The number of participants is 1.36 billion, and the centralized procurement of medicines and consumables continues to reduce the burden on patients——

2020, medical insurance brings more benefits

  Our reporter Li Hongmei

  "People's Daily" (13th edition on January 14, 2021)

  Core reading

  In 2020, the number of people participating in basic medical insurance nationwide will be 1.36 billion, and the participation rate will remain stable above 95%.

Medicare issued a penny for people’s livelihood dividends: 1.63 billion yuan will be paid for the treatment of patients with new coronary pneumonia, and the surplus of the medical insurance fund will be used to pay for the new coronavirus vaccine; the centralized procurement of medicines and consumables, and the negotiation of drug catalogues will save more than 10 billion yuan each; Hospitalization expenses are directly settled across provinces, and the medical insurance fund pays 103.84 billion yuan... The people receive more benefits and convenience, and their sense of gain and happiness continues to increase.

  Use medical insurance fund rollover balance to pay for the new crown vaccine; three batches of medicines were collected by the country, and the average price was reduced by 54%. According to estimates, the annual medical cost was saved by 53.9 billion yuan; the state organized the first centralized procurement of high-value medical consumables and selected coronary stents The price has dropped from an average price of 13,000 yuan to about 700 yuan, a decrease of more than 90%. It is estimated that the annual medical cost will be saved by 11.7 billion yuan; the average price of 114 negotiated drugs will decrease by more than 50%. It is estimated that the patients will be patients from January to November 2020. The burden was reduced by 72.19 billion yuan; the direct settlement of hospitalization expenses across provinces was carried out, and the medical insurance fund paid 103.84 billion yuan...

  The reporter learned from the National Medical Security Work Conference held on January 12: In 2020, the number of people participating in basic medical insurance nationwide will be 1.36 billion, with the participation rate stabilizing above 95%, and the world's largest universal medical security network has been established.

While maintaining a high coverage rate of universal participation, the medical insurance in the past 2020 "distributed" a sum of livelihood dividends, which effectively brought benefits and convenience to the people and enhanced the sense of reform.

  Help prevent and control——

  Pay 1.63 billion yuan for treatment of patients with new coronary pneumonia

  Since December 15, 2020, my country has officially launched the new crown virus vaccination work for key populations.

So far, nearly 7.5 million doses have been vaccinated for key populations across the country. Together with the previous 1.6 million doses for high-risk groups, my country has carried out more than 9 million doses of new coronavirus vaccination.

Next, we will comprehensively and orderly promote the vaccination of high-risk groups, high-risk groups and the general population, and implement free vaccination for all people, so as to build an immune barrier and block the spread of the new coronavirus.

  Residents do not have to pay for vaccinations against the new coronavirus, but they are free for all citizens.

The cost of the vaccine provided by the enterprise at the agreed price, plus all the costs such as vaccination services, will be borne by the medical insurance fund and the finance, and the residents will not bear it.

  On January 12, according to the National Medical Insurance Administration, medical insurance paid for the new coronavirus vaccine is a special measure to deal with special events.

The main use of the medical insurance fund rollover balance will not affect the current income and expenditure of the medical insurance fund, nor will it affect the people's treatment for medical treatment.

  The National Medical Insurance Agency stated that medical insurance pays for vaccines, not simply paying.

It is necessary to do everything possible to ensure that the medical insurance funds exert the maximum protection effect, give full play to the strategic purchase of medical insurance, and make good use of various methods to introduce prices into a reasonable range in stages.

It is necessary to do a good job in medical insurance payment and settlement, monitor the use and payment of vaccines, and ensure that the masses of vaccines are clear and medical insurance funds are paid clearly.

  From the beginning of the outbreak of the new crown pneumonia, the National Medical Insurance Bureau immediately proposed "two guarantees."

Ensure that patients do not affect medical treatment due to cost issues, ensure that hospitals that are admitted do not affect treatment due to payment policies, and promote the realization of "early detection, early reporting, early isolation, and early treatment."

A total of 2.84 billion yuan has been settled for patient expenses, and 1.63 billion yuan has been paid for medical insurance.

At the same time, the drugs and diagnosis and treatment items in the new coronary pneumonia diagnosis and treatment plan were temporarily included in the catalog, and the payment policy for rehabilitation treatment projects for patients discharged from the new coronary pneumonia was formulated.

Encourage localities to carry out centralized procurement of new coronavirus detection reagents, implement a price policy of separation of technology consumption, and reduce the prices of nucleic acid and antibody detection reagents by 70% and 40% respectively.

In terms of fully supporting the resumption of work and production of enterprises, the nationwide phased reductions in employee medical insurance premiums have provided a cumulative reduction of 165 billion yuan for 9.75 million insured units, exceeding the expected goal of reducing burdens by 150 billion yuan, and providing support for promoting the resumption of work and production and maintaining employment stability. A strong policy guarantee.

  Reduce the burden-

  Centralized procurement of medicines and consumables, access to drug catalogue negotiations, saving more than 10 billion yuan each

  Shanghai 69-year-old Ms. Yang suffers from non-small cell lung cancer. She goes to the Tongren Hospital of Shanghai Jiaotong University School of Medicine to prescribe medication every month.

After March 20th last year, her commonly used gefitinib tablets (trade name Iressa) dropped from 2280 yuan to 547 yuan per box, and her monthly self-pay expenses dropped from 2730 yuan to 630 yuan, which surprised Ms. Yang. .

  The sharply reduced gefitinib tablet is an imported original research drug and has been expensive for many years.

After the state organized the centralized procurement of drugs, the price of the drug dropped sharply to the lowest in the world, benefiting a large number of patients who could not afford this expensive and good drug.

  In people's medical expenses, the cost of medicine and consumables dominates.

In 2020, the National Medical Insurance Bureau organized the centralized procurement of drugs and high-value medical consumables, and conducted reform measures such as negotiating access to innovative drugs and exclusive drugs, each of which saved more than 10 billion yuan.

  In 2020, my country organized the third batch of national drug collections, and the average price of 55 selected varieties was reduced by 53%, and it was implemented nationwide.

In addition to the 112 types of drugs previously collected by the state, the average price has been reduced by 54%. According to estimates, the annual cost savings is 53.9 billion yuan.

In November 2020, my country organized the first centralized procurement of high-value medical consumables. The object of centralized procurement was the coronary stent, which is known as the heart stent.

The price of selected coronary stents dropped from an average price of 13,000 yuan to about 700 yuan, a drop of more than 90%. It is estimated that annual medical costs of 11.7 billion yuan will be saved.

  Various localities are also exploring the development of centralized procurement of medicines and high-value medical consumables, squeezing the false high water content, and reducing the burden.

Wuhan carried out bulk purchases of insulin, while Puyang, Henan and Jinhua, Zhejiang took bulk purchases of proprietary Chinese medicines. The "Sanming Alliance" centralized procurement of unreviewed medicines cut their prices by an average of nearly 70%. Many provinces such as Jiangsu and Anhui chose hypertension and diabetes medicines, antibiotics, and anti-diabetics. Centralized procurement of drugs with a large purchase amount such as oncology drugs.

Tianjin, Chongqing, Hubei, Guangdong, Beijing and other provinces have respectively led the procurement of consumables alliances such as intraocular lenses, staplers and patches, new crown detection reagents, and coronary balloons.

  In December 2020, the results of the adjustment of the medical insurance drug catalog were announced. 119 drugs were transferred, 29 drugs were transferred, and there were 2,800 drugs in the catalog.

This is the third consecutive year that the drug catalog has been adjusted since 2018, and a total of 433 new and good drugs have been included.

This means that my country's drug catalog dynamic adjustment mechanism is basically established.

The 114 negotiated drug prices dropped by an average of more than 50%. It is estimated that the burden of patients will be reduced by 72.19 billion yuan from January to November 2020 alone.

Among them, 25 kinds of domestically-made innovative drugs were admitted, which strongly encouraged the innovation of domestically-made drugs.

  In 2020, the burden of medical expenses for the poor will be reduced significantly.

The poor population’s participation rate has stabilized at over 99.9%, and 78.67 million poor people have been funded to participate in the insurance.

To ensure that the benefits are fully enjoyed, with the comprehensive protection of the triple system, the actual reimbursement rate of chronic diseases for the poor in hospitals and outpatients has stabilized at about 80%.

Preliminary statistics show that since 2018, the medical insurance poverty alleviation policy has funded 230 million people insured for poor people, reducing the burden of personal payment by 40.3 billion; benefiting 500 million people in poverty, reducing the burden of medical expenses by 350 billion, and helping nearly 10 million households. The poverty-stricken people have been lifted out of poverty precisely, and "basic medical care is guaranteed."


  103.84 billion yuan in direct settlement of medical expenses across provinces

  In 2020, Ms. Jing from Tianqiao District, Jinan City, Shandong Province issued the country's first platform-based Internet hospital medical insurance electronic settlement form through the provincial Internet medical insurance major health service platform, and experienced convenient online follow-up consultations and medical insurance drug purchase services.

  Participants pay directly when they go to see a doctor across provinces and leave the hospital without paying for medical expenses; they do not need to bring a card when seeing a doctor, and they can see a doctor without a card and show the medical insurance electronic voucher with their mobile phone; Medical insurance can be settled, and medicines can be delivered to home... Medical insurance is getting easier and more convenient, which greatly improves people's happiness.

  As of the end of 2020, 44,000 designated medical institutions have been directly settled for hospitalization expenses across provinces, and the national platform has settled a total of 175.9 billion yuan in total medical expenses and 103.84 billion yuan in medical insurance funds.

The three pilot areas of Beijing-Tianjin-Hebei, Yangtze River Delta and five provinces in southwest China have opened 10177 designated medical institutions and 11771 designated pharmacies. Outpatient expenses have accumulatively directly settled medical expenses of 750 million yuan across provinces and paid 430 million yuan from medical insurance funds.

  Before seeking medical treatment across provinces, insured persons need to file for the record. Currently, 169 coordinating areas in 21 provinces have achieved national channel online filing, which can be easily filed via mobile phones and the Internet.

  The informatization of medical insurance is accelerating, and information is running out of the way, and the masses no longer have to run errands.

In 2020, the main body of the national medical insurance information platform will be established, and it will be officially put into use in Shanwei, Guangdong in November 2020.

Currently, it has been put into operation in Guangdong, Hebei and Qinghai provinces.

All provinces across the country have opened the medical insurance electronic certificate activation service, with over 450 million users.

Participants can use the medical insurance e-vouchers in their mobile phones to see a doctor and buy medicines.

For scenes where it is difficult for the elderly to use smart technology, retain and optimize traditional services, and improve the ageing of online services.