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Medical insurance system reform

The reform of the medical insurance system is an important part of the reform of my country's medical and health system. It aims to improve the level of medical security and better meet the health needs of the people by optimizing the system design.

1. Expanding insurance coverage The primary task of reforming the medical insurance system is to expand insurance coverage and ensure that more people can enjoy medical security.

This includes including more groups of people in the medical insurance system, such as urban and rural residents, flexible employment personnel, etc., and gradually including more medical service items in the scope of medical insurance payment, such as outpatient chronic diseases, special diseases, etc.

2. Optimizing the Financing Mechanism Optimizing the financing mechanism is a key link in the reform of the medical insurance system.

This includes adjusting the proportion of medical insurance contributions to ensure that the level of financing is compatible with the level of economic and social development; strengthening the supervision of medical insurance funds to prevent fund loss and abuse; exploring diversified financing channels, such as introducing social capital and developing commercial health insurance.

3. Improving the Benefit Payment Policy The improvement of the benefit payment policy is an important part of the reform of the medical insurance system.

This includes increasing the proportion of medical insurance payment to reduce the public's medical burden; promoting the reform of payment methods such as payment by disease and payment per capita to promote reasonable cost control by medical institutions; strengthening settlement services for medical treatment in other places to facilitate people's medical reimbursement.

4. Strengthening supervision and management Strengthening supervision and management is an important guarantee for ensuring the smooth progress of the reform of the medical insurance system.

This includes establishing and improving the medical insurance supervision system, strengthening the supervision of medical institutions, medical insurance agencies, etc.; improving the construction of the medical insurance information system to improve management efficiency and service levels; strengthening the publicity and interpretation of medical insurance policies to increase the public's awareness and understanding of the medical insurance system.

Satisfaction.

To sum up: the reform of the medical insurance system is a systematic project involving many aspects and links.

By expanding insurance coverage, optimizing financing mechanisms, improving benefit payment policies, and strengthening supervision and management, a more equitable and sustainable medical insurance system can be built to better meet the health needs of the people.

At the same time, it is also necessary to focus on policy coordination and system integration to ensure that various reform measures are connected and promote each other, so as to form a joint force to promote the in-depth development of the reform of the medical insurance system.

Legal basis: Article 23 of the "Social Insurance Law of the People's Republic of China" stipulates that employees shall participate in employee basic medical insurance, and the employer and employees shall jointly pay basic medical insurance premiums in accordance with national regulations.

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer, and other people with flexible employment can participate in the basic medical insurance for employees, and individuals must pay the basic medical insurance premiums in accordance with national regulations.

Article 27 of the "Social Insurance Law of the People's Republic of China" stipulates: If an individual who participates in the basic medical insurance for employees reaches the legal retirement age and has paid cumulative contributions for the number of years specified by the state, he will no longer pay basic medical insurance premiums after retirement.

The state stipulates that you can enjoy basic medical insurance benefits; those who have not reached the number of years stipulated by the state can pay premiums up to the number of years stipulated by the state.