried out in an orderly manner and steadily promoted, medical assistance will be further standardized, and the functions of the medical security system of poverty prevention and poverty alleviation will be more fully utilized.
The construction of the hierarchical medical security system will be more complete, and the development of medical security will be more comprehensive, fairer, more quality, and more sustainable
.