Russia, the Czech medical insurance inspection report chapter 2

Payment methods: 1, as the employer contributions to all kinds of people, a monthly pay, that is, when receiving the payment of wages paid; 2, engaged in various business activities of the citizens, in accordance with the deadline for payment of personal income tax, personal computing and Income tax revenue base pay; 3, farmers, farms, northern minorities family Corporation, the annual payment of a 4, according to the employment contracts of other citizens of natural persons, the monthly payment last month on the 5th of contributions; 5, the executive arm of the regime On the 25th of the month before, according to no less than the relevant provisions in the budget for the project quarter of the total funds 1 / 3, allocated for non-residents of the mandatory medical insurance contributions. 6, the disabled, retirees create the enterprises and organizations or persons with disabilities, the number of retirees over 50 percent of the enterprises and organizations can be exempted from the compulsory medical insurance. Governance systems: 1, the national health management organizations. Russian reform from the beginning of the retention of the health care management organizations. Although the law does not clearly defined, but the information shows that national health authorities of the functions of governance is: fulfill their supervisory functions, responsible for the formulation and implementation of many of targeted Government Program. 2, medical insurance companies. Perform the functions of an insurer, is not subject to health care management organizations and medical institutions dominated by the main independent operators. And as the insured enterprises and the state medical insurance management agencies signed the contract, the right to choose for the insurers to provide health services in medical institutions and medical institutions to pay medical expenses. Can represent the interests of the insured for health care provided by the medical service quality inspection and supervision. 3, compulsory medical insurance Foundation. Russian government originally planned for completion in 1992-1993 to the medical insurance system for the transition. As at the local medical insurance companies and hampered the development of slow and uneven, delayed down. In order to promote compulsory medical insurance system for the establishment, in April 1993 adopted the "on the establishment of federal and local Foundation for the compulsory health insurance provisions." Mandatory medical insurance funds and its affiliates can not only be authorized with the medical insurance company medical insurance contracts signed, and their insurers can also perform the functions and in their operational activities exempt from income tax, and insurance companies are not the Concessions. Its main function is responsible for the compulsory medical insurance fund raising, distribution and use, and to monitor and control medical insurance companies and medical institutions operational activities. Medical treatment: Russia on the whole of the former Soviet Union to continue the policy of free medical care, their medical insurance covers the majority of the common diseases of essential drugs, clinics and hospital fees. Each insured person in public medical institutions in the region a doctor, simply to produce medical insurance card or tell their card number, in addition to the individual pays part of medicine, other medical expenses from medical institutions and insurance companies settlement. In addition, the Government also encourages high-income class to join the voluntary supplementary medical insurance, compulsory health insurance outside to enjoy better drugs and treatment services, prices Suihangjiushi.

Comments on various medical model

In the United Kingdom, the hospital is a national, state hospitals for the full grant, the doctor is the country's civil servants, belonging to the civil service system, the people directly to the hospital doctor. Comments: China has traversed the system, but the enthusiasm of the doctors is a problem, doctors may be argued that the provision of services and their income does not closely related. Not enough incentive mechanism, to provide the services they may not. If it is on the market, it has anti-incentive mechanisms, namely the excessive services. How to balance these two methods is a very difficult problem. In Canada, public hospitals can also be a private, the patient's doctor reimbursement by the Government pay, but patients have to pay very high taxes and fees. Comments: Canadians love this system, they are willing to pay such high taxes, because they have a good social security system. In the United States, the U.S. health care system is a very high level of the market, of which 70 percent of the service is completely on the market, the Government's commitment to less than 20 per cent, the Government's commitment to the elderly and the poor medical liability, 10 percent There is no medical insurance. But the United States is very expensive health care costs, U.S. per-capita medical expenses are more than 5,000 U.S. dollars each year. Comments: American model that we can learn many things, but we have to consider the cost of medical care. China's per capita GDP of less than 1,000 U.S. dollars, we still a developing country, in such a low-income level, we can not bear this cost since become the biggest problem. In Hong Kong, China, the hospital put the burden entirely by the Government, but the Government's annual investment of 85% of the money is used for the wages of doctors and nurses, operating costs accounted for less than 15 percent. Hospital doctors and nurses are civil servants, Hong Kong's public hospitals throughout the market share of the medical service market more than 95 percent, the proportion of private hospitals is very small, the hospital is all the countries, but governance is the management company. Comments: Hong Kong, China, the model has its advantages, but remarkable is that the doctors they are to profit approach, the patient is in trouble. Mainland China has an advantage, human capital is less expensive, the cost of training doctors is relatively low, the cost of hiring doctors is not high. Another advantage is that a very large volume of patients, from economies of scale, the quantities sufficient to reduce costs. Mainland China should find a suitable model, a model copied there will be any problems.

Russia, the Czech medical insurance inspection report chapter 1

June 18, 2006 to 27, by the Insurance Institute of China's social medical insurance branch of the medical insurance organizations delegation visited the 10 people invited to Russia, the Czech Republic. , Respectively, visited the All-Russian Insurance Association and the Social Insurance Foundation, the Russian Federation and the St. Petersburg branch of the Czech Economic Chamber of Commerce, and other units, listen to the people on the two parties responsible for the medical insurance system established, management and operation, such as the introduction. Will now briefly report are as follows: First, the basic medical insurance in Russia (A) Background The Russian Federation by the Federation composed of 89, including 21 Republic, 6 Krai, 49 states, two federal and municipalities, an autonomous prefectures and 10 ethnic autonomous regions. Current population of 145 million, more than 130 nationalities, including Russians accounted for 82.95 percent. Mainly to the Orthodox religion. In 2004, the GDP growth rate of 7.1 percent, per capita 115,556 rubles (about 4,444 U.S. dollars), per capita monthly wage 6828 rubles (about 263 U.S. dollars). Soviet-era practice of the universal free health care system, medical expenses solely by the State Commission package, not the individual burden of medical costs, full funding from the State budget allocated. At that time, although the number of doctors and hospital beds have both of the world's pre-bit, but at a height of the planned economic system, due to a serious shortage of medical costs, resulting in poor conditions based on medical institutions, medical equipment behind, the lack of enthusiasm for health care workers, not a sense of responsibility Strong, medicines and medical equipment and wasted. Ordinary people to the hospital to wait for long queues, lack of efficacy of high-quality drugs or no. (B) reform Russian existing medical security system to the main statutory health insurance, private medical insurance supplement. The main legal basis for the June 1991 promulgated the "citizens of the Russian Federation health insurance law" and in 1996 the State Duma adopted by the residents of the mandatory health insurance law. Basic principles: 1, compulsory and voluntary health insurance as medical insurance payment the main source of funding, 2, employees of the compulsory medical insurance payment from the enterprise, rather than employment and employees within the budget of the compulsory medical insurance from budget Pay; 3, a mandatory medical insurance coverage provided free medical services in the amount and conditions, all localities based on the approval of the compulsory medical insurance and the basic outline of the local organs of power through the concrete implementation of the Platform for Local 4, Action by non-medical insurance business The commitment of state-owned insurance companies, 5, in addition to compulsory medical insurance, can enterprises and individual citizens pay an additional fee implementation of the voluntary medical insurance. The establishment of the Fund: According to the "citizens of the Russian Federation health insurance law", the establishment of mandatory medical insurance fund, the purpose is to guarantee Russian citizens have the same medical conditions and medicines to help protect citizens enjoy free medical help. Fund fall into two categories: 1, the federal compulsory medical insurance fund. Its main role is to allocate funds in the form of grants, the Russian region of the mandatory medical insurance funds outline the conditions for balance. In recent years, the expenditure of federal funds, about 85 percent of the region are used to fund the grants. 2, in compulsory medical insurance fund. Its main role is to ensure financial resources from all regions of the medical insurance system for normal operation. Fund Source: 1, enterprises, organizations and other insurance units to pay the compulsory health insurance, wage rates-based units of the total 3.6 percent, 0.2 percent turned over to federal funds, 3.4 percent turned over to local funds.

China-EU cooperation in social security pilot project launched in Hunan

vYesterday (23), social security cooperation in Central Hunan pilot project launching ceremony held in Changsha, Hunan Province this marks the China-EU cooperation in social security work of the pilot project officially entered the implementation stage. According to reports, China-EU cooperation projects in the social security on April 1, 2006 officially started, and the Chinese Government and the European Union in the field of social protection of the most content, the biggest investment (total budget of 40 million euros), the longest ( 2006-2010) international cooperation projects. Clearly at the launching ceremony of the pilot project in Hunan, including five aspects: First, insurance agencies to enhance the quality of staff; second is to improve the social insurance agencies at all levels, "five-one-risk insurance levy" - the ability of business The third is to improve the streets of community-based platform for the management of labor and social security services; four - that regulate the business processes, unify technical standards for handling work; five enterprises is the basic old-age insurance information system building. She Baoju Province Chen Fan Xun at the ceremony that the European modern social security system as the birthplace of both the social security system mode, or management ideas, techniques, we have much to learn from the place. We should make full use of the limited resources of pilot projects and favorable opportunity to humbly learn the advanced experience of the European Union, management ideas and techniques, and constantly improve the social insurance agencies in implementation capacity and service capability, social security for our province to provide a more objective body Quality services.

How to see a doctor in New Zealand

"Community Service Card" also known as "poor card", Pingci card to see the family doctor (GP), the registration fee can reduce 18 yuan. (See GP of the registration fee of about 40 to 45 Niubi ranging from 18 yuan cut after some of their own to), and Pingci card to buy prescription drugs also have concessions (see "Looking After Your Health"). The proposed new immigrants as soon as possible after landing and Community Services Card Helpline (0800-999-999) linked to apply for the card (about conditions in the past 12 months Niubi income of less than 30,000, mostly friends arrived to meet this condition it) . We came three months before to apply, get the card before the medical spending can not be payback. Public hospitals in the Waiting List is indeed a problem. Generally speaking if many patients receiving treatment at the same time and not enough resources allocated, then the priority was seriously ill. For Emergency, GP can be seen immediately after you recommend to the public hospitals. It is said that GP with a confirmation letter to the general public hospital emergency room can be treated. Indeed there are many cases waiting too long delayed because of the treatment, but here is a subjective dynamic factors. If the disease themselves very hard without Hangsheng, such as otitis media may have a perforated ear. Hospital Waiting to the notice will be referred to "the waiting period if the conditions change, or you are not satisfied Priority Given to promptly contact your GP" is to remind you to be proactive. Listen to a public hospital nurses for the friend said, once to hospital treatment, or fairly good conditions: Baochibaozhu free of charge, a 24-hour nurses serve, live in the wards are clean, television, on the 1st Three meals a day, food can not complain about it, there are a stuffy nurses, volunteers Peiliao). If the day-to-day had a small headache illnesses such as colds, can go to the street pharmacy, the supermarket to buy a lot of common non-prescription drugs. Auckland also in Chinese medicine clinics and pharmacies to buy the majority of traditional Chinese medicine (animal products such as Chinese caterpillar fungus, cattle pulp, except such as tiger penis). If a lot of accident injuries how to do » This can be by the Government funds the operation of the "Accident Rehabilitation and Compensation" (ACC) plans to address. New immigrants and even temporary Visitor and New Zealand citizens can also, when injured in the accident can enjoy 24 - hour, no-fault cover by ACC. I am the landlord of a sprain of the lumbar do not care for the majority of ACC claims for medical treatment, sick leave during the loss of working income to compensate (Xiangjian "Looking After For Your Health"). To buy medical insurance is a good programme. According to the old immigration proposal if no major physical illnesses, in order to save money, the poor have no cards to buy medical insurance. But if bought medical insurance and medical treatment to private hospitals can and do not have to queue up and wait, better services. Insurance companies to help you will cost you to buy insurance plans vary. Some companies have medical insurance as one of the benefits, or employees and their families can enjoy the Group Discount purchase of medical insurance. I bought a Southern-Scross the Regular Plus plan, insurance premiums, the two weekly 24 yuan, basically cover all medical expenses ( Except for dental). But did not read the first few months since the illnesses, the Preparatory Tuidiao. Asian immigrants of medical problems. Many Asian immigrants because of language barriers, had illnesses are often unwilling to see a doctor, some people simply return to treatment. Recent local newspaper reports this situation and the establishment of a related organization, seeks to more Asian immigrants into New Zealand's medical security system. I have a hands by the Auckland Chinese Medical Association, finishing proficient in Chinese list of family doctors, including Auckland, all registered Chinese medical practitioners name, address, telephone, the region, proficient in language and other information. If flu-loving friends, please inform, after over to the CAB can also be found. Referred to CAB, the way for everyone to tell us about this important source of information agencies - the Citizens Advisory Board (CAB). CAB's purpose is "to ensure that everyone will not do not know their rights and obligations or the availability of services or can not effectively express their needs and losses." There are always people in need of help when. If new immigrants in the life of any difficulties encountered in need of help, CAB that you can provide free and confidential counselling services. Many areas of the CAB also has the obligation to read Chinese consultants. CAB services include: personal and family matters of concern, consumer issues, legal issues, employment issues, family budget, health, social welfare, family housing, education and vocational training, transport and travel, as well as local and general information . CAB in the next general have libraries, new immigrants should make good use of the information resources. Enthusiasm, the Chinese understand the obligations to consultants to Pottinger to the beginning of the new immigrants in the country to train much on the outside 'warm' hotels, restaurants Rapporteur on the reception and was Zaike fear. In fact, most of the volunteers into the New Zealand Government's welfare system operational system. For example, you receive the relief, or from students allowance (no payback, is not a student loan), you are obliged to do a week of volunteer time. Therefore, do not have to doubt their sincerity, do not have people are not accustomed to the warm and thoughtful. Each CAB's' leadership 'in general or the community well known, is itself in some governments, courts and other departments for decades retired JP (JP), in the CAB can be done to the various documents notarized. For example, in New Zealand and you have to link all types of institutions, if you are not personally (in person) to you the various documents such as passports, visas, Axalto transcripts, diplomas and other qualifications received various school authorities, , You have to JP to do to you these documents notarized, certified copy of the original match, you can apply by writing letters. This two-day New Zealand, local newspapers, radio, television and other media focus in the discussion of a government policy change. The Government will improve community services card (Community Service Card) for the eligible limits. This means that about 50,000 are eligible for the last card of community service work in New Zealand low-income people will miss the opportunity of cheap medical care, see a doctor about to be cancelled and Nayao of government subsidies. At the same time, and these low-income people is the social benefits and pensioners can still get the community services card. Opponents believe that this is a disguised form of relief and encourage those who receive benefits live in the community who continue to act as the 'parasites' and not to contribute to society and serve the community. New Zealand Green Party criticized the move is very 'totally unfair' conduct.

Britain Medicare reform: the introduction of the internal market mechanism

Britain's medical security system, also known as the National Health Service system (NationalHealthService, NHS), a typical universal health care system, is famous in 1942 on the basis of the Beveridge report, based on the British "National Health Services Act" in 1948 Built up. 1991 John Major administration, to the Thatcher's reform ideas, according to the U.S. more than TU, Professor of recommendations to improve patient rights and economic efficiency, universal health insurance system for fundamental changes: the introduction of the internal market mechanism . The reform adhere to the "basis for a general tax revenue, the Government allocated budget, the whole society to provide free medical services nationals" principle, while the introduction of competition principles into the internal market (analog), the realization of the medical services in the "money follow the patient Walk ". In the internal market, the NHS will be divided into buyers and providers. The original relevant national medical institutions of governance has become the purchase of medical services, responsible for the medical needs of residents, on behalf of the state and service providers entered into the contract took the form of purchasing services, hospital treatment and no longer exercise the functions and perform the function of providing services . And the only provider through the provision of more and better than any other competitor, even cheaper service, after fierce competition, access to the purchase of the contract, to obtain the funds to continue operating. 1993, the Government of John Major NHS was reorganized, the district health and family medical services merger, on the one hand to simplify management responsibilities, reduce management costs, on the other hand, maintain the primary and secondary health care services consistency. Centre to strengthen the control of the Government of the market. In 1991 the results of the reform is very positive: 1. Reform has brought significant efficiency gains. After four years of reform, improve the efficiency of 1 percent. 2. The cost of treatment greatly improve the information disclosure. Patients and their agents of the available information more fully, forcing providers to efforts to reduce costs, thereby greatly improving the efficiency of the use of health resources. 3. With the average waiting time was shorter, satisfaction increased. But also exposed to repeat the purchase of medical equipment and management costs increased, and so the new issues. December 1997, the Blair government published its reform and a programmatic document - the White Paper "The new National Health Service" (NewNHS), including: 1. Increase in health funding sources. 2. Clearly the rights of patients and improve the evaluation index. 3. Service efficiency and quality: In order to improve efficiency and service quality, set up two new bodies. 4. Reform of the internal market, agent and planning mechanisms. 5. Lower treatment costs. 6. The establishment of regional health services. It is clear that the Blair government's Medicare reform is obvious areas of Western European left-wing "third way" of color, efficiency and equity in more emphasis on social solidarity, at the same time, moderate the absorption of the Conservative government to improve the efficiency of the reasonable initiatives.

Netherlands Medicare reform: the rights guaranteed universal health care

Dutch medical security system to develop and improve in the early 20th century. 1941, the promulgation of the Basic Law medical protection, marking a modern society medical protection mechanism in the Netherlands formally established. The mid-1990s, in the new centre-left coalition government - a coalition government under the leadership of purple, the Netherlands good economic development momentum, which provided for Medicare reform and liberal economic environment. 1994, the new government in德克尔西蒙on the basis of a larger plan changes, the continued implementation of two major reform initiatives: First, to the reunification of the country, a wide range of complex health security system replace the existing division of serious financing System, to ensure that the rights of the people for medical treatment, the national health insurance for the tax base from income to the taxation of funds received by the statutory bodies governance. The second is in the insurance agencies and service providers are among the introduction of competition in governance, to improve efficiency. Government to relax the price level of control and hospitals to provide insurance funds more freedom, and service providers to sign the treaty, consultation fees. A good state of the economy with, in the Netherlands should be good prospects for health reform: in the complex, the institutional framework for privatization obviously lower body show the country some inequality overall balance.

France: medical insurance is unique

French implementation of a social insurance system, medical insurance, endowment insurance and family insurance subsidies is the French general insurance, these social insurance is mandatory in France, all of the country's employment must be insured. Medical insurance is a national social insurance system as an integral part. In France, access to health insurance, annual working hours shall not be less than a month. Illness in six months, must be confirmed in the first three months of work have at least 200 hours, more than six months, have confirmed that the disease 12 months ago to work at least 800 hours, of which the first three months to work for 200 hours . Living in France but not in line with the general social insurance provisions may take part in the individual insurance, to pay an annual insurance payment, reimbursement of medical expenses under the provision. All of the following can be reimbursed for medical expenses: because of injuries or occupational diseases hospital; enjoy Canfeijunren grants; enjoy social insurance chronic disease patients in extraordinary education or vocational training centres of life of disabled young people since the first 31 days since hospitalization ; The diagnosis and treatment of infertility; pregnant women since the first six months of starting treatment for children with disabilities; babies were born within 30 days after treatment; fill shape, orthopaedic equipment; died of cancer and other diseases; organized Diagnosis; elderly people aged over 70 were given influenza vaccination, and so on. However, a blue marker drugs (not shown in the insurance drugs) can only be reimbursed 35 percent of all the other drugs claims. The hospital provides 80 percent of hospital costs reimbursed, the hospital provides medical and dental clinic for the reimbursement of 70 percent, commonly used drugs and vaccines used to prevent 65 percent, laboratory fees at 60 percent, insurance is not included in urgent need of medicine at 35 percent, but no Alternative medicine expensive drugs can be reimbursed 100 percent. The drug, the French have a strict governance, the French authorities has formulated strict distinction between general medicine and nutrition to define the limits of medicine, pharmacy in the sale are clear signs, manufacturers of packaging drugs in the printed on white and blue markers to Distinguished. Sales at pharmacies open documents also clearly marked by the sale of the types of drugs to control medical expenses reimbursed. Although the people to participate in medical insurance only for medical expenses and reimbursement of some drugs, if patients also participated in other non-mandatory professional insurance, may be reimbursed the remaining part. In France, the medical insurance system, an advisory body of medical services, the main task is to study compensation for the rights of patients and identification of medical capability and level of participation and control medical costs and other expenses. This system set up by three organizations, national health insurance Foundation, set up a medical consultant, the region has 17 regional medical consultant, the relative independence of the most basic level, while the leadership of the Board of Trustees. There are two major tasks of medical consultants, the first medical community to identify the second is the community to identify public health, is mainly directed against hospitals and other health care entities. French medical insurance funds come mainly from the members of society to impose the mandatory social insurance payments. French social insurance funds equivalent to the total amount of the total wages of 36.5 percent, of which medical insurance accounted for 19.6 percent of total wages around. Medical insurance with other insurance, and workers from enterprises to be prorated: enterprises by 12.8 per cent of total wages paid, the workers wages deducted from 6.8 percent.

Interpretation of demobilization medical insurance policies for demobilized soldiers how medical insurance

Q: not insured enterprises demobilization demobilized soldiers how to handle medical insurance »

A: According to "enterprises in Shenyang City on the demobilization of demobilized soldiers to participate in the basic medical insurance issues related to notice" (Shen Lao She, [2003] 33), the Shenyang city and municipal enterprises following the founding of the former military retirement demobilized soldiers, the demobilized army division Cadres, December 31, 1953-retirement to join the military and military cadres transferred to civilian jobs, collectively, the "demobilization of demobilized soldiers."

(A) of the insurance business before the founding of retired army demobilized soldiers, the military division level cadres transferred to civilian jobs, December 31, 1953-retirement to join the military, each of the individual medical insurance premiums paid large sums of grant 30 yuan. By the enterprises or their competent authorities reportedly demobilized cadres in some enterprises, and other aspects of the office staff with the relevant departments to identify qualified, to City Center for Medicare enrollment procedures, due to bankruptcies, closures or other reasons since the Consumers eliminate the above-mentioned enterprises, Management took its files for qualification and enrollment procedures.

(B) not insured enterprises demobilized military cadres, the cadres in some enterprises such as demobilized army officers in that office with the relevant departments, enterprises from the "Shenyang basic medical insurance for urban workers" ([2001] 5 municipal government orders ), For serving and retired cadres transferred to civilian jobs for enrollment procedures, to pay medical insurance premiums. Due to inability to solve the special difficulties of enterprises, some enterprises at the same level each year by the demobilized army cadres and other personnel in the office with the relevant departments to co-found, at the same level of medical insurance premiums from the financial sector to solve.

Q: because of bankruptcy, restructuring of enterprises and merged the lifting of labor relations for the demobilized army cadres how medical insurance »

A: The five accounts in the city, Dongling District, Yu Hong areas receiving unemployment payments have not been re-employment upon the expiry of the above-mentioned persons to participate in medical insurance, I have to apply and fill out the "demobilized cadres to participate in the basic medical insurance that," and the Accounts of the District agreed to file insurance department, identified as Jun Zhuanban City, the municipal agent for the Center for unified payment and insurance information to change procedures. Have not yet retired for the above-mentioned procedures according to individual staff members on the city's annual average wage workers, pay 2 percent of the basic medical insurance (ratio of flats to pay 8%), retired personnel of the non-payment of the basic medical insurance premiums. While participating in the basic medical insurance, we must also participate in the large medical expenses supplement insurance, the standard fee per person per year (including retirees) 60 yuan, all units and individuals to pay 30 yuan. Should be above personal commitment to the health insurance agent in charge of the municipal levy. Payment of the units from the accounts of the district financial commitment. Medicare Advisory Tel: 12333 this reporter Liu Jia

Strengthening the basic medical insurance for urban residents measures

The basic medical insurance for urban residents medical services management, including the scope of medical services management, medical services and medical cost management sentinel billing management.

To co-ordinate the establishment of serious illness mainly of the basic medical insurance for urban residents is to implement the people-centered scientific concept of development and building a socialist harmonious society important initiatives. Strengthen and improve the management of medical services, the protection of medical insurance and reasonable rights and interests of residents, standardize medical services, control medical costs, improve medical efficiency in the use of insurance funds to ensure the smooth operation of the system is of great significance. All relevant departments at all levels should closely cooperate in the basic medical insurance for urban residents in the experimental work, strengthen the basic medical insurance for urban residents medical services
Management, the effective protection of vast numbers of participants the basic medical needs of residents.

1, in the light of the basic medical insurance for urban workers, medical services management of the relevant provisions in light of the characteristics of urban residents, improve the basic medical insurance medical services management of the relevant policies. The basic medical insurance for urban residents and the new rural cooperative medical practice management integration, but also can refer to the new rural cooperative medical care of the medical management of the regulations. All localities should in accordance with relevant state regulations and the spirit of this advice, according to local conditions, and actively explore strengthening the basic medical insurance for urban residents medical services management of specific measures.

Second, all localities should improve the basic medical insurance administration, clinics and medical service facilities project management, to strengthen high-priced drugs, new clinics, large medical equipment checks and medical supplies high-value access to and use of management, control medical costs, Improve the basic medical insurance for urban residents efficiency in the use of funds, reduce the urban residents in the basic medical insurance fund and the cost burden on the participants.

Third, the basic medical insurance for urban residents designated medical institutions and the implementation of sentinel retail pharmacy management. Specific management measures in accordance with the basic medical insurance for urban workers designated medical institutions designated retail pharmacy management and the relevant regulations. According to the medical treatment of urban residents characteristics and needs further refinement and improvement of designated medical management services agreement, give full play to the basic medical insurance for medical services bound by the role. According to the medical security system coordinated development of the need to co-ordinate all types of medical protection groups identified medical services sentinel management methods and measures.

4, rationally determine the designated medical institutions and retail pharmacies the scope and number of specific departments from throughout the labor and social security to health, Chinese medicine Food and Drug Administration and regulatory authorities identified. Enrollment residents in the designated medical institutions and retail pharmacies filled by the medical treatment of the costs incurred by the medical insurance fund to be paid in accordance with the regulations. According to participants throughout the medical needs of residents, will meet the conditions of maternity hospitals, maternal and child health care centres, children's hospitals and community health service institutions into the fixed-point range.

5, to explore the participants to promote rational use of medical services residents resource management mechanism, and guide participants residents make full use of community health services, primary health care institutions to provide medical services and Chinese medicine services and explore ways of establishing two-way referral mechanisms. Into the fund to pay for out-patient medical costs of serious illness and co-ordinate the general out-patient medical services, to develop effective use of community and primary health care services for medical treatment and medical management approach to clearing costs. Residents of the participants in the designated community health service organizations and grass-roots medical institutions for medical treatment costs, to increase the proportion of the payment.

6, according to medical services and funding levels, and establish and perfect the basic medical insurance costs of clearing, settlement and reasonable medical expenses set standards and into the management agreement. To meet the medical expenses, according to the agreement in full and timely billing and payment, do not meet the medical expenses not paid.

7, and actively explore the medical insurance agencies designated medical institutions and medical consultation services to the billing method and standards. Actively explore the kinds of payment, such as the amount of prepaid billing method, the designated medical institutions to mobilize the initiative to participate in the management and reduce the cost of medical services initiative.

Not included in the basic medical insurance for urban residents will enjoy medical insurance

To the crowd: universal coverage





As long as they are residents of Guangzhou, where workers health insurance and flexible employment outside of Medicare, can be insured.

● city primary and secondary schools, various colleges and universities, secondary vocational technical schools and technical schools students studying full-time (hereinafter referred to collectively as "students at school")

● urban household registration with the city residents of the following: pre-school children under 16 years old and the other non-school personnel (hereinafter referred to collectively as "minor");

● men and the age of 16 years to 60-year-old woman the age of 16 years to 55-year-old non-employees (collectively, the "employment of non-residents");

● men aged 60 and above, women over the age of 55-year-old, can not enjoy the monthly pension treatment of staff ( "elderly residents")

(With the Guangzhou school students on the trip, even if it is suspended, can pay according to participants)



Payment standards: the participants were government-funded



According to reports, in view of residents to participate in medical insurance personnel are no income groups, therefore, the city medical insurance for urban residents to take individual contribution and all levels of government subsidies to raise funds.

● minors and students in the school's standard fee of 100 yuan / person-years, of which, by individuals to pay 20 yuan / person-years, all levels of government-funded 80 yuan / person-years;

● non-residents of the payment industry standard of 600 yuan / person-years, of which, by individuals to pay 550 yuan / person-years, all levels of government-funded 50 yuan / person-years;

● elderly residents of the standard fee of 800 yuan / person-years, of which, by individuals to pay 300 yuan / person-years, all levels of government-funded 500 yuan / person-years.

(Residents medical insurance will pay the standard annual one-time charge in full. Additional staff should be on an annual enrollment fee residents pay standard medical insurance. The targets included ensuring minimum living, low-income families, severe disability minors Years, the loss of working ability of people with severe, personal medical residents should pay the insurance premiums from the Government to set up a social medical aid to pay the subsidies. Practitioners to guide non-residents as full employment, payment of government subsidies to its less. But For that and other reasons can not be physically employment, a heavy burden of medical expenses, medical aid funds from the community to resolve.)



Registered participants: to encourage the participants



According to the draft of the settings, all types of residents who wish to join the staff needed medical insurance to the relevant agencies for participants to register.

● the first time for residents to participate in medical insurance should carry valid identification cards and social insurance agencies the information requested, to nurseries in the minors, in the corresponding school students from schools or nurseries in the area to the location of the Social Insurance Fund Management Centre for enrollment registration procedures;

● other residents to the streets of Labor and Social Security services for participants registered. Follow-up years, residents have joined the medical insurance in the new year without re-enrollment registration procedures, the residents of automatic renewal of relations between the medical insurance; need to change the enrollment information or to stop residents to participate in medical insurance, from nurseries in schools Or individual participants back to the original registration department.

(Each insured person has a health insurance card in hand, the health insurance Pingka to enjoy medical insurance institutions designated treatment, but medical insurance for urban residents did not have a personal account, that is, health insurance card does not have money)



Treatment of participants: students can enjoy out-patient treatment



● beginning and end: medical insurance to residents of that year on October 1 to September 30 the following year for an insurance year. Participants from the payment of the corresponding year, began to enjoy the medical insurance benefits; payment of the new year did not stop to enjoy the corresponding year of medical insurance benefits.

Newborns at birth within three months after the payment procedures for participants, from the time of birth began to enjoy the appropriate medical treatment for more than three participants on the procedures for payment from the payment of the corresponding month began to enjoy medical treatment.

● enjoy: the participants, including staff enjoy diseases, accidents and family planning policies and regulations in line with the termination of pregnancy or childbirth-patient, out-patient specific projects and specific medical treatment of chronic diseases such as the content. In addition, minors and school students also enjoy the general out-patient medical treatment.

(Enrollment management and staff of the medical expenses for medical treatment billing, payment methods, in accordance with the city of basic medical insurance for urban workers of the relevant regulations.)



Limit standards: Annual up to 72,648 yuan



Residents of the medical insurance fund to pay the basic medical insurance costs of the scope of the city in accordance with the basic medical insurance for urban workers, "the three directories" and the relevant regulations. Enrollment staff with the family planning policy of termination of pregnancy or childbirth in hospital medical costs, according to city workers maternity insurance companies pay the medical expenses of the project and directories and the "measures" the implementation of the required standards.

At the same time, residents have set up a medical insurance fund to pay an aggregate annual limit of this standard. In accordance with the policy settings, participants hospital staff, out-patient specific projects, specified chronic disease and general Mun (radical) attending the basic medical expenses, medical insurance fund for residents in an aggregate payment limit for the city last year, workers in urban units of 2 times the average wage To 2008 as an example, the standard limit can be reached 72,648 yuan / year.



Cover ratio: one-time reimbursement of up to 80%



● non-residents and business Qifubiaozhun were elderly residents of the city by urban workers, retirees basic medical insurance in-patient and out-patient medical expenses of the project-specific standards; minors and students at school by the basic medical insurance Qifubiaozhun 50 % Implementation.

● Qifubiaozhun reached after what happened to enter the medical expenses of individuals and funds to pay a total of stage, the proportion of the funding will be paid in accordance with the participants for the first time participants and staff to distinguish between two types of treatment. For the first time enrollment fee, inpatient and outpatient medical expenses specific projects, the proportion of residents in Medicare funds to pay for: 50% of three hospitals, two hospitals 60 percent, 70 percent of a hospital; enrollment fee for two years Above: 60% of three hospitals, two hospitals 70 percent, 80 percent of a hospital.

(Guangzhou, the current basic medical insurance for urban workers, the participants were hospitalized Qifubiaozhun: a hospital for 500 yuan, 1,000 yuan for the two hospitals, three hospitals to 2,000 yuan, according to retired officers more than the 70 percent standard set .)

Urban residents in the basic medical insurance pilot scheme

Chapter I. General Provisions
First of all types of coverage for the establishment of sound urban residents in the multi-level social medical insurance system to protect urban residents in the basic medical needs, in accordance with "the State Council on urban residents carry out the basic medical insurance pilot guidance" (State of the [2007] 20) And "urban residents in Hunan Province basic medical insurance pilot implementation method (Trial)" (G Gordon, [2007] 22) the spirit of the document, the actual city of Zhuzhou, the enactment of this approach.
Article 2 of the basic medical insurance for urban residents adhere to the medical security level and the level of economic development to the principle of co-ordination mainly to ill health, focusing on protection of patient treatment. According to the branch in order to, a balanced budget, a slight raise and balance the principle of the use of medical insurance funds; adhere to the fee-based individuals and families, the principle of appropriate subsidies to raise funds.
Article 3 of the basic medical insurance for urban residents implementation of the municipal co-ordination, territorial management.
Article 4 of the basic medical insurance for urban residents object to the participants in Zhuzhou Shixia area for urban workers do not belong to the basic medical insurance system within the coverage of the following persons:
(A) primary and secondary stage of the students (including vocational high schools, secondary and technical schools), children (the children of students);
(B) over 18 years of age and above, the following 60 years of age, with urban household registration in Zhuzhou City of non-residents and business district exempted township (town) of rural residents (hereinafter referred to practitioners of non-residents);
(C) above the age of 60 years of age with urban household registration in Zhuzhou City residents, the district exempted township (town) of rural residents (hereinafter referred to the elderly residents).
Article 5 of Zhuzhou City, where the basic medical insurance urban residents in terms of enrollment, to the family as a unit to the street location of residence (township), community labor and social security services for participants registered.
Chapter II organizations and responsibilities
Article 6 of city, county (city) labor and social security administrative departments in charge of urban residents in the basic medical insurance administration. Its main duties are:
(A) is responsible for the basic medical insurance for urban residents of the organization and implementation;
(B) develop the basic medical insurance for urban residents of supporting policies;
(C) validation of basic medical insurance for urban residents designated medical institutions eligible;
(D) the preparation of the audited agencies the basic medical insurance for urban residents to pre-fund, the accounts of urban residents in the basic medical insurance fund management oversight;
(E) of urban residents in the basic medical insurance policy for the implementation of the inspection and supervision.
Article 7 of the city, county (city) medical insurance agencies in charge of handling the basic medical insurance for urban residents, whose main responsibilities are:
(A) The medical insurance agencies in charge of urban residents in the urban basic medical insurance fund raising, management and payment;
(B) of counties (cities) of medical insurance agencies in charge of the county (city) area within the urban residents in the basic medical insurance fund raising, management and payment;
(C) responsible for the preparation of urban residents in the basic medical insurance fund PWC, the accounts;
(D) is responsible for urban residents and the basic medical insurance designated medical institutions signed a service agreement;
(5) is responsible for the development of urban residents in the basic medical insurance business management methods.
Article 8 of the District labor and social security administrative departments in charge of the area in the basic medical insurance for urban residents of the organization and implementation work.
Article 9 of the District medical insurance agencies in charge of the area in the basic medical insurance for urban residents registered participants of the audit summary, reporting and work to raise medical insurance premiums.
10th streets (township) labor and social security services contractor in this specific area in the basic medical insurance for urban residents of the participants registered for review, and change, the information recorded, summarized and reported to the collection of medical insurance and so on.
Article 11 of the financial departments in charge of urban residents in the basic medical insurance fund-raising part of the financial assistance and disbursed; responsible for urban residents in the basic medical insurance fund accounting of financial accounts, audited the Budget and Final Accounts; responsible for the medical insurance agencies working budget for the organization of work.
Article 12 of the health sector responsible for the formulation and implementation of urban residents for medical treatment of preferential policies to standardize the designated medical institutions of medical services.
Article 13 of the education sector to help students do a good job in the basic medical insurance enrollment work.
Article 14 of price, auditing, civil affairs, food and drug supervision, CDPF and other departments and perform their duties to the basic medical insurance for urban residents in the related work.
Chapter III of the basic medical insurance fund raising and management
Article 15 of urban residents in the basic medical insurance fund sources:
(A) individual residents to pay the basic medical insurance;
(B) The Government grants the basic medical insurance for urban residents;
(C) of the Fund's interest income;
(D) other income.
Article 16 of Zhuzhou City of urban residents and the district exempted township (town) of rural residents in accordance with the basic medical insurance premiums to raise the following criteria: students 80 yuan per person per year for children; non-elderly residents and business people 280 yuan per person per year.
Article 17 grants the Government and individuals pay the standard:
(A) Student grants children 40 yuan per person per year, individuals paid 40 yuan; non-resident business grant 80 yuan per person per year, individuals paid 200 yuan; elderly residents of 180 yuan per person per year for grants, individual pay 100 yuan.
(B) to enjoy the minimum living guarantee, holders of "Disabled People's Republic of China" and disability rating for the level of 1-2: Student children grant 65 yuan per person per year, individuals paid 15 yuan; practitioners of non-residents per person 220 yuan subsidy a year, individuals paid 60 yuan; elderly residents of 240 yuan per person per year for grants, individual pay 40 yuan.
(C) of urban residents without the ability to work, no source of life, can not be Shanguang (honestly, help) support obligations of staff and the district exempted township (town), "Wu Baohu" full subsidy from the Government.
Article 18 of conditional employing units or organizations can provide for immediate family members or employees of the Habitat (Village), the enrollment fee for subsidies, grants funds to enjoy preferential tax policies for the country.
Article 19 of the community to promote and encourage donors to support the development of urban residents and the basic medical insurance industry.
Article 20 established the basic medical insurance for urban residents risk reserve fund system. Risk reserve fund, the income of 3 percent from year to year, earmarked for special circumstances make up the fund risks. Risk reserves and the interest of all urban residents into the basic medical insurance fund special fiscal account unified management. The total cumulative risk from the reserve fund to co-ordinate the 15 percent annual income no longer extract.
Article 21 of urban residents in the basic medical insurance funds in addition to the central government grant, part of the financial assistance, the remainder of the municipal, county (city) District financial commitment grade. City, district financial commitment to a ratio of 6:4; cities and counties in accordance with the proportion of financial commitment.
Article 22 of the financial sector under the medical insurance agencies approved the actual number of participants, according to no less than two yuan per person per year the standard for the community and other units had allocated Daiban Fei. Dai Banfei included in the budget.
Article 23 of the basic medical insurance for urban residents pay an annual basis. The annual October 1 to November 30 next year for the basic medical insurance for urban residents of the participants, payment period. Participants in the payment period provided for in full and on time to pay medical insurance premiums, the following year from January 1 onwards to enjoy basic medical insurance benefits.
Article 24 of the participants when the residents were not in full payment of the basic medical insurance premiums from next year on January 1 cease to enjoy basic medical insurance benefits. Within three months back, from the back, with effect from 1 to enjoy basic medical insurance benefits; more than three months from the date back 90 days later to enjoy basic medical insurance benefits.
Article 25 of urban residents in the basic medical insurance funds into the financial accounts of social security funds unified management, separate accounts, earmarking. No unit or individual shall not be misappropriated, embezzled. Medical insurance agencies for funding and staff from the budget for, shall not be extracted from the Fund.
Article 26 of urban residents in the basic medical insurance fund the implementation of national reunification of the Budget and Final Accounts system of social insurance funds, financial accounting systems and internal audit system.
Article 27 of urban residents in the basic medical insurance fund income and expenditure management, should be periodic report of Social Insurance Fund Oversight Committee, and regularly to the public and accept supervision by society.
Chapter IV of the basic medical insurance benefits
Article 28 of the basic medical insurance for urban residents each year from January 1 to December 31 for an annual settlement.
Article 29 of the basic medical insurance urban residents in major medical and hospital out-patient protection ill health.
Article 30 of the participants in the basic medical insurance for urban residents designated medical institutions (hereinafter referred to designated medical institutions) in the required hospitalization expenses for urban residents from the basic medical insurance funds and personal burden on the common.
Article 31 of the basic medical insurance for urban residents of the medication, treatment, services and facilities of the reference to the basic medical insurance for urban workers, the implementation of relevant provisions.
Article 32 of urban residents in the basic medical insurance fund set up hospital Qifubiaozhun settlement and the highest limit.
Qifubiaozhun hospitalized for: community health service center 100 yuan, 450 yuan a hospital; two hospitals 650 yuan, 800 yuan three hospitals.
A clearing house for clearing the highest level: for the children of students 70,000 yuan; non-residents and elderly residents of employment for 30,000 yuan.
Article 33 of the hospital medical insurance for urban residents from the basic medical insurance funds and patients were provided by the following commitments:
(A) The following hospitalization Qifubiaozhun part, by an individual own.
(B) Qifubiaozhun above, the maximum limit of clearing the following components: community health service agencies, funds to pay 65%, individuals own 35 percent of a hospital, the fund paid 60%, individuals own 40 percent; two hospitals, the fund paid 50 %, Individuals own 50 percent; three hospitals, the Fund paid 40 percent, individuals own 60 percent.
(C) above the maximum limit of the settlement by individuals own.
Article 34 of urban residents for participating in the basic medical insurance for more than five years, each additional year, raising funds to pay proportion of 2%. The highest percentage increase of not more than 10 percent.
Article 35 of enrollment staff out-patient radiotherapy and chemotherapy cancer, renal failure dialysis treatment into the hospital out-patient management, according to the provisions of Article 33 of the proportion paid Kangpai Yi organ transplant recipients and immunosuppression out-patient treatment costs the highest settlement below the limit Part of the fund to pay 50%, individuals own 50 percent above the maximum limit of the settlement by individuals own.
Article 36 of the students children without third-party liability in the accident, the designated medical institutions in the door, emergency medical expenses, medical insurance fund by 50 percent.
Article 37 staff participants in the following cases, their medical expenses for urban residents are not included in the basic medical insurance fund to pay:
(A) due to traffic accidents, medical accidents medical treatment;
(B) because of delinquency, alcohol abuse, assault, suicide, self-mutilation (except for mental illness) for medical treatment;
(C) in foreign countries or Hong Kong, Macao and Taiwan region for medical treatment;
(4) in non-designated medical institutions for medical treatment (emergency rescue);
(E) other than the one provided for hospital procedures, without authorization to other medical institutions for medical treatment;
(6) of industrial injury insurance (including occupational disease) or maternity insurance coverage; (7) the other provisions not paid.
Chapter 5 of the basic medical insurance service management
Article 38 of the basic medical insurance for urban residents designated medical institutions practice management, staff should be insured to the designated medical institutions for medical treatment. Designated medical institutions for by the labor security department confirmed in health administration departments.
Article 39 of the basic medical insurance for urban residents implementation of the first consultation and referral system. Participants in the registration procedures for participants, to the family as a unit with a choice of hospital conditions of medical institutions designated as my doctor first diagnosed medical institutions. First of all insured persons sick in my choice of attending designated medical institutions, the need for referral of the disease, medical institutions should first diagnosed in time for referral of patients registered.
The first medical consultation, without a referral agency for the registration procedures and hospital medical costs, the basic medical insurance fund is not paid. Emergency, the rescue directly with the exception of hospital treatment.
Article 40 of the participants to designated medical staff for hospital procedures, I should Jiaoyan "Zhuzhou City of basic medical insurance for urban residents Handbook" and residents proof of identity and personal Precrosslinked pay. The end of discharge for medical procedures, should be the individual pays the medical expenses incurred by individuals and medical institutions settlement; urban residents should be the basic medical insurance fund to pay part of the medical insurance agencies and medical institutions settlement.
Article 41 should be designated medical institutions for the hospital's medical insurance costs of hospital staff to provide daily lists, strict control at their own expense, drugs, medical supplies, the use of project clinics, must be used and should be informed prior written consent of patients or their relatives Consent. Without a staff or their families authorized participants, the participants or the right of families to dishonour the medical expenses.
Article 42 designated medical institutions should conscientiously implement the relevant policies and regulations, standardize medical services and consciously act in ensuring basic medical care under the premise adhere to reasonable inspection, rational drug use, reasonable treatment, reasonable fees.
Article 43 of the participants and staff for referral to visit relatives, vacation and other reasons in remote medical institutions for medical treatment management methods, labor and social security departments provided otherwise.
Chapter VI.
Article 44 of the financing for the standard approach, treatment of payments, in the implementation process, according to the city socio-economic development and basic medical insurance for urban residents practical operation of timely adjustment.
Article 45 because of a major outbreak of urban residents in the disaster-patient medical expenses, arranged by the Government to solve the capital.
Article 46 of Labor and Social Security Bureau in accordance with the relevant departments to formulate the implementation details.
Article 47 of this approach since January 1, 2008 will go into effect. Urban Labor and Social Security Bureau is responsible for the interpretation.

Coordinating urban and rural medical insurance - objectives, tasks and thinking

• co-ordination is not uniform
• medical insurance to meet the requirements of socio-economic development
• Development is the last word - the impact on economic development
• to build a harmonious society and protect people's health requirements
• urban-rural dual economic prolonged presence
• rapid industrialization and modernization, urbanization
• large-scale movement of personnel
Development goals and tasks of the current
• objectives: the establishment of a unified urban and rural medical insurance system
-- Long-term, complicated and arduous nature of the
-- To strengthen the research, meet legislative requirements
-- City of the pilot
• The immediate task
-- Establish and improve the system, the system covers all
-- Accelerate the expansion of the vast majority of participants were able to
Adhere to the basic principles of medical insurance
• low-level (low level of funding; can afford to pay; change and development)
• wide coverage (all citizens)
•-basic (in order to set sticks)
• multi-level (meet the different needs of staff)
• Sustainable (balance of payments; base fee and rate)
• social services (direct billing and medical institutions)
On the fairness of the principles of thinking
• the basic medical insurance fair
-- The level of pay is not fair
-- The basic medical service pack is not fair
-- Not to lift the employing units and individual responsibility for the fair
» The pursuit of health insurance: the level of pay equity
Co-ordinate the funding of medical insurance
• determine the level of funding
-- The ability of different groups of people and the government subsidy payment capacity
-- Local medical consumption levels and basic medical services package
-- A fair level of pay (ill, out-patient)
-- Support for admission (and base rates)
• financing
-- Social Management
-- Payment to non-employees
Financial assistance
• subsidies for:
-- Agricultural population
-- No income staff
-- Low-income staff
• subsidies principles:
-- It reflects fair
-- To promote employment
-- Adapt to economic development and urbanization
Co-ordinate the management of medical insurance payments
• social management - and the medical institutions of direct billing
• on behalf of the insured person to purchase medical services (price and quality)
• develop medical services in the basic medical insurance package (standard)
• the purchase of medical services in the management mechanism (billing method)
• expand the basis for negotiations
-- Improve co-ordination level
-- The reunification of the purchase of medical insurance services
The requirements of the current Kuomiangongzuo
• speed up the pilot medical insurance for urban residents
-- This year 229 pilot cities (up to 85 percent of prefecture-level cities)
-- Strive for a comprehensive open next year
-- 2010 strive to cover 80 percent of the residents
-- Students solve the problem of medical insurance
• accelerate the workers medical insurance
-- A clear mandate and responsibility
-- Category formulation of policies and measures
Workers health insurance problems and focus
• closed and bankrupt enterprises and enterprises difficulties
• flexible employment of low-income people
• small and medium-sized, private economy enrollment
• migrant workers
Close corporate bankruptcy and difficulties
• problems left over from history
• first address retirees
-- The appropriate time flat fee and severed ties
• financial assistance and into the community management
Flexible employment of low-income staff
• staff to define
-- Finds that employment
-- That no employer
-- Finds that low-income
• social insurance subsidies
-- Base pay adjustment policy »
-- And pension insurance relationship »
-- Financial benefits: the level and the implementation of
Small and medium-sized private (township) of the participants economy
• clear responsibility and obligation of the employer participants
• the Government's subsidy policy meeting in the Ming Chu
• attention to changes in labor costs, promote development and employment
The issue of migrant workers
• migrant workers Category: no classification that it has no policy
-- The gradual separation household registration
-- Stable employment of migrant workers: integration into the city
-- Mobility, employers of migrant workers: special policies
-- The convergence of migrant workers policy
-- The families of migrant workers converge
Unify thinking, problem solving, focus on convergence
Coordinating urban and rural medical security system
Pay attention to top-level design; improve the existing system
Do a good job in the system interface; accelerating coverage
For the health of the people to make our contribution to the cause

Human Resources Department of Social Security earthquake relief during the emergency deployment of the basic medical insurance and work injury insuran

May 14, the Department of Human Resources social security issue "and do a good job on the earthquake relief during the basic medical insurance and industrial injury insurance work of the emergency notice," during the earthquake relief medical insurance and industrial injury insurance work of an emergency deployment. Request the affected areas the labor security departments and social insurance agencies in accordance with the "Teshiteban" principle, adopt effective measures, in-depth medical treatment first-line, to do a good job during the earthquake relief medical insurance and industrial injury insurance management services.

The circular requires that all the affected areas Yinzai should effectively protect medical personnel were injured participants security benefits. On first aid, rescue essential drugs and clinics, could be included throughout the medical insurance and industrial injury insurance funds to pay range. Participants were injured in non-sentinel (agreement) by the medical institutions where the medical costs, should be designated as the (agreement) medical institutions, and provisions to be paid.

The circular stressed, it is necessary to do a good job in a timely manner to participate in earthquake relief work that the staff work. Where in the earthquake relief work of the casualties of cadres and workers, should be promptly found work-related injuries. It is necessary to streamline work processes, proactive work for the identification and treatment of work-related injuries, such as payment of full and efficient service.

The circular called on participants to effectively protect medical treatment for injuries to pay. For rescue workers injured in medical treatment fees, priority should be promptly from the industrial injury insurance funds to pay. For earthquake relief in the sacrifice of the dead workers and their dependents to the timely payment of the one-time grants and other fatal crash for treatment. Due to payment for work in the earthquake casualties in the treatment of injured workers in the underserved areas, or on a local labor and social security departments should promptly called industrial injury insurance or swap gold reserves to ensure that the earthquake relief work injury insurance casualties of timely and adequate treatment The amount paid.

Notice clear, participants in the field injured in the earthquake, the payment of their medical treatment light of the above provisions, medical insurance and insurance sector to ensure the implementation of its medical treatment. Where the need for trans-regional treatment of the affected areas enrollment, medical care and social insurance institutions to help do a good job-related services management.

The end of 2007 China's endowment insurance, medical insurance enrollment numbers have been 200 million

The end of 2007 China's basic endowment insurance, basic medical insurance and the number of participants reached more than 200 million people, the basic old-age insurance, basic medical insurance, work injury insurance and maternity insurance enrollment numbers than the end of last year increased more than 13 million people.

This is the human resources and Social Security Ministry and the National Bureau of Statistics jointly released on the 20th of the "2007 Labor and social security cause the development of statistics Communique" released by the data.

Notice, which, by the end of 2007 the country participated in the number of urban basic old-age insurance for 201.37 million, an increase over the previous year 13.71 million people, participated in the number of rural endowment insurance for 51.71 million people, in 2007 a total of 3.92 million farmers received old-age pensions, compared with An increase of 370,000 people.

The end of 2007 to participate in the national basic medical insurance in cities and towns to 223.11 million, an increase over the previous year 65.79 million people. Whole towns basic medical insurance fund total income of 225.7 billion yuan, spending 156.2 billion yuan. The end of the accumulated balance of 247.7 billion yuan.

In addition, the end of 2007 to participate in the national industrial injury insurance for the number of 121.73 million, an increase over the previous year 19050000; participate in the number of maternity insurance 77.75 million, an increase over the previous year 13.16 million people.

Human Resources and Social Security Ministry official said, China's social security system continuously improved and the social insurance coverage continues to expand, the number of participants and fund size continued to grow.

States to study the insurance policy

Australia: Admission to buy insurance

In many countries, medical insurance for international students is enforced. Australian students studying abroad must first participate in medical insurance, to get a visa, enrolled.

Australia for its overseas students to study the establishment of a specialized medical insurance system, medical insurance system for overseas students, with the exception of Sweden and Norway all the students outside, on a student visa in Australia during their stay must apply for overseas students have medical insurance. To join the insurance must be prepaid a year's insurance costs, about 349 Australian dollars; after a year must pay premiums, state slightly different, but all of the 300 Australian dollars from top to bottom. After joining Medicare, with the exception of ophthalmology, medical and dental expenses can be reimbursed over 80 percent.

Britain: do not have to buy medical insurance

Foreign students, students or family members of the staff if the UK living or studying in the United Kingdom more than six months, you can enjoy national health care system of free services, students studying abroad to the United Kingdom do not have to buy medical insurance.

To the United Kingdom more than six months studying the students to school registration, as long as the students specifically to the Office for the record, about four weeks will be a medical card, with the card can be designated to free medical treatment there, but the prescription to close Fee, about a six pounds, while drugs need to themselves.

Would like to remind students that in the United Kingdom, the dentist is not free, and expensive.

United States: schools forced to buy insurance

Australia and similar to the United States to international students on the insurance with a mandatory, but mainly refers to medical insurance. When you register, the schools will be in attendance on notice that the number of medical insurance costs are the costs.

Studying in the United States, the purchase of medical insurance There are two main ways, the first online purchase, you can purchase directly to the number of agencies, generally 300 U.S. dollars a year, but insurance is not complete and the other is to buy the school to three months for Period, generally the higher the cost of greater age, like the Chinese high school students to the United States, such insurance is about 300 U.S. dollars a, MS, about 400 U.S. dollars.

"Medical insurance" policy read: the family pay medical insurance for urban residents mainly

The basic medical insurance for urban residents try
More than 100 million urban residents will be non-practitioners in the
Points before the official start of the implementation and
Benefits.
Will be fully open in 2010, the two
"With the establishment of this system,
Relief and improve the system of universal, '
Will be basically formed. "Under the Department of Labor and Social Security
And the basic medical insurance for urban workers,
11th Five-Year Plan 'end of the decade, China's urban and rural coverage
Minister Hu Xiaoyi said.
New-type rural cooperative medical care, urban and rural health care
Residents of the basic medical insurance systems
Payment forms --
Fee-based family, the government "classification" grant
The basic medical insurance for urban residents to
, The annual per capita by not less than 40
Student enrollment for children and families pay
Non-practitioners are minimal needs of the residents object
Grants were given to 60 yuan.
Fee-based family, the appropriate
Yuan for subsidies. On this basis, the
Fees, in principle, the Government each year and then not low
And severe disability and low-income families 60
Grants. The participants of the pilot cities residents
The object is minimal needs or severe disability
Per capita to 10 yuan in subsidies; into the
Over the age of the elderly, then no less than people
Fund --
In order to be with, into the social security fund special fiscal account unified management
The basic medical insurance for urban residents -
Li developed the basic medical insurance for urban residents
Reasonable control medical costs, increased funding
The fully integrated into the social security fund
The use of in accordance with the order to be with, or
Qifubiaozhun Fund, and the proportion of pay
Use efficiency to ensure that the Fund's income and expenditure -
Unified management of the special account, separate accounts, indeed
- Balanced, slightly balance the principle of
Limit high-paid, improve the payments,
Value system and the smooth operation. This base
Fund security.

Urban residents basic health insurance policy interpretation

Medicare main - non-employment of urban residents can participate in the voluntary

The forthcoming trial of the basic medical insurance for urban residents, who can actually participate in the «

According to the Ministry of Labor and Social Security, the urban workers who do not belong to the basic medical insurance system coverage of the primary and secondary stage of the students (including vocational high schools, technical secondary school, technical school students), children and other non-employment of urban residents can participate in the voluntary The basic medical insurance for urban residents.

The basic medical insurance for urban residents will benefit more than 200 million urban residents of non-practitioners. 1998, the State Council decided to establish urban workers basic medical insurance system, begun in 2002 to establish a new rural cooperative medical system in 2003 to establish urban and rural medical assistance system. The basic medical insurance for urban workers, the number of participants has more than 160 million people, a new type of rural cooperative medical coverage population has more than 700 million people without medical insurance system for the only non-industry town residents. These people mainly rely on family medical expenses, once had more serious, often unbearable. The pilot medical insurance for urban residents, will contribute to a fundamental resolution of the serious illness of their medical costs.

At the same time, the state encouraged working age have the ability to work within the urban residents, in a variety of ways to participate in employment and basic medical insurance for urban workers.

Medicare focus - ill patient and out-patient medical expenses

Participated in the medical insurance for urban residents, medical expenses which can be "reimbursed" » And the different medical insurance for urban workers, residents focus on medical insurance fund for residents of the participants ill patient and out-patient medical expenses. The reason why such requirements, in view of the current lead to some urban residents Yinbingzhipin, returning illness is the main inpatient and outpatient risk of serious illness, should first of all through the social medical insurance system for regulating the functions of the co-ordination to resolve this risk. At the same time, countries of the region gradually encourage qualified medical expenses out-patient trial co-ordination, to explore co-ordinate out-patient cost for urban residents to solve problems.

Pilot areas will be "in order to be with, a balanced budget, a slight savings" to the principle of the use of residents of health insurance funds, development of specific Qifubiaozhun, payment limits and the proportion of the highest paid. Particularly difficult for non-urban residents in employment, all localities will explore appropriate to their economic capacity to bear the cost of medical services and payment methods, to reduce their burden of medical costs.

Payment methods - Family-based pay, the Government grants, at least 40 yuan per capita

Medicare residents are against the employment of non-residents, including a large number of elderly children, how they pay » According to reports, the general principle is family-based pay, the Government give appropriate subsidies.

Enrollment residents in accordance with the regulations to pay the basic medical insurance, enjoy the corresponding treatment, conditional on the employer can pay workers to grant the families of participants. State subsidies to these funds and pay taxes to encourage the development policy.

Taking into account the different groups of people in the risk of disease, medical expenses there are greater differences, the pilot cities for funding standards will be separated from adults and minors identified.

The participants of the pilot cities residents, the annual per capita by not less than 40 yuan for subsidies, which, the central government annually starting from 2007 through special transfer payments, the central and western regions on a per capita 20 yuan for subsidies. On this basis, the minimal needs of the target of severe disability or the student enrollment for children and families to pay the principle of not less than a year and then to grant 10 yuan per capita, the central financial authorities by the central and western regions Five yuan for per capita subsidies; minimal needs of other objects, loss of working ability of people with severe, low-income families over the age of 60 elderly residents of difficulties for participants pay part of the family, then no less than the annual per capita 60 Yuan for subsidies, the central finance for the central and western regions on a per capita 30 yuan for subsidies. The central government for the eastern region pilot cities reference to the new rural cooperative medical care subsidies to give appropriate subsidies.

Financial assistance funds to be included at all levels of government financial budget.

Pilot goals - and strive to fully open the 2010

According to the plan, the basic medical insurance for urban residents this year in the province conditional choice 2-3 start pilot cities, in 2008 to expand the pilot, the pilot cities for 2009 reached more than 80 percent, in 2010 the country fully open, and gradually cover all cities and towns Non-business residents. Joint Office should be organized before the end of an investigation and inspection of the guide, complete control of the pilot regions and cities, by January next year, the pilot of the 2007 evaluation report and 2008 to expand the pilot scheme.

Pilot started to take low-level principle that the pilot in the initial stage, from China's economic and social development level of real national situation, according to the parties to bear the ability to determine funding levels and security standards, focusing on protection of inpatient and outpatient serious illness. With economic and social development, and will gradually raise the security level, expanding the benefits of the system, efforts to achieve wide coverage.

State Council on urban residents carry out the basic medical insurance pilot guidance

Provincial, autonomous regional, and municipal people's governments,国务院各部委, directly under the agency:
Center Party and the State Council attach great importance to solve the broad masses of the people of the medical security issues, and constantly improve the medical security system.
1998 China began to establish urban workers the basic medical insurance system and then launched a new rural cooperative medical system test
, The establishment of the urban and rural medical assistance system. There is no medical security system for the main towns is non-business residents. For real
The establishment of basic urban and rural areas are now covered the entire population of the objectives of the medical security system, the State Council decided that, starting this year for urban residents
The basic medical insurance pilot (the pilot). All localities and departments should fully familiar with the importance of this work, as
Implementing the scientific concept of development, building a socialist harmonious society important task, attach great importance to co-ordinate the planning, guiding norms,
Steady progress.
First, objectives and principles
(A) goal of the pilot. 2007 in the provinces conditional choice 2-3 start pilot cities, in 2008 to expand the pilot,
Pilot cities for 2009 reached more than 80 percent, in 2010 the country fully open, and gradually cover all urban residents in non-practitioners.
Through the pilot, and explore and improve the basic urban residents medical insurance policy system, form a reasonable funding mechanism, sound
Governance systems and standardizing the operation mechanism, and gradually establish a more serious co-ordination of urban residents mainly of the basic medical insurance system.
(B) the principle of the pilot. Experimental work to adhere to low-level start, according to the level of economic development and all aspects of sustainability,
Rationally determine the funding levels and security standards, focusing on protection of non-urban practitioners of more serious medical needs of residents, and gradually improve the protection of water
Ping; adhere to the voluntary principle, and fully respect the wishes of the masses; clearly the responsibility of central and local governments, the Centre established the basic principles and
Major policy, local formulation of specific measures, the implementation of territorial residents enrollment management; adhere to coordinate and do a good job in various medical -
Barrier between the basic system of policies, standards and management measures, such as the interface.
Second, the scope and funding level of participants
(C) of the participants. Urban workers do not belong to the basic medical insurance system coverage of the primary and secondary stage of the students (including
Including vocational high schools, technical secondary school, technical school students), children and other non-employment of urban residents can voluntarily participate in the basic urban residents
Medical insurance.
(4) funding levels. Pilot cities should be based on the local level of economic development and adults and minors, such as different people
Groups of basic medical consumer demand, and families of local residents and financial affordability, determine appropriate funding levels; exploration
Establish funding levels, the payment period and the level of treatment linked to the mechanism.
(5) payment and subsidies. Urban residents in the basic medical insurance payment to the family mainly due to government subsidies. Enrollment
Residents required to pay the basic medical insurance, medical insurance enjoy the corresponding treatment and conditions of employment units can workers
Grants to pay the families of participants. State of the individual units and grant funds pay tax to encourage the development policy.
The participants of the pilot cities residents, the annual per capita by not less than 40 yuan for subsidies, of which the Financial Center from 2007
Every year through special transfer payments, the central and western regions on a per capita 20 yuan for subsidies. On this basis, the minimal needs of
The object of severe disability or the children's enrollment for students and families pay part of the Government in principle, then no less than the annual per capita
10 yuan for subsidies, of which centre on the central and western regions to five yuan per capita grant; minimal needs of other objects, loss of
The ability to work in severe disabled, low-income families over 60 years of difficulties, such as the elderly residents of the enrollment fee for families
Points, then no less than the annual per capita 60 yuan for subsidies, of which centre on the central and western regions on a per capita to 30 yuan
To grant. Center Financial reference to the eastern part of the new rural cooperative medical approach to grant appropriate subsidies. Financial subsidies
Specific programmes by the Financial sector to labor and social security, the Home Department study determined that grant funds to be included at all levels of government financial pre -
Operators.
(6) to pay costs. Urban residents in the basic medical insurance fund for the participants focused on residents of inpatient and outpatient ill health
Expenditures, conditional region can be gradually co-ordinate the pilot out-patient medical expenses.
Urban residents in the basic medical insurance fund is used to adhere to the set-to, the balance of payments, the principle of balance slightly. To a
Justifications for the development of urban residents Qifubiaozhun the basic medical insurance fund to pay the highest proportion of pay and limits, to improve the pay, or
Justifications for control medical costs. Explore difficult for non-urban residents in employment affordability of medical services and costs paid to
Reduce their burden of medical costs. Urban residents in the basic medical insurance fund to cover the requirements within the scope of medical expenses,
He can add the cost of medical insurance, commercial health insurance, medical assistance and social charitable contributions, and other solution.
Third, strengthen governance and services
(7) organizations governance. Of the basic medical insurance for urban residents of governance, in principle, the light of the basic medical insurance for urban workers
The implementation of the relevant provisions. All localities should make full use of existing management service system, improve governance and enhance governance efficiency. Encourage
Conditional region with the basic medical insurance for urban workers and new-type rural cooperative medical care of the actual governance, and further integration of basic
Health care management resources. We need to explore the establishment of a sound by government agencies, participants residents, social organizations, medical service organizations and other side
Of the participation of representatives of social medical insurance supervision organizations, to strengthen the basic medical insurance for urban residents governance, services, the operation supervisor
The Governor. The establishment of medical insurance professional and technical standards and expert advisory body, and improve medical insurance management services professional and technical standards
And business norms. According to the development of the cause of the medical insurance needs, and effectively strengthen the health insurance management services and the building of the contingent.
Establish and perfect the system of governance, improve the operational mechanism, strengthen the medical insurance information system building.
(8) fund governance. To urban residents in the basic medical insurance funds into the financial accounts of social security funds unified governance,
Separate accounts. Pilot cities should, in accordance with the social insurance fund management and other relevant regulations and strictly implement the financial system, strengthen the basic
Medical insurance fund governance and oversight, explore and establish a sound risk prevention and fund transfers mechanism to ensure that funds security.
(9) management services. Of the basic medical insurance urban residents in the management of medical services, in principle, the basic reference for urban workers
Health insurance implementation of the relevant provisions, the specific method for pilot city labor and social security department in the development of reform, financial, health, etc.
The development sector. To residents of the participants considered the basic health care needs and basic medical insurance fund, such as the affordability factor, or
Justifications for determining the scope of medical services. Through the formation and performance point-of-service agreement regulating the designated medical institutions and retail drug sentinel
Shop governance, clear medical insurance agencies and designated medical institutions, retail pharmacies the rights and obligations. The medical insurance
Office agencies to streamline approval procedures, facilitate enrollment and reimbursement of medical expenses; clear medical expenses billing methods, in accordance with the regulations and
Medical institutions timely settlement. To strengthen the medical costs of governance, explore and establish a medical insurance management services of reward and punishment mechanism.
Actively promote the medical costs paid by disease, such as the amount of prepaid billing methods, and explore the agreement set the standard method of medical expenses.
(10) give full play to urban community service organizations such as the role. Integration, enhance and broaden the urban community service organizations Gong
To strengthen the building of community service platform, do a good job in the basic medical insurance management services. Vigorously develop community health services,
Meet the requirements of the community health service organizations in the medical insurance sentinel; residents of the participants to community health service organizations for medical treatment
In medical costs, we need to improve the medical insurance fund to pay proportion.
4, deepening related reforms
(11) continue to improve the medical security system. Further improve the urban basic medical insurance system for workers, have taken
Efficiency measures will be mixed, non-public economic organizations, practitioners and flexible employment into the basic health care for urban workers
Insurance; vigorously promote the migrant workers of migrant workers to participate in the basic medical insurance for urban workers, focused on solving the problem of serious illness and Manpower; Ji
Continued working hard to resolve difficulties of state-owned enterprises, such as closure of bankrupt enterprises and retired workers of the medical staff protection to encourage working-age
Have the ability to work within the urban residents, in a variety of ways to participate in employment and basic medical insurance for urban workers; further standardize the existing
The basic medical insurance for urban workers, the pay policy, and strengthen health services management. Speed up the implementation of the new rural cooperative medical system.
Further improve the urban and rural medical assistance system. Improve the multi-level medical security system, do a good job of the medical security system
Convergence.
(12) promoting the coordination of medical and health system and pharmaceutical production and circulation system. According to deepen the medical and health system reform
The general requirements, and coordinated health care, pharmaceuticals production and circulation of the security system and medical system reform and convergence, full of
Hui medical security system in the mobilization of medical resources, improve health care quality and control medical costs, such as the role. Further change
Government functions and strengthen regional health planning and improve the medical service system. Establish and improve the health industry-standard system, strengthen the medical
Spa and the pharmaceutical market regulation. Standardize medical services, gradually establish and improve standards of operation, clinical treatment means
South, clinical drug norms and standards, such as admission to the technical standards. Speed up the urban community health service system, give full play to clubs
District health services and Chinese medicine services in the role of medical services, conditional area residents participants can explore the medical classification
Approach.
Fifth, strengthen organizational leadership
(13) the establishment of the State Council, the basic medical insurance urban residents in the Inter-Ministerial Joint system. Under the leadership of the State Council, state councilor
Hospital medical insurance for urban residents in the Inter-Ministerial Joint (hereinafter referred to the Inter-Ministerial Joint) is responsible for the organization and coordination of macro guidance and
Experimental work, study and formulate relevant policies and supervise and inspect the implementation of the policy, summed up the pilot assessment, coordination try to resolve
Point in the issue and major issues to the State Council to report and recommendations.
(14) to select the pilot cities. Provincial People's Government in accordance with local conditions can select 2-3 pilot cities, to
Inter-Ministerial Joint audited. Pilot cities of the implementation of the pilot programme at the Office of the Inter-Ministerial Joint filing, the provincial (autonomous regions and municipalities) people
The government approved the implementation.
(15) To develop coordinated policies and measures. Labor and social security departments must coordinate the development of reform, financial, health, civil affairs, the
Yuk, drug supervision and management departments of Chinese medicine development of relevant supporting policies and measures. All departments should in accordance with their respective duties,
Synergies and the acceleration of the supporting reforms. To mobilize all social forces to promote the medical insurance system reform to create good
Good environment and provide strong support to ensure the smooth progress of experimental work.
(16) and organize implementation. Local governments at all levels should fully familiar with the experimental work of great significance to strengthen
Organization and leadership. Provincial People's Government in accordance with the provisions of this guidance pilot goals and tasks, basic policies and working procedures,
Overall planning, actively and steadily push forward the administrative district of experimental work. Pilot cities to fully research, careful calculations, more
On the basis of the demonstration, the development of pilot implementation of programmes and the implementation of meticulous organization. Has been the basic medical insurance prior to the work of the City
City to timely sum up experience, improve the system, to further explore the more realistic the basic medical insurance systems and mechanisms.
(17) to public opinion and propaganda work. The establishment of urban residents in the basic medical insurance system for the masses directly related to the immediate
Interests, is a major livelihood projects, a strong policy. All localities are required to adhere to the correct guidance of public opinion, strengthen the experiments
Importance of the basic principles and policies of publicity, strengthening the pilot of good practices and promote a summary of experience, so that this
Benefiting the policy enjoys popular support, the broad masses of people and really get the community's understanding and support so that the masses become a pilot
Participate actively in practice.
All localities must pay attention to the process of the pilot study the new situation and new problems, and actively explore solutions, to properly handle
Leather, development and stability of the relationship. In an important case to the Inter-Ministerial Joint timely report.