Problems And Optimization Suggestions Of Basic Medical Insurance For Urban And Rural Residents In Dalian

In order to achieve the goal that urban and rural residents can enjoy fair basic medical insurance rights,the CPC Central Committee and the State Council proposed to establish a unified basic medical insurance system for urban and rural residents in 2016.On January 1,2020,the basic medical insurance system for urban and rural residents in Dalian began to operate.The system has been implemented for more than a year and is still in the exploratory stage.There are still some problems that need to be continuously optimized.This paper reviews the exploration process,policy situation and work effectiveness of the basic medical insurance system for urban and rural residents in Dalian,and carries out universal interviews with relevant department staff,medical institution leaders and urban and rural residents insured persons.Through the statistics,comparison and analysis of the data of the insured situation,medical treatment and fund operation of the basic medical insurance for urban and rural residents in different years in the data center information management system,it is found that after the integration of the system,there are still some problems such as the trend of medical treatment is still tilted to high-level hospitals,the lack of outpatient support ability,the pressure on the expenditure of the medical insurance fund for the elderly residents,the need to strengthen the handling of services,and the occurrence of fraud and fraud.It is believed that the main reasons for the problems are the uneven distribution of medical resources,the insured’s pursuit of high-quality medical services,the low level of financing,the aggravation of the aging population,the inadequate service subsidence,and the imperfect regulatory mechanism.It is suggested that the medical security department should continuously promote the improvement of China’s socialist medical security system and better serve the insured from the aspects of strengthening the allocation of grassroots medical resources,improving the treatment guarantee mechanism,strengthening the financing operation mechanism,optimizing the management services,and cooperating with commercial supplementary medical insurance.