People’s Daily Online Commentary- Focus on the urgent needs and worries of the masses and promote the high-quality development of medical insurance
On September 10, the State Council Information Office hosted a press conference in Beijing titled “Promoting High-Quality Development.” Officials from the National Healthcare Security Administration took the opportunity to address critical questions regarding medical insurance.
Medical security plays a vital role in public well-being, and both government and party officials have consistently made health assurance a top priority in their strategic planning. Considerable efforts have been invested in reinforcing the social healthcare security system. Currently, enrollment in China’s basic medical insurance is stable at approximately 95% annually, protecting over 1.3 billion individuals and establishing the largest medical security network worldwide. The financial health of medical insurance funds is robust, with reimbursement rates for inpatient expenses at around 80% for employee insurance and 70% for resident insurance. Ongoing enhancements in healthcare assurance have led to increased public satisfaction.
To foster high-quality development within medical insurance, the primary focus must be on reducing the financial burdens faced by patients. For example, the cost of a targeted liver cancer drug has plummeted from 108 yuan to 18 yuan, while cardiac stents saw a price drop from thousands of yuan to just over 700. Insulin prices have also been slashed by more than 50%. The institutionalization and normalization of centralized procurement for pharmaceuticals and medical supplies have transformed once-expensive items into affordable options for the public. The current list of negotiated medications now includes 3,088 essential and specialized drugs for rare diseases, benefiting 720 million insured patients. Collectively, these initiatives have alleviated financial strain by over 700 billion yuan, showcasing the advantages of “group purchasing” within the medical insurance framework. The scope of centralized procurement is continuously expanding, now including high-value medical supplies like cochlear implants, promising even greater benefits for more insured individuals.
Improving the quality of insurance coverage is crucial for advancing high-quality development. Initiatives are being launched to strengthen inpatient coverage, establish outpatient treatment for chronic diseases, and create a coordinated approach for common services, such as hypertension and diabetes care for both urban and rural residents. The medical insurance system is responding with agility to public needs. To combat the significant challenges posed by common and chronic diseases, a management system for special disease categories has been established, providing not only financial support to patients but also incentivizing improvements in the quality of healthcare services. In essence, medical insurance is evolving into a “long-term remedy” for patients with chronic conditions.
Given society’s realities of high mobility, efforts are underway to streamline the direct settlement of expenses across provinces for outpatient services addressing five chronic conditions, including hypertension and diabetes. This initiative significantly simplifies the patient experience and eases concerns regarding out-of-pocket expenses for insured individuals. The idea of achieving “efficient handling of medical insurance matters” is transitioning from conceptualization into tangible action.
With a focus on the urgent needs of the public and addressing areas of weakness, all levels of government and relevant departments are expected to take a highly responsible approach toward enhancing the content and quality of medical insurance. Continued reforms in payment methods are set to better safeguard the health rights of citizens while developing a more comprehensive social security network, thus laying a solid foundation for modernization in China.
