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The author:(作者)hpmailerpublished in(发表于) 2013/11/19 11:38:17 Free medical care to reduce the scope of individual provinces
People: free medical care to reduce the scope of individual provinces
Expert: future healthcare workers, both urban and rural areas exist only module
Publicly funded health care system is gradually disappeared from the stage of history. The economic information newspaper recently learned from the Ministry of human resources and social security, and in some provinces this year cancelled a public medical care and national staff included in the basic medical insurance system for urban workers, free medical care has been reduced to individual provinces.
Experts believe that, at the third plenary session identified the integration of urban and rural residents of basic pension insurance, basic medical insurance system under the background of, currently running four sets of medical insurance system for workers, both urban and rural residents will be integrated modules.
At present, China's rural and urban medical insurance system has four main sets: the employee's basic medical insurance system, public health care, basic medical insurance system for urban residents and new-style rural cooperative medical care system. Among them, the institutions for free medical care and the treatment of urban employee basic medical insurance in payment and there is a big difference on both "combination" become important aspirations of that people.
As early as at the end of 1998, the State Council announced the decision on establishing the basic medical insurance system for urban employees, requires that towns all employers, including State-owned enterprises, agencies, institutions are required to take basic medical insurance, after which the health care is gradually becoming extinct. At the end of last year, Beijing, Chongqing, Shaanxi, Jilin, Zhejiang, Anhui, Fujian, Hunan, Guangxi, Sichuan, Xinjiang and other 24 provinces achieve the full medical insurance for urban workers basic old-age insurance of the civil service.
Institutions and fully implement the health insurance for urban employees "integration" has become an irresistible trend, simultaneously with the next, and the basic medical insurance system for urban residents and the integration of new-style rural cooperative medical care system. Has recently announced a comprehensive reform of the CPC Central Committee on several major issues identified in the decision, "the integration of urban and rural residents of basic endowment insurance, basic medical insurance system. ”
Chu Fuling, Director of China Research Center of the economic information daily reporter said that based on this vision, healthcare integration objectives of the future will be "+ employee's basic medical insurance system of urban and rural residents of basic medical insurance system" frame structure. Include the consolidation of public medical care for workers ' basic medical insurance system, basic medical insurance for urban residents and the integration of new rural cooperative medical care to rural and urban resident basic medical insurance system, landless farmers or their participation in trade unions or participating in basic medical insurance for urban and rural residents of basic medical insurance, does not establish a separate regime.
In specific operations, Chu Fuling recommendations to do draw the point of old and new is different from: always point to implement publicly funded volunteered for an informed choice whether to participate in the system of medical insurance for workers, after a certain point in the new employees ' medical insurance as required. Medical insurance benefits gap be addressed through the establishment of supplementary health insurance.
In addition, to achieve multiple payment and treated differently from. "After the consolidation of social medical insurance system covering urban and rural residents in urban and rural areas, due to the different urban and rural residents ' ability to pay, you can set different pay grades for the residents ' voluntary choice, but pay grade is not at the same time there are certain differences in treatment. "Chu Fuling further stated that the medical insurance payment at sight sight to enjoy treatment without accumulated interest, not with workers ' payment age limit for conversion.
Chu Fuling believes that integration if you follow this line of thinking, medical security system in China will eventually form four pillars: pillar I national basic health-care system for all citizens, based on Government subsidies and personal contribution, moderation of Pratt and Whitney national basic health-care system. The system special subsidy funds provided by the Government, reflect the Pratt and Whitney and equity. The second pillar is intended for employees and other workers employed in Government grant preferential taxation policy and fallback responsibility, equity and efficiency. Third pillar of medical needs for multiple levels of supplementary plan to social health insurance systems. Payment by individuals or units can be operated by commercial insurers or social security bodies, the Government has given policy guidance for, and efficiency. The fourth pillar system significant disease-oriented medical aid and contributions. Special funds established by the Government on major diseases to help.
人社部：公费医疗范围缩减至个别省份
专家：未来医保将仅存职工、城乡居民两大模块
公费医疗制度正逐渐退出历史舞台。《经济参考报》记者日前从人力资源和社会保障部了解到，今年又有部分省份取消了公费医疗制度并将国家工作人员纳入城镇职工基本医疗保险体系，公费医疗范围已经缩减至个别省份。
专家认为，在三中全会明确提出整合城乡居民基本养老保险制度、基本医疗保险制度的背景下，目前在运行的四套医保制度将被整合为职工、城乡居民两大模块。
目前，我国的城乡医疗保险制度主要有四套：职工基本医疗保险制度、机关事业单位公费医疗、城镇居民基本医疗保险制度和新型农村合作医疗制度。其中，因机关事业单位公费医疗和城镇职工基本医疗保险在缴费和待遇上存在较大差别，两者“并轨”成为民众一直以来的重要诉求。
早在1998年底，国务院公布《关于建立城镇职工基本医疗保险制度的决定》，要求城镇所有用人单位，包括国有企业、机关、事业单位都要参加基本医疗保险，此后，公费医疗就逐渐走向消亡。截至去年年底，已有北京、重庆、山西、吉林、浙江、安徽、福建、湖南、广西、四川、新疆等24省区市实现了公务员全部参保城镇职工基本养老保险。
机关事业单位和城镇职工完全实现医保“并轨”已是大势所趋，接下来与之同时进行的，还有城镇居民基本医疗保险制度和新型农村合作医疗制度的整合。近日公布的《中共中央关于全面深化改革若干重大问题的决定》明确提出，将“整合城乡居民基本养老保险制度、基本医疗保险制度。”
中国社会保障研究中心主任褚福灵对《经济参考报》记者表示，基于这一愿景，医保未来整合的目标将是“职工基本医疗保险制度+城乡居民基本医疗保险制度”的框架结构。包括将公费医疗制度整合为职工基本医疗保险；将城镇居民基本医疗保险与新型农村合作医疗整合为城乡居民基本医疗保险；征地农民或者参加职工基本医疗保险或者参加城乡居民基本医疗保险，不建立单独制度。
在具体操作上，褚福灵建议，要做到划清时点，新老有别：一定时点前实行公费制度的现职人员自愿选择是否参加职工医疗保险，一定时点后的新人按规定参加职工医疗保险。医疗保险待遇水平差距通过建立补充医疗保险加以解决。
此外，要实现多档缴费，待遇有别。“整合后的城乡居民社会医疗保险制度覆盖各类城乡居民，由于城乡居民的缴费能力不同，可以设置不同的缴费档次供居民自愿选择，但缴费档次不同时待遇上有一定差别。”褚福灵进一步表示，居民医疗保险应该即期缴费即期享受待遇，不累计权益，不与职工缴费年限进行折算。
褚福灵认为，如果按照这一思路进行整合，最终我国医疗保障体系将形成四大支柱：第一支柱面向全体公民的国民基本卫生保健制度，建立基于政府补贴与个人缴费的、适度普惠的国民基本卫生保健制度。该制度由政府提供专项补贴资金，体现普惠与公平。第二支柱面向职工及其他从业人员，政府给予税收优惠政策和承担兜底责任，体现公平与效率。第三支柱面向多层次医疗需求的大病补充医疗保险制度。由个人或者单位缴费，可以由商业保险公司或社会保险机构经办，政府给予政策引导，体现效率。第四支柱面向重大疾病患者的医疗救助与捐助制度。政府建立专项资金，对重大疾病患者给予救助。
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