1, medical insurance refers to social medical insurance. It is a social insurance system that meets the basic medical needs of the state and society according to laws and regulations when workers are sick.
2. 2065438+65438 in 2006+10/2. the State Council issued the Opinions on Integrating the Basic Medical Insurance System for Urban and Rural Residents to promote the integration of urban residents' medical insurance and the new rural cooperative medical system, and gradually establish a unified national medical insurance system for urban and rural residents. On February 20th, 2065438+0616, Ministry of Human Resources and Social Security held a video conference on the nationwide networking of basic medical insurance and direct settlement of medical treatment in different places, and signed letters of responsibility with the first batch of 22 provinces including Beijing, which applied for nationwide networking of basic medical insurance and direct settlement of medical treatment in different places, marking the formal implementation stage of direct settlement of medical treatment in different places. According to the statistical bulletin of June 20021year, the number of people participating in the national basic medical insurance in 2020 is 136 13 1 10,000, and the participation rate is stable at over 95%.
3. The basic medical insurance system in China adopts the mode of combining social pooling with individual accounts. The basic medical insurance fund shall, in principle, implement municipal co-ordination. The basic medical insurance covers all employers and their employees in cities and towns; All enterprises, state administrative organs, institutions and other units and their employees must fulfill the obligation to pay the basic medical insurance premium. At present, the employer's contribution ratio is about 6% of the total salary, and the individual contribution ratio is 2% of my salary. Part of the basic medical insurance premium paid by the unit is used to establish the overall fund, and part of it is included in the personal account; The basic medical insurance premiums paid by individuals are included in personal accounts. Pooling funds and individual accounts bear different responsibilities for payment of medical expenses. The overall fund is mainly used to pay for the hospitalization and outpatient treatment of some chronic diseases, and the overall fund has a minimum payment standard and a maximum payment limit; Personal accounts are mainly used to pay for general outpatient expenses.
4. In order to ensure that the insured employees enjoy basic medical services and effectively control the excessive growth of medical expenses, the China Municipal Government has strengthened the management of medical services, formulated the basic medical insurance drug list, diagnosis and treatment items and medical service facilities standards, provided qualified medical institutions and pharmacies with basic medical insurance services, and allowed the insured employees to choose independently. In line with the reform of the basic medical insurance system, the state has also promoted the reform of medical institutions and drug production and circulation systems. By establishing the competition mechanism between medical institutions and the market operation mechanism of drug production and circulation, we will strive to achieve the goal of "providing better medical services at lower cost". In addition to the basic medical insurance, large medical expenses mutual aid system is generally established in all localities to solve the medical expenses above the maximum payment limit of social pooling funds. The state has established a medical subsidy system for civil servants. Conditional enterprises can establish supplementary medical insurance for employees. The state will also gradually establish a social medical assistance system to provide basic medical security for the poor.
5. The reform of the basic medical insurance system in China has been steadily advanced, and the coverage of basic medical insurance has been continuously expanded. By the end of 20001,97% of cities and towns in China had started the reform of basic medical insurance, and 76.29 million employees had participated in the basic medical insurance. In addition, free medical care and other forms of medical security system have covered 1 100 million urban population, and China government is gradually bringing these people into the basic medical insurance system. 20 16 65438+ 10/2 the State Council issued "opinions on integrating the basic medical insurance system for urban and rural residents" to promote the integration of medical insurance for urban residents and the new rural cooperative medical system, and gradually establish a unified national medical insurance system for urban and rural residents.