Study On The Construction Of Medical Payment System For Serious Diseases

The medical security system of serious diseases is an important part of the medical security system in various countries in the world.and this system can alleviate the economic risk of people suffering from serious diseases and failure to meet the needs of basic medical services in the diagnosis and trealment of serious diseases,which plays an important role and is an important measure to prevent people from returning to poverty and poverty due to disease.In recent years,the Party and the government have attached great importance to the construction of the medical security system for serious diseases in China,and have successively established a serious illness insurance system for urban workers,which is based on the basic medical insurance system and is divided between urban and rural areas and occupational areas.The new insurance system for serious diseases in rural and urban areas,the insurance system for serious diseases among urban and rural residents,and the medical assistance system for serious diseases among urban and rural residents have fully covered the system of medical insurance for serious diseases.However,according to the existing policy design and practice process,there are still some problems in the current medical security system of serious and serious diseases in China,such as different definitions of serious diseases,imperfect security model,unclear positioning of system attributes,and so on.This reinforces the need to establish a unified.comprehensive medical payment system for serious diseases.The gradual increase in the incidence and mortality rate of serious diseases has led to the development of such diseases as a common chronic disease in mankind and,as a result,has led to the inability of patients and families with serious diseases to solve the problem of high medical costs under the existing medical security system,The serious physical and mental burden on the individual and family of the patients is the realistic basis for the establishment of the medical payment system for serious diseases.In recent years,China undefineds urban workersundefined serious illness insurance system,the new rural cooperative insurance system.The pilot and summary of the insurance system of urban and rural residents and the medical payment system of serious diseases provide a solid institutional basis for the construction of the medical payment system of serious diseases.In order to guarantee the high medical expenses of the patients with serious diseases,the study puts forward that the percentage of the actual self-paid medical expenses to the local average disposable inco me of the family should be taken as the criterion of judging the serious diseases.The medical payment system for serious diseases exists as a supplement and extension of the basic medical insurance system.In terms of the definition of the object of guarantee.the whole population is taken as the object of coverage.When 40%of the household disposable income is paid for medical expenses due to serious diseases,it is paid for by the medical security system of serious diseases.In terms of coverage,we should guide the demand for basic medical services,break through the scope of th e basic medical insurance catalogue,bring basic medical services and essential drugs in the course of treating serious and serious diseases into the scope of payment,and take the concept of development-oriented social security as the guide.The combination of inpatient security and out-patient support should be carried out;In the aspect of fund raising,we should abandon the present way of transfer from the basic medical insurance fund,adopt the payment structure of individual contribution mainly,the government subsidy as auxiliary,expand the fund source,encourage the society to contribute;In terms of payment mode,we should gradually reduce the starting line of the medical reimbursement system for serious and serious diseases,implement a hierarchical classification of reimbursement rates,and gradually abolish the setting of the top line to further improve the overall reimbursement level;In the management system,the construction of medical reimbursement information svstem for serious diseases is established and perfected,the "one-stop"settlement is carried out,and the dynamic an d real-time monitoring of the operation of the system is realized.In order to promote the smooth implementation of the medical payment system for serious diseases and ensure the rational and efficient use of the fund.in the process of building the supervision system for the medical payment system for serious diseases,it is necessary to construct the government as the main body.The diversified supervision subject supplemented by the general public shall carry out all-round supervision over the related subjects such as designated medical institutions,commercial insurance companies.government departments and individual insured persons,and shall adopt the combination of current supervision and forward supervision.The process supervision and the result supervision are unified,and the traditional supervision and the information supervision are coordinated to promote the smooth implementation of the medical payment system for serious and serious diseases.As the supplement and extension of the basic medical insurance system,the medical payment system for serious diseases is the expansion of the function of the basic medical insurance system and guides the direction of reform and perfection of the basic medical insurance system.In order to further reduce the medical expenses of patients with serious diseases,different price management mechanisms should be set up for different types of drugs in the process of system development.The construction of the social care system for serious diseases has become the next key point in the demand for medical care services for serious diseases following the realization of the economic security function of medical security for serious diseases.