Medical insurance refers to social medical insurance. Social medical insurance is a social security system created by our country and the society according to certain relevant laws and regulations to ensure that employees within the scope of insurance have basic medical service needs when they are sick. Basically, the medical insurance fund consists of pooling funds and personal accounts, and all the most basic medical insurance premiums paid by employees themselves are credited to personal accounts; Basically, the medical insurance premiums paid by the employing company are divided into two categories, some of which are classified into individual accounts and some are used to create overall funds.
In recent years, with the reform, innovation and development of the medical service system, the social medical insurance rules and regulations have been formed, which integrates the urban and rural residents' medical security system and the urban and rural residents' medical social insurance system. It plays a vital role in thoroughly solving the long-term puzzle of China residents' difficulty in seeing a doctor. With the gradual advancement of this policy, China has basically completed full medical insurance.
1. Popularization of medical insurance cards in various provinces and cities: Most experts who scientifically study the causes of medical problems in various parts of the country point out that the causes of medical problems in various parts of the country are due to the increasingly frequent population mobility and transfer, the unbalanced allocation of medical resources in China and the poor overall planning ability of social medical insurance in big cities in China. Some experts and scholars emphasize that the social reasons leading to this problem mainly include: the urbanization process has produced a lot of population mobility and immigrant investment.
Third, the advantages of administrative division in big cities are also inconsistent with the specific whole process of personnel mobility. Therefore, the total number of cross-regional medical personnel across the country has increased, and the elderly population has a higher demand for medical conditions. The aging society has increased the demand for field medical services. Practically speaking, a regional hospital in China represents the highest medical conditions in China. If the hospital outpatient service cannot be treated, most of them mean that they can give up treatment.
2. Here comes the answer!
As far as the current relevant policies are concerned, the answer may make everyone feel chilling. The existing medical insurance cards are still unable to be popularized across the country. Although many provinces and autonomous regions have implemented this current policy, it will take a long time to complete the rise of medical insurance cards in various provinces and municipalities, which is related to the current medical insurance policy in China. Because the social and economic development and social aging in various provinces and municipalities are different, the medical insurance policies in various provinces and municipalities will be different.
Next, let's discuss two issues, namely, cross-regional settlement and cross-regional settlement. For the so-called cross-regional installation, the relevant medical insurance policies require that there be no more than three hospitals in the specified metropolis. The so-called cross-regional solution is in line with everyone's understanding. My medical insurance card can be applied to several provinces and regions all over the country, and at the same time, it will not be subject to regional hospitals and restrictions. From this point of view, it is very obvious that cross-regional settlement cannot meet the requirements of cross-regional settlement.
3. Solving difficulties across regions: To realize the cross-regional settlement encouraged by the medical insurance card, the most realistic problem is that, in view of the provinces with relatively high overall planning level, or in the provinces with similar socio-economic development, equity financing and treatment level, the difference in medical pressure among regions is inconspicuous, and the financial pressure is great. Although it has increased, it is not great.
However, there are great differences in social and economic development between different places and counties, especially between the two provinces. Because of the great differences in fund-raising ability and salary level, each province and city sets the deposit ratio and medical insurance reimbursement ratio according to its own situation, which may cause some insured people to be dissatisfied with the expense reimbursement system and increase the financial pressure of provinces and cities with low insurance standards.
at this time, there will be two situations: first, if the specification of the place to buy insurance is higher than that of the non-local clinic, the proportion of the insured's medical insurance reimbursement will be relatively reduced, and the insured is not satisfied with the conclusion of expense reimbursement; second, conversely, if the specification of the place to pay social security is smaller than that of the non-local address, the pension insurance cost of the non-local place will increase continuously.
From then on, it will be more difficult to adjust the medical insurance fund nationwide. In addition, the functions of local financial transfer payment bureaus are limited, which will expand the pressure difference between each place, and the pressure difference between urban and rural residents, households and new rural medical insurance will be significantly enlarged, resulting in more and more prominent medical insurance differences.
From the above analysis, it seems that China's medical insurance card is not suitable for cross-regional settlement in the coming year, and this current policy is not easy to achieve overnight. The main reason is that the overall planning level of medical insurance in China's provinces and cities is different, and the overall planning level of medical insurance in economically developed cities is also high, while the overall planning level of medical insurance in economically backward areas is low. Once the medical insurance card is settled across regions, it will also cause many problems.
Although there are some problems, how to finally solve this problem still needs our country to take the lead and find a region that is satisfactory to all provinces. Finally, I want to ask you, do you think I must apply cross-regional medical insurance card settlement?
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