Health & Beauty

Recently, the General Office of the State Council issued the "Opinions on Improving the Medical Insurance and Relief System for Major and Critical Diseases" (hereinafter referred to as the "Opinions"), focusing on reducing the burden of medical expenses for patients with major diseases, focusing on a unified and standardized system, improving corresponding security mechanisms, and enhancing The medical security system makes arrangements and deployments to support the basic functions of the medical insurance system.

The "Opinions" pointed out that, guided by Xi Jinping’s Thought on Socialism with Chinese Characteristics for a New Era, we should thoroughly implement the decisions and deployments of the Party Central Committee and the State Council on deepening the reform of the medical security system and improving the social assistance system, adhere to the people-centered approach, adhere to the direction of common prosperity, and adhere to We should ensure that all insurances should be guaranteed, basic guarantees should be provided, the functional positioning of the system should be clarified, the comprehensive protection of the triple system of basic medical insurance, critical illness insurance, and medical assistance should be strengthened, and a long-term mechanism for preventing and resolving poverty and returning to poverty due to illness should be established and improved. Persist in doing our best and doing what we can, and seeking truth from facts to determine the standard of treatment, not only to ensure the sustainability of the system, but also to avoid excessive protection. Persist in coordinated development and effective convergence, and promote the formation of a comprehensive security synergy between the triple system, charity assistance, and commercial health insurance.

u3000u3000 The "Opinions" clarified five measures: First, scientifically determine the scope of medical assistance. Coordinate the urban and rural population in difficulties, implement classified assistance, and ensure precise policy implementation. Relief targets not only cover low-income people such as subsistence allowance recipients, extremely poor people, marginal family members of subsistence allowances, and poor people who are prone to return to poverty in rural areas, but also include patients with severe illness caused by illness into the scope of assistance to enhance the fairness and accessibility of assistance. The second is to strengthen the comprehensive protection of the triple system. Fully implement the financial subsidy policy, classify and optimize the insurance policies for subsidizing the needy to ensure that the insurance is fully covered. Clarify the functional positioning of the triple system, give full play to the protection function of the basic medical insurance body, enhance the burden reduction function of critical illness insurance, and strengthen the protection function of medical assistance. According to the principle of "insurance first, rescue", the system functions should be well connected to give full play to the guarantee. The third is to consolidate the underpinning protection of medical assistance. Insist on basic protection, and properly address the basic medical needs within the scope of the recipient's policy. Reasonably determine the basic level of assistance, and categorize and set the assistance threshold and assistance ratio according to the categories of assistance objects. It is clear that the overall planning area shall reasonably set the annual relief limit, and include the basic medical insurance and critical illness insurance costs below the minimum payment line into the scope of relief protection. Both outpatient chronic diseases and hospitalization assistance are guaranteed, the annual assistance limit is shared, the use of funds is coordinated, and inclined assistance is implemented. The fourth is to establish and improve a long-term mechanism for preventing and resolving poverty and returning to poverty due to illness. Strengthen the information management of medical assistance recipients, do a good job of early warning and monitoring of high medical expenditures, and timely include eligible people into the scope of assistance. Comprehensively establish an application-based rescue mechanism, unblock the application channels for assistance, and enhance the timeliness of assistance. Implement hierarchical and categorized assistance to ensure that the policy is fully enjoyed. The fifth is to guide social forces to participate in assistance and guarantee. Develop and expand charity assistance, make good use of social charity assistance resources, and play a complementary role in assistance. Encourage the development of mutual medical assistance and commercial health insurance to better meet the protection needs beyond basic medical insurance.

The "Opinions" clarified measures to standardize management services in terms of accelerating integrated management, optimizing assistance application review procedures, and improving comprehensive service management. At the same time, it requires strengthening organizational leadership, departmental coordination, fund budget management, and grassroots capacity building , To ensure the implementation of policies, implementation of benefits, and benefits for the masses.