Tongliao City Urban And Rural Residents Of A Serious Illness Insurance Situation Investigation Report

The new rural cooperative medical system in the serious illness insurance system(hereinafter referred to as the new rural cooperative medical insurance),is a serious illness occurred in patients with high medical expenses to give secondary security system to arrange the system can expand the effectiveness of security,Supplement to the depth and breadth of the basic health care system.The development of the new rural cooperative medical insurance system to alleviate the serious medical expenses to farmers to bring a heavy burden and pressure to enhance the farmers on the advent of serious illness,in order to avoid the disease caused by poverty,due to illness and poverty to build the last wall;In the promotion of health insurance,medical care,medicine,"three medical linkage",and government management leading market open mechanism under the balance of the two,can effectively enhance the basic medical support capacity and scope of protection.In 2013,Tongliao City as the autonomous region pilot cities,the first in the city opened the new rural cooperative medical insurance institutions to promote the operation to Guangdong Province,"Zhanjiang model" modeled,combined with Tongliao actual economic livelihood,introduced the government pay,Commercial insurance institutions to operate a new rural cooperative medical care,in order to avoid the rural family catastrophic medical expenditure as the goal,to determine the sustainable illness insurance policy,to benefit the city’s 2.11 million farmers and herdsmen.Years of practice,surviving some problems to be solved.This investigation is intended to uncover the real operation of the new rural cooperative medical insurance in Tongliao City for three years.From the four aspects of policy objectives,fund raising,rescue standard and rescue procedure,according to relevant policies and data,This paper analyzes the problems existing in the operation and the deep-seated reasons,and draws lessons from the advanced experience of the new rural cooperative medical insurance in other areas of the country,and puts forward the improvement of the farmers’ protection level in Tongliao City Rationalization The main contents of this study are as follows:Policy objectives,Tongliao City,the new rural cooperative medical insurance coverage increased year by year,large medical insurance reimbursement category alsoexpanded year by year to better enhance the level of protection;but because of the "Pratt& Whitney" and the definition of fuzzy,combined with rural family self-resistance Weak risk,leading to the actual reimbursement ratio is low,leading to Tongliao City,the new rural cooperative medical system to alleviate the actual situation of rural families due to poor ability to return to poverty.In the aspect of fund raising,personal payment and financial subsidy at all levels have been improved year by year,and efforts have been made to expand the financing channels to better improve the quality of the guarantee.However,due to the "heavy and light defense" concept and the excessive reliance on serious illness insurance,the lack of commercial insurance supplement,The insurance fund is overburdened.In terms of salvage standards,the proportion of outpatient treatment and hospitalization is higher than that of national policy,and it is improved year by year to improve the ability of protection.However,due to the lack of propaganda and lack of medical policy,"The effect is not obvious,not only caused a" difficult to see a doctor,"returned to the serious co-ordination fund has brought a burden.Rescue procedures,the formation of " commercial insurance and social insurance combined with the stability of the security model,the overall level of upgrading to better enhance the efficiency of protection;but because of the " compliance " directory matching is not high and the proportion of unreasonable assessment of the proportion of drugs The serious illness insurance reimbursement area out of the actual needs of the local,deviated from the new rural cooperative medical policy of the original intention.On the basis of the research situation of the above research,combined with the advanced experience of the new rural cooperative medical insurance in other areas of the country,it is proposed to improve the protection level effectively,make efforts to improve the propaganda and make efforts to create the innovation mode,perfect the system and match the actual demand.Countermeasures for Promoting Healthy and Sustainable Development of New Rural Cooperative Medical Insurance in Tongliao City.