Legal analysis: There are some problems in the current "medical insurance", which are worthy of serious study by the relevant departments to facilitate the people participating in the "medical insurance" to seek medical treatment. First, it is difficult for people living in different places to reimburse medical expenses. At present, there are not a few retirees who return to their hometown to settle down or live with their children in different places. They usually go to the place where they live to see a doctor, but it is inconvenient to reimburse them. First, cardholders in big cities can only swipe their cards in big cities because of the inherent deficiency of medical insurance cards. Once out of the city, it is useless in other cities inside and outside the county or province. Once people living in other places get sick, they can't use their cards. They must go back to Dazhou for medical treatment or medicine, otherwise they will have to pay for themselves. At present, the method of "seeking medical treatment in different places at your own expense and reimbursement at the end of the year" is still adopted for foreign personnel without cards. Because of their old age and illness, large amount of advance payment and long reimbursement time, these old comrades will inevitably bear economic pressure. Second, the outpatient medical reimbursement standard is too low. The salary of retirees is not high. In recent years, the government has continuously raised the salary level of retirees, and correspondingly raised the level of medical expenses, but the increase is not large. At present, employees' medical insurance is paid by employers and individuals at 6% and 2% of their personal wages respectively according to the salary standards of employees, while retirees are paid by units, and personal accounts are only 4%. According to this standard, taking the average monthly salary 1500 yuan as an example, the annual personal account balance is only about 450-600 yuan. Retirees are old and weak, prone to illness, and the cost of seeing a doctor and taking medicine is very expensive. Coupled with the inability to reimburse the medical expenses, this outpatient fee has become a "drop in the bucket" and it is difficult to solve the dilemma of seeing a doctor and taking medicine. Third, the reimbursement procedures for special outpatient expenses are complicated. First of all, the publicity is not in place, so many patients do not know the preferential policies and bear high costs for a long time. Secondly, the declaration procedures are complicated, and there are many hospital inspection items, which are expensive. Thirdly, after the approval, it is also inconvenient for people living in other places to get medicine at designated stores, and the price of medicine is discounted. The above problems mainly involve policy issues, and there is a process to solve them, but some problems are only technical problems and can be solved without much money. Therefore, it is suggested that: 1, medical expenses reimbursement should be "swiped", and medical insurance cards should be established as soon as possible to connect with counties and cities inside and outside the province, so as to realize "one card in hand, seeking medical treatment everywhere" and facilitate employees to seek medical treatment. 2. When the financial resources are possible, appropriately raise the reimbursement standard for medical expenses, so that ordinary people can afford to get sick and medicine, especially for old comrades to spend their twilight years. 3, special outpatient expenses reimbursement, increase the cost should be credited to the personal account, cancel the provisions of the designated drug purchase, convenient for old comrades to seek medical treatment.
Legal basis: Article 30 of the Social Insurance Law of People's Republic of China (PRC), the following medical expenses are not included in the scope of payment of the basic medical insurance fund: (1) those that should be paid by the industrial injury insurance fund; (2) It shall be borne by a third party; (three) shall be borne by public health; (4) Go abroad for medical treatment. Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.