The Chinese Medical Insurance Bureau responded to the account entry and decreased: the

Residents in some cities in China have recently protested by the reduction of personal account funds on the reform of medical insurance. The China National Medical Insurance Administration explained to this.Coordinated reimbursement.Reform involves the adjustment of interests, and the funds that many insureds enter their personal accounts will decrease to varying degrees.In particular, considering the imbalance between the development of between various regions of China, there is a certain difference in medical insurance policies, and the Medical Insurance Bureau strives to handle the policy connection before and after the reform, and gradually achieve the reform goals.

According to a statement issued by the China National Medical Insurance Bureau's website in the form of question and answer, some places have promoted the reform of employee medical insurance clinics for the reform of the protection mechanism, which has aroused the attention of some people.Some people have doubts about the reduction of personal accounts for employees after the reform, and they have concerns about the convenience of seeking medical treatment after the reform.

In response to whether the balance of the balance in the personal account of the insured after the reform is generally concerned about the reform, the Medical Insurance Bureau said in the statement that this reform is under the premise that the social and individual burdens are not increased.Establish an overall reimbursement mechanism for general outpatient medical insurance for employees, and provide financial support for general outpatient reimbursement through the reduction of the payment of the unit's payment and the coordinated fund to be included in the personal account.The reform clearly requires that after the capital translation is all used in outpatient reimbursement, to meet the demand for the majority of insureds, especially retirees for reimbursement of ordinary outpatient costs, simply speaking, "treatment replacement, capital translation".

The adjustment of the personal account entry method, the guidance is clearly designed.Specifically, there are three main "unchanged" and two "adjustments".First, the ownership of personal accounts remains unchanged.The principal and interest of the personal account, whether it is the historical balance before the reform, or the newly divided into the balance after the reform, is still owned by individuals, and can still be transferred and inherited.Second, the proportion and flow of personal payment of employees are unchanged.The payment of personal medical insurance for employees is still fully included in personal accounts.Third, the policy that retirees do not pay.Retired personnel still do not need to pay, and personal account funds are still entered by the Medical Insurance Fund.

Two "adjustments" refer to the method of adjusting the personal accounts of working employees and retired employees in accordance with different methods.First, for the employees, before the reform, the source of the funding of the personal account consists of a part of the unit paid by the unit and the personal payment of the individual; after the reform, the individual payment is still all included in the personal account.Coordinating funds.Second, for retirees, before the reform, the funds of most of the monthly personal accounts of the personal account are "the actual number of personal pensions is issued in the standard";In the year, the average level of pensions in the reform of the year was divided into standards. "Among them, the reform standards after reform were reduced compared to before the reform.

The Medical Insurance Bureau pointed out that the core of this reform is to use the method of adjusting the personal account to "replace" the general outpatient clinic for reimbursement.Reform involves the adjustment of interests, and the funds that many insureds enter their personal accounts will decrease to varying degrees.In particular, considering the imbalance between the development of between various regions of China, there are certain differences in medical insurance policies, and the Medical Insurance Bureau has always adhered to steadily progress, strives to handle the policy connection before and after the reform, and gradually achieve the reform goals.

The Medical Insurance Bureau also introduced that the Chinese employee's medical insurance system was established in 1998, and a guarantee model of combining social overall planning and personal accounts was implemented.Specifically, the individual of the unit and employee pays together.Part of the unit's payment and the personal accounts of the employees are allocated into personal accounts, which are mainly used to ensure the cost of ordinary outpatient clinics and drug purchase.Another part of the unit's payment forms a coordinated fund, which is mainly used to ensure the hospitalization expenses of employees.This system played an important role in a specific historical period at that time, but with the huge changes in the economic and social economic and social over the past 20 years, the way of personal account risk and self -guarantee outpatient costs have become increasingly difficult to meet the needs of ensuring the health of the masses.The specific manifestations are "three unsuitable", one is not to adapt to the increasingly chronic disease spectrum; the other is to not adapt to the rapid progress of medical technology; and the third is that it is not suitable for China's aging development trend.

As for what are the considerations of the reform of this reform, the Medical Insurance Bureau said that the first is to pay attention to tilting to the sick people.The second is to pay attention to tilting to the elderly.

The Medical Insurance Bureau also pointed out that in order to reduce the burden of general outpatient costs that the masses reported strongly, not only need to establish a general outpatient reimbursement mechanism, but also require a series of systematic reforms to support each other.Medical insurance services, the third is to strengthen the supervision of medical price costs.

The General Office of the State Council of the State Council issued a guidance on the establishment and improvement of the basic medical insurance clinic guarantee mechanism for the establishment of a health -guarantee guarantee mechanism for the establishment of an outpatient protection system in the country.The core content of the reform is to transfer about half of the funds that were originally included in the personal account into a coordinated account for the establishment of the general outpatient clinic coordination guarantee, that is, the reduction of funds in the public's personal medical insurance account, and the increase in the reimbursement of ordinary outpatient clinics.

Hubei Wuhan has appeared in succession earlier this month to gather rights to protect their rights, protesting the reform of medical insurance, which led to a reduction in personal account funds, and once again attracted public opinion on the reform of medical insurance reform.