(A) the lack of long-term linkage mechanism for the rising medical insurance costs of urban and rural residents.

The people don't understand the bid payment. For example, 202 1 medical insurance payment

Compared with 2022, the charging standard will be raised from 280 yuan to 320 yuan, and from 380 yuan to 420 yuan. The masses don't know why they want to raise their bids, and they don't know to what extent they will raise them next year. There is no clear source or reference for raising the payment standard, which leads to some urban and rural residents' doubts about participating in insurance and discourages the enthusiasm for payment.

(2) Some insured people have fluky psychology, which affects the participation rate.

Some insured residents are lucky in the center of the insurance payment process, and only pay for the elderly, children or people with physical diseases. Young people do not participate in the insurance, which leads to selective insurance and affects the participation rate. Example: There are four people in Li's family in Heping Village, Anle Town. Among them, there are two families of young adults over 40 years old who think they are young and strong. After repeated persuasion by the cadres of the town and village groups, they will not get sick and are unwilling to pay the fees.

(3) Overtreatment happens occasionally, and there is a risk of loss of medical insurance funds.

The management of designated medical institutions and pharmacies needs to be further standardized. Starting from their own interests, designated units carry out minor illnesses and excessive diagnosis and treatment through prescription, random inspection, selling high-priced drugs and charging fees, resulting in the loss of medical insurance funds and inefficient expenditure.

(d) The latest medical insurance payment system is not stable enough. Latest national

The medical insurance system has been implemented. First, the maintenance of the specialized personnel module is not timely enough, which leads to the current inability to participate in insurance smoothly, which affects the progress of insurance participation and increases the difficulty of grassroots work. Second, the unexpected failure of the medical insurance card system leads to untimely reimbursement, and the reimbursement procedures for the masses are cumbersome and inconvenient. Third, because of the complicated reimbursement procedures, it is difficult for patients to prepare all the information needed for reimbursement at one time. People in our town occasionally report that the process of reimbursement to the hospital is very complicated. For example, the medical insurance individual payment module for poor households, households easy to return to poverty and low-income households is still under maintenance, which leads to the lag and normal operation time of a large number of people going to the town medical insurance window consultation system. On the one hand, it causes people to run more, on the other hand, it increases the burden of repeated policy propaganda at the grassroots level.

Second, suggestions

(1) Establish a stable long-term mechanism for payment of medical insurance for urban and rural residents.

Referring to the operation mode of endowment insurance for urban and rural residents, it is suggested that the floating base of annual medical insurance premium payment standard should be determined according to the average wage of urban and rural residents to solve the problem of grassroots interpretation.

(2) Effectively strengthen the self-construction of medical insurance institutions and improve the management service level.

First, speed up the construction of medical insurance information system and improve the management level of medical insurance information.

The second is to strengthen the construction of agencies, enrich the medical insurance agencies, and get effective protection.

Work funds, strengthen staff training; Ensure efficient work and improve management level.

(three) to further strengthen the supervision of designated medical institutions to ensure the base.

Gold is safe.

First, improve the supervision mechanism and establish a credit rating and evaluation incentive mechanism.

Implement hierarchical dynamic management. Strictly manage the service agreement and implement the reward and punishment system.

(4) Effectively intensify publicity and strive to achieve full insurance coverage.

Villages and communities work together, make full use of all kinds of propaganda media, choose easy-to-understand propaganda methods, publicize the medical insurance policy in an all-round, multi-level and multi-channel way, and let cadres and the masses have a more comprehensive and accurate understanding of the policy through relevant business processes, so that the medical insurance policy will continue to be deeply rooted in the hearts of the people, and everyone in urban and rural areas will enjoy basic medical security.

(5) Establish and improve the information sharing platform, and smooth the coordination and communication mechanism between departments.

Popularize the "one-stop" method to facilitate the insured people.