Shandong Commercial Daily
yesterday afternoon, the provincial CPPCC held a "civil voice connection - medical insurance" consultation. The people who made medical insurance proposals by dialing "popular voice" 0531-88197600 in the previous period were invited to the provincial CPPCC members as well as the provincial Office of the people's society, the Provincial Health Planning Commission and the medical insurance office of the hospital to discuss the current health insurance policy and reform measures of the residents in our province. Reporter Yang Fang
symposium, everyone on the residents of medical insurance issues each express Wang Xiaofeng / >
How are high value consumables so expensive?
even doctors think the price is too high for
the previous period of time, Ji'nan citizens Li Chunxiang and Li Shujuan both dialed "public voice", reflecting the medical insurance and the problem of medical care. Li Shujuan said that a thrombus protector placed in the blood vessels is 26 thousand yuan, a domestic 1.7 in case, and a patient in general should be loaded with several.
"we also want patients to spend less money on diseases, but doctors think consumables are too expensive." Qilu Hospital, Sun Zhuping, director of the medical insurance office, said yesterday, "the hospital's common cerebrovascular stent, is a small spring ring, the price of 16 thousand and 800 yuan, a 2 cm size of the brain hemangioma, the operation is about to use 16-20 supports, how much money? Can the patient feel expensive? There is also aortic dissection, with large stents, which are also sky high and cost up to 400 thousand yuan... " However, hospitals and hospitals do not have pricing power for these drugs and medical consumables.
"more than 200 yuan of consumables, the hospital only 4% plus! We are always talking about friends and neighbors doing an operation, and spent hundreds of thousands of hospitals. But where are these hundreds of thousands of dollars used? " Sun Zhuping believes that the urgent need to do is to reduce the high price of drugs and consumables.
804 kinds of high value consumables are bidding for the problem of excessive medical costs in
. The deputy director of the Provincial Health Planning Commission, Song Xinqiang, said that to control the rapid growth of medical costs, the government run the zero difference in the implementation of the medicine of the grass-roots medical institutions, and the county hospitals in the reform of the public hospitals in the province. The product is also a zero difference.
to control the price of high value medical consumables, provincial centralized bidding is being carried out in our province. At present, the second batches of 804 kinds of high value consumables are in progress, and the decline is expected to reach 15%. In the general hospitals above grade two, 20 diseases have been implemented, and the number of disease cases will be expanded to more than 50 this year.
"medical expenses now increase by more than 15% per year, much higher than the growth rate of health insurance funds." Qi Jun, director of the provincial social insurance bureau, said they are also exploring the reform of the medical insurance payment system to control the unreasonable rise of medical expenses.
the reimbursement ratio of medical insurance reimbursement for large diseases is also more than 40%
. However, the hospital also has different views on the way of medical insurance payment. Sun Zhuping said, at present, medical insurance for large medical expenses to pay the implementation of the sharing mechanism, more than 150 thousand yuan of medical expenses by the hospital and social security part 37, more than 50 thousand yuan to 46. "That is to say, the rescue of difficult and critical patients, the hospital dozen doctors and nurses in the operation room, guardianship and ward day and night to fight, put a lot of manpower and material resources, in the end, to pay 30% of the medical costs!"
Sun Zhuping said, up to now, Qilu Hospital for Ji'nan residents medical insurance patients pad 23 million 570 thousand yuan. In Shandong Province, the medical insurance patients in sixteen cities except Ji'nan were discharged from the hospital in 2015, 24 thousand and 900 people were discharged in the hospital, the medical fee was 640 million yuan, the medical costs were more than 50 thousand yuan and the major diseases were 3496, and the hospital had a total of 54 million 738 thousand yuan.
Hua Yongxin, the director of medical insurance from Ji'nan Central Hospital, said that the hospital per month of medical insurance was about 1000 people. From their statistics, even with medical insurance, the proportion of reimbursement for patients was more than 50%. This statement is confirmed by Sun Zhuping. "From the statistics of our hospital in 2015, we usually exceed 40% because of many serious diseases."
statistics of Qilu Hospital found that in the medical insurance patients of urban and rural residents hospitalized in 2015, there were 690 patients with more than 50 thousand yuan of medical expenses. Among them, the medical expenses were 536 people of 5 to 100 thousand yuan, 130 of 10-20 million yuan, 24 people of more than 200 thousand yuan, and the maximum consumption 725 thousand yuan. The reasonable medical expenses of these groups are more than 12 thousand yuan, and some of them enjoy serious illness reimbursement, so that their reimbursement ratio reaches 37-38%.
the crest line of medical insurance can be reduced to 200 thousand yuan
to 60%-70%
. "In our actual work, we are sorry to see these patients, especially for many patients." Hua Yongxin suggested that it would be possible to reduce the current reimbursement cap from 300 thousand to 200 thousand, and to increase the reimbursement rate to 60% or even 70% for the patients who spend less than 200 thousand, and for more than 200 thousand of the costs, the public or government incentives to buy commercial insurance can be used to improve their compensation ratio.
Hua Yong said that the public financing is to pay more than 10 yuan per month or 20 yuan per person to solve a partial reimbursement of more than 200 thousand yuan. The commercial insurance is to encourage the participants to buy 20 yuan a month in addition to the current medical insurance. The government is proportionately funded, so that if there is a major illness, there are also the above measures for reimbursement. The last line.