According to the 20 19 national statistical bulletin on the development of medical security published by the National Medical Security Bureau, as of 20 19, the current balance of employee medical insurance pooling fund (including maternity insurance) was 206.6 billion yuan, the accumulated balance (including maternity insurance)1412.8 billion yuan, and the current balance of personal account was 65438 billion yuan.

However, the excessive precipitation of account funds leads to the inefficient use of funds, which is an important reason why medical insurance personal accounts have suffered many criticisms. Experts believe that in terms of vertical personal security, although personal account funds have been included, the cumulative effect is not obvious, and the accumulated balance of elderly insured persons is small, which has limited effect on outpatient expenses.

In terms of horizontal risk diversification, although there are a lot of deposits in personal account funds, they are mainly accumulated by young and healthy people. Because these people have little demand for medical treatment, they can only let funds accumulate in their accounts. Therefore, it is suggested that in the future, the proportion of fund transfer in medical insurance personal accounts can be further reduced and the scale of medical insurance personal accounts can be controlled and reduced.

Extended data:

"Weakening" personal accounts will not damage the level of protection.

For individual employees, after the implementation of this opinion, the outpatient economic security mechanism will be established and improved, and the outpatient expenses will be paid by the overall fund, with the payment ratio starting from 50%. At the same time, the scope of personal accounts will be expanded, so the "weakened" personal accounts will not have a negative impact on the security level of employees, but actually improve the security level.

Experts believe that the establishment and improvement of outpatient economic security mechanism is a long-simmering reform direction. Under the premise of not increasing the burden on enterprises and employees, by adjusting the fund structure, improving the payment method and the outpatient system, we can further play the strategic purchase function of medical insurance value, guide the allocation of medical resources and the behavior of both doctors and patients, promote the adjustment of medical service structure, improve the efficiency of fund use and reduce the medical burden on patients.

Based on the income of employee medical insurance fund in 20 19 years (overall fund 10005 billion yuan, personal account 584 billion yuan), it is roughly estimated that the overall fund will increase by about 200 billion yuan after the reform, which makes it possible to improve the security level of the insured and reduce the medical burden of patients.

CCTV-unit medical insurance payment no longer enters personal accounts, with accumulated balance exceeding 800 billion.