To address the problem of low-income households having no money to see a doctor, the state has put in place support measures.
The General Office of the State Council recently issued the "Opinions on Improving the Medical Insurance and Assistance System for Major Illnesses" which proposes to promote the complementary connection of the three systems - to give full play to the main protection function of basic medical insurance, strictly implement the payment scope and standards of basic medical insurance, and implement fair and appropriate protection.
Critical illness insurance plays a supplementary role and provides preferential protection to aid recipients.
The goal of basic security is to ensure that people in need can obtain basic medical and health services and to ensure that medical expenses will not affect the basic life of their families.
Regarding the design of payment instruments that affect the policy benefit levels of aid recipients, such as deductibles and self-payment ratios, the "Opinions on Improving the Medical Insurance and Assistance System for Major and Critical Illnesses" emphasizes that the fund's affordability, the actual needs of the people and other factors must be comprehensively considered.
, refine treatment standards by group of people.
It is clearly required that in principle, the minimum payment standard for subsistence allowances and special poverty-stricken people be cancelled. The annual minimum payment standard for those who do not meet the conditions shall not be higher than 5% of the disposable income of residents in the coordinated area in the previous year.
The annual minimum payment standards are determined based on approximately 10% and 25% of the per capita disposable income of residents in the coordinated area in the previous year.
In terms of the assistance ratio, subsistence allowance recipients and extremely poor people will be assisted at no less than 70%, while other assistance objects will be provided with a slightly lower assistance ratio than the subsistence allowance determined by each locality based on actual conditions.
The annual bailout limit is also reasonably determined based on the actual payment ability of the fund.
In terms of what areas the support measures should focus on, the arrangement of support measures should focus more on patients with major diseases among the poor.
In the past, assistance policies focused on hospitalization assistance, but the "Opinions on Improving the Medical Insurance and Assistance System for Major Diseases" requires increasing outpatient assistance for chronic diseases and special diseases.
The annual assistance limit for outpatient and inpatient assistance will be used to coordinate the use of assistance funds. In the long run, it will help guide difficult outpatients with chronic diseases to seek medical treatment reasonably and reduce the phenomenon of "outpatient transfer to hospitalization".
If the personal burden is still heavy after the comprehensive protection of the triple system, preferential assistance can continue to be provided, provided that referrals are standardized within the province and the scope of medical assistance payment is consistent with the catalog of drugs, consumables and diagnosis and treatment items of the basic medical insurance.
In short, medical assistance guarantees "basic" medical and health services for people in need, and should be combined with referral mechanisms, standardized diagnosis and treatment and other measures to control unnecessary payments and reduce waste.