Medical network, June 20, the ministry of human resources and social security recently, according to data released by the end of 2016, China's urban employee basic medical insurance personal accounts accumulate 520 billion yuan, has doubled over the past four years. Some experts believe that a huge precipitation reflects the fund operation efficiency is not high, suggest to expand reasonable individual account pay limits, and gradually reduce until cancel unit delimit individual account funds.
The total income of urban basic medical insurance funds in 2016 was 1308.4 billion yuan, and expenditures totaled 1076.7 billion yuan, according to the 2016 statistical bulletin on the development of human resources and social security. At the end of the town's balance as a whole fund of insurance of primary medical treatment is 976.5 billion yuan RMB (including the balance of urban residents basic medical insurance fund is 199.3 billion yuan RMB), personal accounts accumulate 520 billion yuan. By the end of 2012, the personal account had accumulated 269.7 billion yuan. It also shows that the personal account has doubled in the past four years.
Our country town and town worker medical insurance adopts "unified account combination" pattern, namely, the social whole account and individual account make up. According to determine policy, 1998 units in accordance with about 6% of the wage payment, of which 30% delimit individual account, individuals according to 2% of salary payment, all included in the individual account. From around the practice, individual account closed management generally, pay for outpatient pharmacy to buy medicine and other pay below fees, health insurance as a whole fund to pay for medical expenses.
"On one side is facing in bottom risk as a whole fund, one side is a large number of" sleeping "individual account surplus funds, which restricted the healthy and sustainable development of the system of medical insurance for urban workers." Some experts argue that the large deposit of funds also reflects the low efficiency of funds. At the same time, the situation in social planning accounts is not optimistic, and some regions have already seen their current deficits go unsupported.
In fact, due to the constraints of the scope, some ginseng protect a worker individual account fund long-term precipitation, derived from the use of personal account to buy the drug even cash requirements, and health such as some retail pharmacies designated institutions cater to actively, to provide convenience for cash, and even formed a medicare card interests chain. The disclosure of audit from 2015 to 2016 in the first half of the medical insurance fund special audit, according to the results of 140 million yuan of medical insurance personal accounts are extracted cash or used to buy daily necessities, such as spending, involving 539 pharmacies.
To solve this problem, individual regions implement the personal account fund families, commercial health insurance products, and even allowed to use personal account funds for physical examination, buy health card and swimming card. The local policies and management of the personal accounts of health insurance are in turmoil.
"From a policy designed to speak, the individual account has the control function and accumulation function. Because in some areas of the provisions of the personal account is imperfect and so on, with a cost individual account fund, the use of personal account funds to buy daily necessities. There are also some personal accounts accumulate more, other people use the phenomenon such as individual account have enough money." Chu fuling, director of the social security research center at the central university of finance and economics, told the economic reference newspaper.
An analysis of the fairness and efficiency of a personal account has led to a social debate over the existence of individual accounts. Some experts believe that personal account on the system flaws, do not have risk dispersion function, the fairness and efficiency are questionable, high regulatory costs at the same time, the capital accumulation of waste and the recessive loss is higher, should fade and cancel out individual accounts.
There are also experts who believe there is still a need for personal accounts, although there is confusion in the local policies and management of individual accounts. Tsinghua university school of public management, employment and social security research center, Yang was professor in an interview with the economic information daily "reporter said, should expand the reasonable individual account pay limits, and gradually reduce until cancelled unit delimit individual account funds, wage increase about 2% of the total payment to enter society as a whole fund, in order to increase the ability of society as a whole fund to pay. She suggested to keep individual pay cost included in the policy of the personal account, in accordance with the law to pay limits, especially for the payment of the outpatient service family doctors and slow disease management service fees, or to participate in the long-term care insurance.
Chu also suggested that measures should be taken to regulate the use of policies in personal accounts and to enable family sharing of personal accounts. "Coming from pay-as-you-go, health care system in China was a percentage, regardless of outpatient or hospitalization expenses in outpatient costs surge. Only reimburse hospital since most of the region, leading to hospitalization rates rose sharply, overall rising health care costs. Therefore to set up individual account tube of outpatient service, as a whole fund pipe system in the hospital."
Tsu fu ling believes that if the individual accounts are cancelled, the cost of outpatient care will rise sharply. He suggested that the establishment of a unified outpatient outpatient service, such as the Beijing area, would be reimbursed for a certain percentage of outpatient visits, thereby mitigating the risk of the disease. It is also recommended that individual accounts be opened (directly to individuals), and individual accounts will be paid for themselves. "In this way, it is worth exploring the path of reform that will both reduce the cost of account management, control outpatient care costs, and be able to share the risk of large outpatient outpatient care costs." He said. |
