National Medical Insurance Administration: Currently, it is difficult to establish a unified standard subsidy for medical assistance | Medical Insurance | National
In response to the suggestion put forward by National People's Congress deputies to further increase support for poverty prevention monitoring targets, the National Medical Insurance Administration recently replied that it is currently difficult to establish unified medical assistance standards and financial burden ratios at the national level. The bureau will work with the Ministry of Finance to coordinate and increase the central government's investment in medical assistance subsidies, and support various regions in providing assistance for low-income rural populations to participate in insurance and direct assistance.
The central government's urban and rural resident medical insurance subsidy funds are currently allocated according to the factor method, providing preferential support to the central and western regions, with subsidy funds arranged at a ratio of 60% and 80%, respectively. The authority to formulate national basic standards for medical assistance and other difficult or temporarily ineligible conditions may be determined by local authorities based on actual conditions. Once conditions are met, the central government shall formulate national basic standards. The National Medical Insurance Administration stated that considering the objective differences in economic and social development levels, residents' difficulties, and assistance levels in various regions, and the incomplete standardization and scope of identifying assistance targets and other groups, it is currently difficult to establish a unified medical assistance standard and financial burden ratio at the national level.
The National Medical Insurance Administration stated that it is necessary to strengthen the comprehensive guarantee hierarchy of the three systems of basic medical insurance, major illness insurance, and medical assistance, reduce the burden, classify and optimize the policies for assisting disadvantaged groups in participating in insurance, improve the long-term mechanism for preventing and resolving poverty caused by illness, and gradually achieve the transition from centralized resource support for poverty alleviation to the normalized guarantee of the three systems. Last year, 25 provinces that originally undertook the task of poverty alleviation through medical insurance provided a total of 88.991 million rural low-income people with assistance to participate in insurance. The participation rate of poverty alleviation and rural low-income people remained stable at over 99%, basically achieving full coverage. The comprehensive guarantee policy of the triple system has benefited 145 million low-income rural residents in seeking medical treatment, helping to reduce the burden of medical expenses by 148.7 billion yuan.
Last year, the National Medical Insurance Administration, together with relevant departments, made overall arrangements to guard against the bottom line of large-scale poverty caused by illness. On the basis of classifying and ensuring the assistance and insurance of extremely poor individuals and subsistence allowance recipients, it is necessary to clarify the monitoring targets for preventing poverty return due to illness during the transition period, and guide various regions to improve the proactive detection, monitoring and warning, information dissemination, and collaborative assistance mechanisms for patients with high cost burdens. It is also necessary to improve the assistance mechanism based on application, timely include eligible monitoring targets for preventing poverty return into the scope of medical assistance, and work together to prevent the risk of returning to poverty due to illness. Overall, in the arrangement of transitional medical insurance assistance policies, measures such as classifying medical assistance to support participation and increasing preferential assistance have been taken to provide basic support for special disadvantaged groups. Medical insurance departments across the country timely implemented medical assistance for 216000 people last year.