The medical insurance system is an effective financing mechanism for residents' health care undertakings, is a relatively progressive system that constitutes the social insurance system, and is also a mode of health cost management that is currently quite commonly used in the world. China's medical insurance system is mainly divided into three kinds, one is the labor insurance medical system applicable to enterprise employees, the second is the public medical system applicable to the staff of institutions and agencies, and the third is the cooperative medical system applicable to rural residents.
Expanded InformationThe labor insurance medical system was established in accordance with the Regulations of the People's Republic of China on Labor Insurance published by the State Council on February 26, 1951, which mainly applies to state-run enterprises. The system applies mainly to workers in state enterprises and some collective enterprises. Labor insurance medical expenses in 1953 before all by the enterprise; in 1953, according to the nature of the industry were changed to 5% to 7% of the total payroll extraction. 1969, the Ministry of Finance issued regulations requiring the central state-owned enterprises of the incentive fund, welfare and medical and health costs of the implementation of the combined extraction method, unified in accordance with the enterprise payroll of 11% of the employees' welfare fund withdrawn directly into the cost.
The main contents of the medical treatment of labor insurance include: (1) the medical treatment of employees or non-work-related negative report, the required consultation fees, surgical fees, hospitalization fees and general drug costs, are borne by the enterprise, the cost of expensive medicines, hospitalized meals and medical expenses are borne by the person himself or herself, such as his or her own financial situation is really difficult, can be subsidized under the discretionary labor insurance fund. (2) When an employee stops working for medical treatment due to illness or injury not caused by work, the period of medical treatment during which he or she stops working, which is less than six consecutive months, shall be paid by the enterprise for sick leave according to his or her length of service in the enterprise, and the amount shall be 60% to 100% of his or her salary; if the period of medical treatment during which he or she stops working is more than six months, he or she shall be paid a monthly sickness relief fee, which shall be 40% to 60% of his or her salary, under the Labor Insurance Fund until the employee is able to work or is determined to have a disability. The amount is 40%~60% of one's salary, until one is able to work or until one is determined to be disabled or dead.
(3) When an employee who has been injured due to illness or non-work-related injury is determined to be disabled at the end of the medical treatment and retired from work with total incapacity for work, the wages for the leave of absence for sickness and injury or the sickness relief fee are stopped, and the disability relief fee is paid to the employee under the Labor Insurance Fund instead, and the standard of the disability relief fee is determined as follows: for those who need assistance in eating and living, the amount is 50% of their wages, for those who don't need assistance in eating and living, the amount is 40% of their wages until they are able to work or until they die or return to working capacity. The period of disability relief is 50 percent of one's salary for those who need assistance with food and living, and 40 percent of one's salary for those who do not need assistance with food and living, until one's ability to work is restored or one dies. (4) The employee's immediate family members are dependent on the employee.
In case of illness of the immediate family members supported by the workers, they were entitled to free consultation and treatment at the medical clinics, hospitals, contracted hospitals or contracted Chinese and Western medical practitioners of the enterprises, and the operation fee and the general medicine fee were to be borne by the enterprises at 1/2 of the cost.
In response to the situation that the burden of enterprises and the state was too heavy on the medical care of the workers, the Ministry of Labor and the All-China Federation of Trade Unions in April 1966 issued a Circular on the Improvement of the Medical Care System of the Labor Insurance for the workers of the Enterprises on a number of issues, and made some new provisions on the medical care of the workers. Labor insurance medical made some new provisions, such as the provisions of the workers sick and non-work-related injuries, in the clinic required registration fees and consultation fees are borne by the workers; medical treatment of expensive medicines required by the enterprise, but the cost of taking nutritional supplements, should be borne by the workers and so on.