The representative of the National People's Congress suggested that the new crown vaccine be included in the full reimbursement of medical insurance, and the National Medical Insurance Bureau responded
On October 9, the National Medical Security Administration issued on its official website the "Response to Recommendation No. 9354 of the Third Session of the Thirteenth National People's Congress" (hereinafter referred to as the "Response"). According to the suggestion of including the full reimbursement of medical insurance, the reply stated that there are a large number of people vaccinated against new coronary pneumonia, and the total cost is high, which is obviously beyond the capacity of the medical insurance fund.
According to the "Reply", since the outbreak, as of July 19, 2020, 135,500 medical insurance settlements have occurred for confirmed and suspected patients with new coronary pneumonia across the country, involving 1.847 billion yuan in medical expenses, 1.232 billion yuan in medical insurance payments, and the payment ratio reached 67%. .
The remaining part of the fiscal subsidy was provided in accordance with regulations, which resolved the worries of patients and medical institutions and laid a solid foundation for defeating the epidemic.
The Paper (www.thepaper.cn) learned that, according to the "People's Republic of China Vaccine Management Law" implemented on December 1, 2019, my country divides vaccines into immunization programs and non-immunization programs.
Among them, the immunization planning vaccine is organized by the State Council’s health department in conjunction with the State Council’s financial department to organize centralized bidding or unified negotiation. All provinces, autonomous regions, and municipalities implement unified procurement, and the government provides residents free of charge.
In addition, according to Article 30 of the "Social Insurance Law of the People's Republic of China", medical expenses that should be borne by public health are not included in the scope of payment by the basic medical insurance fund.
The "Interim Measures for the Administration of Basic Medical Insurance Medications" announced in July 2020 pointed out that preventive vaccines are not included in the scope of medical insurance payments.
Therefore, disease prevention and control projects such as vaccine and vaccination costs should be resolved through public health service funding channels.
According to the "Reply", the current level of funding for basic medical insurance in my country, especially for urban and rural residents, is relatively low. In 2019, the per capita funding for urban and rural residents’ health insurance is only about 800 yuan. However, there are a large number of people receiving vaccination, and the total cost is obviously high. Exceed the capacity of the medical insurance fund.
"From the perspective of the overall development of the medical insurance system at this stage, the people’s disease treatment needs, and the level of financing of medical insurance funds and the ability to resist risks, the current basic medical insurance system is still based on providing the people with basic disease treatment protection and striving to meet the basic medical needs of the people. It has not been able to expand the scope of payment to non-therapeutic items such as vaccines."
At the end of the "Reply", the National Medical Insurance Administration pointed out that in the next step, it will work with relevant departments to study the cost of the new crown vaccine.
The Paper Journalist Zhao Siwei