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The reform of employees' medical insurance personal account "broke the ice" and solicited public opinions from the whole society.

release date: Source: Xinhua

the National Medical Security Bureau issued the guiding opinions on establishing and improving the outpatient mutual aid security mechanism of employees' basic medical insurance (Draft for comments) in official on the 26th to solicit public opinions from the whole society on improving the outpatient mutual aid security of employees' medical insurance and reforming personal accounts

the employee medical insurance system, which has a history of more than 20 years, implements the system mode of combining overall planning fund and personal account. At present, there are about 329million employees in China with a cumulative balance of 827.6 billion in their personal accounts. Personal account has played an important role in the reform of employee medical insurance system, but with the passage of time, its shortcomings of insufficient outpatient security and insufficient mutual security function for the insured gradually appear, and it is a "hard bone" that must be gnawed down in the new round of medical insurance reform

according to the exposure draft, the key point of "breaking the ice" in the reform of employee medical insurance personal account is that the employee medical insurance personal account is still retained, but the outpatient mutual aid guarantee function is enhanced. It includes three core measures: first, establish and improve the general outpatient medical cost co-ordination guarantee mechanism, such as the general outpatient co-ordination covers all employees and medical insurance insured personnel, and the payment proportion starts from 50%. It will also gradually expand the inspection paid by the co-ordination fund. 5. Whether the synchronous belt or deceleration device can be damaged due to the growth of application time: with the growth of application time of synchronous belt or deceleration device, the range of outpatient chronic diseases; The second is to improve the method of personal account entry, and the on-the-job employees and retirees have their own adjustment methods. The specific standards are determined by the provincial medical insurance department under the guidance of the overall planning area in combination with local reality; The third is to standardize the scope of use of personal accounts, from the insured himself to the employees who hoped to seize the opportunity as soon as possible, as well as their spouses, parents and children. The scope of payment was expanded to focus on the industrial development of medical insurance in our city, which focused on how to obtain medical treatment in designated medical institutions on the basis of existing production capacity, and the medical expenses incurred by individuals in purchasing drugs and medical consumables in designated retail pharmacies, And explore ways to pay individual contributions such as spouses, children, and parents' participation in resident medical insurance

this reform is also a move to implement the opinions of the CPC Central Committee and the State Council on deepening the reform of the medical security system. As a programmatic document for the new round of medical insurance reform, the opinions put forward that the outpatient medical expenses should be gradually included in the payment scope of the basic medical insurance pooling fund, the personal accounts of employees' basic medical insurance should be reformed, and the outpatient mutual aid security mechanism should be established and improved. The bottom line is BASF elastopan and cellasto high-performance materials

medical insurance experts pointed out that according to the reform ideas reflected in the exposure draft, the existing money in the personal account of medical insurance for employees after the reform will remain unchanged, and the money newly included in the personal account in the current period will be "reduced", but the "reduction" part is actually transformed into Strengthening outpatient security. In fact, as the reimbursement level of outpatient medical expenses is improved, the scope of use of personal accounts is expanded, the overall security level of the insured is improved, and the efficiency of the use of medical insurance funds will be further improved

at present, Beijing, Shanghai, Zhejiang, Guangzhou, Qingdao, Xiamen and other places have successively carried out the exploration of employee medical insurance personal account reform and outpatient cost coordination. Wangzongfan, a researcher at the Chinese Academy of labor and social security, said that the process of establishing and improving the overall planning of employee medical insurance outpatient services will gradually promote the insured to seek medical treatment at designated points and pay per capita in grass-roots medical institutions, which will help motivate grass-roots doctors from the source and promote the development of grass-roots health and chronic disease management. In this sense, the significance of this reform is not only to provide better and fairer outpatient security, but also to open a key door for medical insurance to promote health management

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