On April 3, 2002 1,1,the state issued "Guiding Opinions on Establishing and Improving the Economic Security Mechanism for Employees' Basic Medical Insurance Outpatients", which officially opened the curtain of medical insurance system reform.

Moreover, with the gradual advancement of the reform of the medical insurance system, various localities have successively issued specific implementation plans such as the Measures for the Implementation of Economic Security for Outpatients with Basic Medical Insurance for Employees to promote the reform of the medical insurance system.

Benefits of medical insurance reform:

Since the beginning of this year, many provinces across the country have successively launched economic reform programs for employees' medical insurance clinics.

In the past, it was stipulated that the medical insurance account could only be used by myself. In this way, the money returned by medical insurance to many young people's medical insurance personal accounts may not be used for several years, and they are all sleeping in medical insurance personal accounts.

After the reform, it is to promote families to use personal medical insurance accounts, that is to say, the money in young people's personal medical insurance accounts can also be used by parents and children at home, which promotes the flow of medical insurance funds.

Another important direction of this reform is to reduce the proportion of medical insurance funds returned to personal accounts and improve outpatient reimbursement. This regulation has increased the total amount of medical insurance funds and activated the sleeping medical insurance funds.

This reform is great news for retired people who often suffer from chronic diseases and frequently-occurring diseases and often see outpatient clinics!

But some people worry:

After the medical insurance reform, the money put into the medical insurance card has decreased every month. The older the elderly, the more money they spend on diseases. Should medical insurance be retired according to age? For example, at 65 100, at 70, at 200, and at 80, at 300?

So, is this feasible?

In fact, there are indeed some areas in China that use the fixed return of medical insurance personal accounts according to different ages.

For example, in Shanghai, the medical insurance return standard in Shanghai is under 74 years old 1.680 yuan/year, that is, 1.40 yuan/month, and over 75 years old 1.890 yuan/year, that is, 1.57 yuan/month;

Beijing: People under 70 years old are included in the 100 yuan/month standard, and those over 70 years old (inclusive) are included in the 1 10 yuan/month standard.

Tianjin: 40 yuan under 70 years old, 50 yuan over 70 years old (inclusive), 60 yuan, an old worker before the founding of the People's Republic of China.

Then, why is it difficult to popularize 65 100, 70/200 and 80/300?

Then, why is it difficult to popularize 65 100, 70/200 and 80/300?

1, the medical insurance fund is unbearable.

China's medical insurance fund, to put it bluntly, is the accumulation of monthly medical insurance contributions.

If you return to 100 at the age of 65, 200 at the age of 70 and 300 at the age of 80, the medical insurance fund says that the pressure is great!

According to the national average pension of retirees from state-owned enterprises is 3,000 yuan, taking Qingdao as an example, 3,000 * 4.5% =1.35 yuan, which is the monthly repayment amount of most retirees.

2, across the board, seemingly fair, in fact, more unfair.

At present, the medical insurance refund in most areas of China is linked to my pension and returned according to a certain proportion of my pension.

For example, take Qingdao medical insurance personal account inclusion standard as an example:

On-the-job employees under the age of 35 are included in 2% of their salary;

Employees aged 35 and above and under 45 shall be paid according to 2.2% of the paid wages;

Employees over 45 years of age, personal accounts are included in the standard of 3% of their wages;

Retirees: Personal accounts are included in the standard of 4.5% of my pension.

In addition, in order to give full play to the efficiency of the use of funds, fine-tune individual accounts according to the principle of rising and falling, and continue to tilt towards the starting standard of individual accounts for low-income retired employees, and stipulate that:

Under the age of 70, if the amount included in the month is lower than that in 80 yuan, it will be included in 80 yuan;

For the elderly over 70 years old, if the monthly credit amount is lower than that of 90 yuan, the credit will be granted in 90 yuan.

Take retirees as an example. If my basic pension is 65,438+00,000 yuan, the monthly repayment amount of the medical insurance personal account is:

10000*4.5%=450 yuan

Why should medical insurance be linked to the pension amount?

Because the medical reimbursement treatment we enjoy after retirement is the result of the minimum payment of 25 years for women and 30 years for men when we are on the job!

The base of payment is high when working, and the payment period is long. After retirement, you can enjoy good treatment. If it is across the board, the standard of high and low fees is the same, then it is unfair to those who pay long and high fees!

3. After the reform, the proportion and treatment of outpatient reimbursement have been improved.

After the reform, although the proportion of personal accounts has decreased, the proportion of outpatient reimbursement has increased.

Outpatient chronic diseases and major diseases can apply for outpatient reimbursement and enjoy outpatient reimbursement treatment.

Therefore, it is difficult to carry out medical insurance reform. Personal accounts are returned at the age of 65 100, 200 at the age of 70 and 300 at the age of 80.