Chinanews client, Beijing, October 21st (Reporter Zhang Ni) 2020 is a year of resolute victory in poverty alleviation.
For many poor families, disease is the biggest obstacle to poverty alleviation.
How to prevent the "root of disease" from turning into "poor root" is an arduous task facing medical insurance departments in various places.
According to data from the National Medical Insurance Administration, since 2018, the poverty alleviation policies of medical insurance have benefited more than 460 million people in poverty and helped reduce the burden of the poor by nearly 300 billion yuan. The participation rate of the poor in 2019 has stabilized at more than 99.9%...the poor population" The goal of getting medical treatment for diseases is being fully realized.
Data map: Members of the doctoral medical service team of Fudan University provide free consultations for people in poor areas.
(Photo courtesy of Fudan University School of Medicine)
The medical insurance poverty alleviation policy has benefited more than 460 million people in poverty
Statistics show that among the poverty-stricken households in China who have registered for registration, more than 42% of households who have become poor due to illness and returned to poverty are the main cause of poverty in the rural population.
To gnaw on the "hard bones" that lead to poverty and return to poverty due to illness is crucial to the fight against poverty.
The reporter learned from the medical security poverty alleviation sub-forum of the 2020 National Poverty Alleviation Day series activities held in Beijing recently that since 2018, the medical insurance poverty alleviation policy has benefited more than 460 million people in poverty, helping the poor reduce their burden by nearly 300 billion yuan.
In 2019, the poor population's participation rate has stabilized at over 99.9%.
In addition, under the comprehensive protection of the triple system of basic medical insurance, critical illness insurance, and medical assistance, the actual reimbursement ratio of chronic disease medical expenses for inpatients and outpatients of the poor has stabilized at around 80%.
In recent years, the medical insurance department has always insisted on demanding dividends from reform and benefits from management. Through the implementation of centralized drug procurement, strengthening fund supervision, promoting "one-stop" settlement, improving outpatient and chronic disease service guarantee, and speeding up the implementation of direct medical treatment in different places. Reform measures such as settlement, continued to optimize management services, and continuously improved the accessibility of medical services for the poor. The problem of "expensive and difficult medical care" for the masses was effectively solved.
In 2019, the National Medical Insurance Administration and the National Health Commission and other departments issued the "Guiding Opinions on Resolutely Completing the Hard Tasks of Medical Security Poverty Alleviation", which clarified the hard tasks, guarantee standards and requirements, and main directions that must be completed in the medical security poverty alleviation. Claim.
In addition, the National Health Commission, the National Medical Insurance Bureau and other departments have successively jointly issued documents to deploy special treatment for serious diseases of the rural poor, and continue to expand the scope of treatment.
At present, the number of special treatments for serious diseases of the rural poor has been expanded to 30.
While the policy is being implemented, positive data has emerged.
According to Fu Wei, director of the National Health Development Research Center of the National Health Commission, according to the health poverty alleviation dynamic monitoring system, the proportion of out-of-pocket medical expenses for the poor has dropped significantly, and the out-of-pocket ratio for patients with key diseases has narrowed from 15% to 80% in 2016 6% to 22% by 2018.
The burden of medical expenses for common diseases, chronic diseases and serious illnesses of the poor has been effectively reduced, which has played an important role in alleviating poverty and helping poverty alleviation.
Data map: People swipe their cards to pay at a hospital window.
(The graphic is irrelevant) Photo by Zhang Tianfu
Full data coverage, one-stop service... all local medical insurance departments recruited to solve poverty caused by illness
In the process of policy implementation, local medical insurance departments are also actively introducing detailed measures.
For example, in Heilongjiang, the province has developed a dynamic monitoring system for poverty alleviation through medical security to achieve full coverage of the seven levels of major poverty alleviation data of provinces, cities, counties, townships, villages, households, and people, and accurately grasp the participation, funding, and poverty of the poor Reasons, policy standards, hospitalization expenses, outpatient chronic diseases and special treatment expenses, etc.
Focus on strengthening the monitoring of poor people whose annual self-paid medical expenses exceed 10,000 yuan, and further increase medical assistance for poor people who meet the requirements in a timely manner.
In addition, all 67 counties (cities) in Heilongjiang province realized “one-stop service, one window processing, and one-single system settlement” within counties for hospitalization expenses for poor people, and all 13 cities and regions realized “one-stop” settlement services within the city. , And earnestly allow poor people to be hospitalized for reimbursement "at most once.
According to data from the Heilongjiang Provincial Medical Insurance Bureau, since 2019, none of the poverty-stricken households in Heilongjiang Province who have registered for registration have returned to poverty due to illness.
In Yunnan, since the beginning of this year, the province’s medical insurance and poverty alleviation departments have further cooperated closely to improve the data sharing mechanism and achieve weekly data exchange and comparison.
At the same time, the medical insurance departments at all levels in the province set up dispatch rooms, deploy dispatch command systems, adhere to regular dispatch every working day, and form a new working mechanism of real-time linkage between upper and lower, immediate problem solving, and timely removal of obstacles.
From a national perspective, China has included all the poor into the safety net of the “triple guarantee” system of basic medical insurance, critical illness insurance, and medical assistance. The burden of medical expenses has been reduced, and the number of people returning to poverty due to illness has dropped significantly from 28.5 million in 2014 to 969,000 in 2019.
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