Early
Hunsheng Paper
"When is our turn? Seeing the disease is too tossing ..."
In the bustling waiting hall, an old aunt with a pale hair next to me, with a strong Northeast accent, and weakly asked the young people who accompanied her to see the doctor.
The first two days ago, a specialist clinic number was hung in a public hospital in Shanghai. It arrived according to the appointment time. The call screen on the wall showed that there were 20 people in front of me.
The waiting hall is squeezed, and there are no empty seats. Many people can only stand on the wall.Some anxious patients stood at the door of the clinic and kept asking whether they could let them see a doctor first.In order to prevent cutting in, the clinic is even equipped with a security guard who maintains order.The anxious air echoed the accent of the South China Sea, some spoke Shanghai dialect, some spoke Sichuan dialect, and some could not hear where it was dialect.
After waiting for two hours, I finally entered the clinic, but the previous patient was reluctant to leave.She and her family begged the doctor: "We came from outside, and finally made an appointment with your number. Can you prescribe medicine today?"
The doctor sighed: "I said all, your previous inspections were not standardized and could not be diagnosed. Now the person waiting for the inspection has been ranked next week.You can prescribe medicine. "
I am also a patient, I can feel the anxiety and helplessness of the patient, and understand the hard work and helplessness of the doctor. I have deepened why so many retirees have been deeply dissatisfied with the reform of medical insurance, so that I have to leave.Protest on the street.
China launched the reform of the personal account of employee's medical insurance more than two years ago. The core content of the reform was to transfer about half of the funds that were originally classified as the personal account to the coordinated account for the establishment of the general outpatient clinic coordination guarantee.
China Medical Insurance is composed of personal accounts and overall accounts.Personal account funds are dominated by individuals. They are mainly used in outpatient clinics to see minor illnesses and pharmacies to buy medicines. The coordinated accounts are managed by the government uniformly to reimburse the cost of hospitalization and diagnosis and treatment of major illnesses.After this round of reforms, the money scratched in personal accounts has become less, but the ordinary outpatient costs originally affordable by the individual can be reimbursed at a certain ratio.
Retirees with decreased wage income and increased medical expenditures have the most intense response to new medical insurance regulations.They are worried that the amount of funds used for daily medicine will become less, and it will take time to go to the hospital to see the clinic.Since the implementation of the new rules at the end of last year, from Guangzhou in the south to Wuhan in the central region, to Dalian in the northeast, a large number of retirees have gathered in front of government departments to protest and demanded that the official withdrawal of medical insurance reform measures.
After the protests, the government departments in many places have responded to civil doubts this month.The Official Media Economic Daily also published a review article entitled by the reform of personal accounts entitled by the medical insurance personal account on Tuesday (February 21), calling on the public to "calculate big accounts" and "long -term accounts" to treat medical insurance reform rationally.
The origin of the medical insurance system of Chinese employees has a certain relationship with Singapore.When China established a employee medical insurance system in 1998, it has learned that Singapore has established two sets of accounts and individuals.Such a design has made the medical insurance account more flexible, and it also increases the sense of acquisition of the insured, and effectively promote the smooth transition of China to the social insurance system from the public expenses and labor insurance medical systems to the social insurance system.
However, with the development of the times, the limitations of this system have gradually appeared.Taking Wuhan as an example, more than 60 % of personal account precipitation funds in the city are among young and healthy groups, and the personal accounts of elderly patients are not enough.To this end, more patients will choose to be hospitalized to obtain reimbursement when they are hospitalized and not hospitalized, further increasing the pressure of overall account expenditure.
Statistics show that in 2020, only six provinces and cities in China have surpluses, and the others are basically not available.Over the past three years, the aging population has intensified and epidemic prevention expenditure has increased significantly. Coupled with the economic downturn and the weak property market, the fiscal pressure of local governments has increasingly heavier.The medical insurance system will not be reformed, and it will face an unsustainable crisis.
The reform of medical insurance has to be issued as arrows on the string. The question is how to change it, how to change the public.From the current plan, the original intention of policy makers is that on the basis of not increasing medical insurance payment, the money settled in the personal account is replaced into the capital pool of the coordinated account, thereby improving the level of outpatient guarantee.
However, this complex reform plan did not attract widespread attention at the beginning of the formulation, and no strong publicity was seen before implementation.Until it landed quietly, the insured was surprised that the money in the personal account became less, and the new plan stirred a strong rebound in the people.
As the protests are growing, the National Medical Security Bureau announced last week that more qualified retail pharmacies will be included in the scope of reimbursement of the overall fund.This is the one of the dead sheep, but it also shows that the policy is not sufficient enough to investigate the time when planning, and the consideration before landing is not thoughtful enough.
How to establish a reasonable and sustainable medical insurance system is a common problem faced by countries around the world.Over the past 40 years, the Singapore medical insurance system has experienced at least five rounds of reforms, thereby achieving the purpose of gradually reducing the burden on patients and achieving lifelong protection.
For China with a huge volume, a large population, and a huge regional difference, the medical insurance reform process will only be more difficult, and the new policy will also face greater resistance when landing.This not only tests the determination of policy makers, but also the patience and perseverance of all parties.
