The "universal welfare" statement of medical insurance is untenable
with the increase of medical expenses and the improvement of the level of security, the pressure of long-term expenditure in the medical insurance fund is increasing, and the risk of huge financial subsidies for residents' medical insurance is gradually appearing. Reporters learned that in 2016, the proportion of urban residents' basic medical insurance and the new rural cooperative medical system will increase. Experts believe that from the perspective of financing mechanism, the financial subsidy has accounted for about 3/4 of the total fund raising, and the residents' medical insurance has a tendency of "universal welfare".
not long ago, the head of the Ministry of Finance wrote, "Research on the implementation of the policy for the payment of medical insurance retirees". The media also disclosed that the proportion of individual contributions to the residents' health insurance and NCMS will rise. If this is true, it means that three kinds of medical insurance will increase personal payment to relieve the pressure of payment.
, then, should the percentage of personal payment of medical insurance be increased? The view of some experts is that the proportion of financial subsidies is too large. In other words, the proportion of individual contribution should be increased. It is worth noting that the Ministry of Finance pointed out that "insurance can not be treated as welfare". Experts from the Ministry of human resources and social affairs also said that the excessive proportion of financial subsidies also made residents' medical insurance slip into the danger of welfare system. This view means that residents' medical insurance should not have a touch of welfare.
although the literal meaning of insurance and welfare is different, in my view, the basic social insurance is originally a welfare component. For example, "social insurance law" stipulates that "basic endowment insurance fund is made up of employers and individuals and government subsidies," "the basic medical insurance of urban residents is combined with individual payment and government subsidies", and the "government subsidy" is the benefit that all people can enjoy. If we recognize that the social insurance act is a law protecting and improving people's livelihood, the color of public welfare is indispensable.
, therefore, the residents' medical insurance and welfare can not be completely separated. For the vulnerable groups, there should be more financial subsidies to enable them to enjoy more public benefits. Free medical care in some countries and regions in China is a kind of welfare. Therefore, it is untenable to say that the "welfare of medical insurance" is concerned. Trying to separate medical insurance from welfare is not in line with the spirit of law.
the author thinks that the proportion of individual payment must be prudent, even if the proportion of individual contribution has a precondition: one, the solution of the pressure of medical insurance fund must exhaustion other management means, eliminate the excessive diagnosis and treatment and fraud of medical insurance fixed-point units, and effectively control the unreasonable expenditure of medical insurance.
Second, ensure that financial investment is transferred to state-owned assets. In terms of "the ratio of financial subsidies to individual contributions is close to 4: 1", financial subsidies seem too high, but it is worth rethinking whether the financial support for social security (including medical insurance) is generally in place and the structure is reasonable. It is reported that the total social security (including social insurance) expenditure accounts for only 12% of China's fiscal expenditure, far lower than the proportion of 30% to 50% in developed countries. It is necessary for the financial sector to bear more responsibility for medical insurance. In addition, the transfer of state assets to social security can also cope with the shortfall in medical insurance funding, but this reform is lagging behind.
Third, the medical insurance system must be reformed first. The low level of medical insurance co-ordination and the division of management system will bring about many problems, which will affect the healthy development of medical insurance and naturally affect the public's recognition of medical insurance. In this case, there will be complaints about improving the proportion of personal payment for medical insurance. Only by rationalizing the institutional mechanism can the residents approve and support the development of medical insurance.