The state's reimbursement for acute leukemia medicines is 10-20%.

The medical insurance reimbursement for poor children with leukemia is less than 20%, and it is difficult to reimburse imported drugs. On May 28, the Red Cross Foundation of China and the Youth Research Institute of the China Youth University for Political Science *** jointly released the "Survey Report on the Survival Status of Poor Children with Leukemia in China" (hereinafter

(referred to as "Report").

The "Report" shows that medical insurance accounts for only 13.87% of the treatment costs for children. At a time when the cure rate is nearly 70%, 40% of children with leukemia are unable to undergo transplantation due to poverty.

It is difficult to reimburse for treatment in other places. Some families need to go across provinces for treatment in order to seek better treatment results for their children. However, the reimbursement ratio for treatment in these provincial and municipal hospitals is low, the threshold is high, and even reimbursement is not possible.

In July last year, at a press conference for a leukemia relief action project launched by a public welfare organization, a non-Beijing father of a child with leukemia asked: "My son's disease cannot be cured in my hometown. The cost of treatment in Beijing is high and reimbursement is difficult. What's the problem?"

When can it be solved?" No one responded at the scene.

At present, my country's New Rural Cooperative Medical Care System reimbursement standards have different reimbursement ratios for different places, hospitals at different levels, and different types of leukemia.

The reimbursement ratio of large hospitals at the provincial and municipal levels is lower than that at the county and town levels.

In addition, reimbursement can only be provided if the patient is transferred to a medical institution in another place in accordance with regulations. If you seek medical treatment directly out of town, you need to return to the place of insurance within the specified time to complete the procedures.

Chen Tao, a professor at the Youth Research Institute of the China Youth University for Political Science and director of the "Report", pointed out that this system is to encourage medical treatment nearby and reduce unnecessary medical expenses, which is understandable.

However, under China's current medical conditions, municipal hospitals are the lowest-level hospitals equipped to treat leukemia, so patients can only choose municipal and provincial hospitals.

Some families even need treatment across provinces in order to provide their children with better treatment. However, the reimbursement ratio for treatment at these levels of medical institutions is lower, the deductible is higher, or even reimbursement is not possible.

The "Report" found that some parents eventually gave up on reimbursement due to complex, time-consuming and labor-intensive procedures for returning to the insurance place, low reimbursement ratio, and the need for care of their children.

In August 2012, six ministries and commissions including the National Development and Reform Commission, the Ministry of Health, and the Ministry of Finance jointly promulgated the "Guiding Opinions on Carrying out Critical Illness Insurance for Urban and Rural Residents", and various localities have successively issued implementation measures. However, there is still no significant breakthrough in the restrictions on the reimbursement ratio for skip-level and off-site treatment.

"Our children were treated in Beijing, and many of them were not reimbursed outside the province. One operation cost more than 300,000 yuan. I thought I would be reimbursed at least 100,000 yuan, but I didn't expect that the reimbursement was less than 30,000 yuan or 50,000 yuan."

Said a parent of a non-Beijing child.

The minimum payment is frequently deducted. Even if a child with leukemia recovers well, he or she will have to be hospitalized at least four times a year. This means that four times of 2,000 yuan and 3,000 yuan will be deducted from the reimbursement. These deductions are enough to cover the cost of a new course of treatment.

.

Leukemia usually requires two to three years of treatment.

Children who receive chemotherapy as the mainstay need to be hospitalized several times, starting with chemotherapy once in half a month or once a month, and then once in two months or four months. Under normal circumstances, the cost of each hospitalization for chemotherapy is not much.

would be too high.

At present, medical reimbursement in my country is based on one-time admission standards.

Take Henan Province as an example. Since 2012, Henan Province has launched a new policy under the New Rural Cooperative Medical System. If the one-time hospitalization cost exceeds 60,000 yuan, the hospitalization expenses within the scope of the new rural cooperative medical care policy will be based on the corresponding level of medical institutions after deducting the deductible.

Compensation will be provided at a rate of 90%; if the one-time cost of hospitalization exceeds 100,000 yuan, after deducting the deductible, compensation will be provided at a rate of 90%.

Although the reimbursement ratio is higher than in the past, patients who need to be hospitalized multiple times still cannot receive high compensation because each hospitalization does not meet the required standards.

Luoyang City's new rural cooperative medical policy stipulates that the minimum payment threshold for hospitalization reimbursement in provincial hospitals is 2,000 yuan, and if it is across provinces, it is 3,000 yuan.

"Currently, even if a child recovers well, he or she has to be hospitalized at least four times a year, which means that four times of 2,000 yuan and 3,000 yuan have to be deducted from the reimbursement. These deductions are enough to cover the cost of a new course of treatment.

"Chen Tao said.

Regarding this kind of policy, Chen Tao said that although the policy has taken into account the one-time cost of major surgeries, if the one-time treatment cost can be adjusted to the total annual medical cost, it will have a better protection effect.

When asked about the reimbursement ratio, a parent of a child in Guangdong said: "The insurance stipulates reimbursement after each hospitalization. After deducting the minimum payment and self-paid medicine expenses, the reimbursement is only a few dozen yuan, so we will not reimburse it."

"The upper limit of medical insurance is low and it is difficult to reimburse for imported drugs. For children with low resistance and poor blood conditions after chemotherapy, many drugs are off-list.

Due to the need for regular chemotherapy, the deductible and self-paid drugs are deducted each time, and the actual reimbursement rate is very low.

According to the new medical reform policy in 2012, the reimbursement ratio for childhood acute lymphoblastic leukemia and acute promyelocytic leukemia has reached 70%, and the reimbursement ratio for especially poor families can reach 90%.