The Ministry of Human Resources and Social Security proposed to accelerate the integration of urban and rural basic medical insurance, and at the same time strive to achieve the introduction of integration plans by all provinces (autonomous regions and municipalities) by the end of the year. In 2017, it began to establish a unified urban and rural resident medical insurance system.

The notice requires that the medical insurance payment mechanism be improved, the interest control mechanism be improved, and the people be guided to seek medical treatment in an orderly manner, so that hospitals have the motivation to rationally use drugs, control costs, and rationally admit and transfer patients, and stimulate the endogenous motivation of medical institutions to standardize behavior and control costs.

At the same time, we should improve the medical insurance financing and benefit adjustment mechanism, gradually establish a stable and sustainable financing mechanism for basic medical insurance that is consistent with the level of economic and social development and the affordability of all parties, and improve the basic medical insurance benefit adjustment mechanism that is consistent with the level of financing.

It is necessary to improve the critical illness insurance system for urban and rural residents.

In terms of accelerating the national network of basic medical insurance and direct settlement of medical treatment in other places, the notice requires that starting from next year, direct settlement of hospitalization expenses for retirees resettled in different places across provinces will be basically realized. By the end of 2017, direct settlement of hospitalization expenses for medical treatment in other places that comply with the transfer regulations will be basically realized.

In addition, the notice also puts forward requirements such as improving the medical insurance handling mechanism, accelerating the establishment of a personnel compensation system that conforms to the characteristics of the medical industry, and mobilizing the enthusiasm and creativity of medical personnel.

17 provinces have realized the unified management of universal medical insurance, human resources and social security. Since the issuance of the "Opinions of the State Council on Integrating the Basic Medical Insurance System for Urban and Rural Residents", 8 provinces (autonomous regions and municipalities) including Hebei, Hubei, Inner Mongolia, Jiangxi, Xinjiang, Beijing, Hunan, and Guangxi have officially

Documents were issued to make plans and arrangements for the province's integration of urban and rural residents' medical insurance systems, and the first half-year task requirements set by the State Council for the integration of the system were completed as scheduled.

The above eight provinces have considered the "three-in-one" of straightening out the system, integrating the system, and improving efficiency, and made plans and arrangements for the comprehensive advancement of the integration of the system.

First, it is clearly proposed to merge the new rural cooperative medical management functions undertaken by the health and family planning department and the urban residents’ medical insurance management functions managed by the human resources and social security department, and unify them under the management of the human resources and social security department.

Second, in accordance with the requirements of the "Six Unifications" in the State Council document, requirements are put forward to comprehensively establish a unified basic medical insurance system for urban and rural residents by integrating the two systems of urban residents' medical insurance and new rural cooperative medical care.

The third is to clarify the division of labor for the integration work as well as the promotion timetable and roadmap, and also put forward specific requirements to ensure the smooth and orderly advancement of the integration work.

Up to now, among the 32 provinces, autonomous regions and municipalities (including the XPCC) in the country, 8 provinces including Hebei, Hubei, Inner Mongolia, Jiangxi, Xinjiang, Beijing, Hunan and Guangxi have introduced integration plans, while Tianjin, Shanghai, Zhejiang, Shandong, Guangdong, Chongqing and Ningxia

Nine provinces, including Qinghai, Qinghai, and Xingtuan, have fully realized system integration before the release of the State Council document. The above 17 provinces have broken through the institutional barriers of urban and rural separation of medical insurance and clearly placed the unified basic medical insurance system for urban and rural residents under the management of the human resources and social security department.

, realizing the unified management of the universal basic medical insurance system and even the entire social insurance system, which fully demonstrates the local party committee and government’s high-level awareness of the unified medical insurance management system and its deep understanding of the social security system with Chinese characteristics.

Judging from local practice, system integration has achieved remarkable results: First, the masses have generally benefited and have an enhanced sense of gain from the reform.

In practice, various localities have adopted the idea of ??"paying as low as possible rather than high, remuneration being as high as possible rather than low, and the catalog being broad rather than narrow". The fairness of the resident medical insurance system has been significantly enhanced, especially the level of utilization and security of medical services for rural residents.

All have generally improved.

The second is to improve public service efficiency and reduce administrative costs.

Relying on the social insurance public service system, it has realized integrated management services such as insurance registration, fund collection, rights recording, and benefit payment, avoiding duplication of investment and multi-party construction, and reducing duplication of insurance participation and duplication of subsidies.

Integration in Shandong Province alone eliminated 2.5 million people who were duly insured, saving more than 800 million yuan in duplicative financial subsidies that year.

The third is to enhance the mutual aid and financial capacity of the medical insurance fund, which is conducive to giving full play to the basic role of medical insurance in medical reform.

All localities pay attention to the laws of the social medical insurance system and promote the external incentives and constraints of medical insurance on medical services, providing a solid foundation for the reform of the three medical linkages.

China’s current basic medical insurance system (1) Basic medical insurance for urban employees.

It is a social medical insurance system that guarantees the basic medical needs of employees based on the affordability of finance, enterprises and individuals. It implements local management. Basic medical insurance premiums are jointly borne by both the employer and the employee. Basic medical insurance is subject to social coordination and individual

accounts combined.

(2) Basic medical insurance for urban residents.

It is a medical insurance system that mainly covers urban minors and unemployed urban residents who have not participated in the urban employee medical insurance; the basic medical insurance for urban residents is mainly based on family contributions, and the government provides appropriate subsidies; (3) New rural cooperative medical care

.

It is a farmers' medical mutual aid financial system organized, guided and supported by the government, with farmers voluntarily participating, individuals, collectives and the government raising funds from multiple sources, and focusing on overall planning of serious diseases.