Beginning Jan. 1, 2013, Nanjing will abolish its publicly-funded medical system. It was the last of 13 prefectural-level cities in Jiangsu to announce this reform.When Nanjing announced the abolition of the benefit on Dec. 8, it did not cause any ripples in the civil service system. The deputy director of the General Office of the Nanjing Municipal Party Committee said at the meeting that this is to clarify the relationship between the government and the market, the transformation of government functions, a "self-revolution". Nanjing "brewing for a long time" of this reform, but also confirms a megatrend, the public health care system will gradually withdraw from history, replaced by universal health insurance. Eighty percent of the country's provinces and cities to cancel the public health care "Realistically speaking, the public health care system has played a role in history, but with the development of the market economy, its shortcomings are more and more prominent." The deputy director of the Nanjing Municipal Bureau of Human Resources and Social Security admitted at a press conference on the same day. Talking about the drawbacks of publicly-funded medical care, the director of the finance office of a university in Nanjing told reporters that for historical reasons, the medical insurance of a general-level cadre with notable war service was housed in the school, and the large amount of medical expenses consumed each year seriously crowded out the amount for other faculty and staff at the school. "We have had to invest huge sums of money in purchasing commercial insurance for the faculty and staff in recent years to make up for it." In 1994, the state decided to carry out employee health insurance system, preferred Jiangxi Jiujiang and Jiangsu Zhenjiang to start the pilot, commonly known as the "two rivers pilot", the next year expanded to 50 cities, Jiangsu Suzhou, Wuxi, Nantong, Yancheng and other cities to enter again. "That year, responsible for this reform of the State Councilor Peng Peiyun had seven times to Zhenjiang research, it can be said that the country to establish the enterprise employee health insurance system is invested a lot of energy." In 1998, the State Council decided to push the reform across the country, said the source. At the same time, the abolition of public medical care became a trend. However, taking into account the deployment of national institutions, military enterprises and other special characteristics different from other cities, Nanjing in 2001 only began to pilot, while the implementation of the "dual-track system", in order to stabilize the transition. The reform was accelerated after Yang Weize came to power in Nanjing as one of the key ways to reverse the gap with the traditional southern Jiangsu economies of Suzhou, Wuxi and Changzhou. "This is mainly due to the gradual improvement of the basic healthcare system over more than a decade in employee health insurance, urban residents' health insurance, new rural cooperative healthcare and hardship assistance." Chen Jianning, deputy director of the Nanjing Human Resources and Social Security Bureau, said. As of November 2012, Nanjing's basic medical insurance has covered 3.33 million people. However, Nanjing has a population of about 8 million. After the abolition of the public medical system, Nanjing has about 200,000 institutions (mainly concentrated in the municipal organs and eight main urban areas) into the employee health insurance system, they will be the same as the existing employees, to achieve a unified system of policies, contributions, treatment standards, handling procedures, and in the future to see a doctor to enjoy "the same" medical The same" medical services in the future. In fact, the abolition of publicly-funded medical care is a trend. By the end of 2011, 24 provinces and municipalities have canceled this benefit, the civil servants into the employee health insurance system. It is reported that Shandong Province has set up this reform at the end of November. "Deputy hall" above not included "system framework gradually formed, policy provisions continue to improve, the number of participants increased, fund income and expenditure slightly surplus, improve the level of protection, management capacity to strengthen, is now China's health insurance system is characterized." A person in charge of the Health Department of Jiangsu Province has told this reporter. Chen Jianning, in response to reporters' questions, also emphasized that the measurement, this time the abolition of municipal public medical care will not affect the interests of the existing employees' insurance population. According to the reform program, participants in the basic medical insurance premiums paid by individuals are all transferred to their personal accounts, the integrated fund, respectively, according to the active employees themselves (age as a distinction) contribution base or retirees themselves last month's retirement (pension) of a certain percentage of the monthly transfer into the personal accounts of participants. However, the deployment of agencies in Ning, provincial organs and provincial management of institutions, due to the attribution of authority, this reform is not involved. The newspaper was informed that the Jiangsu provincial public health care for the deputy director level has been realized below the designated hospitals and differential reimbursement of the "double premise", that is, completely abolished 100% reimbursement of benefits. As for the "deputy director level" above, because of its cadre management authority at the provincial level, this newspaper was informed that is still in the implementation of the public health care system, the place of treatment is generally in the various larger hospitals in the high-level wards, such as the Jiangsu Provincial People's Hospital, Gulou Hospital and so on. Specifically, the level of deputy hall level or above (including retirement), there will generally be an identification card, with which you can go to the hospital directly for treatment, free of queuing and other procedures and formalities, treatment space, medical equipment and medical staff are relatively independent of the time is not too much restriction. Informed sources told reporters that Jiangsu provincial organs level into the employee health care system preparatory work has been carried out, the current controversy is to participate in the retirement "male less than 25 years, female less than 20 years," the personnel of the "should be in accordance with the provisions of a one-time complementary to the difference in the years of the basic medical insurance premiums for employees "In the end, by whom to bear. It is learned that some provincial units have been on the possible arrival of the reform planning, "the current preliminary design of the program is, a small portion of the financial subsidies, the unit out of pocket part of the individual self-funding part." After entering the universal health insurance, "if there is a difference in the level of enjoyment of health care in the future, it lies in the construction of the various units and individual supplementary health insurance, such as investment in commercial insurance." Related sources said.
Legal objective:Nanjing Municipal Party Committee and the municipal government held a press conference on the reform of the public medical system on the afternoon of the 8th, announced that from January next year the city will no longer implement the public medical care, but all to participate in the employee health insurance, and the reform involves 200,000 civil servants, who will be the same as the city's 3.33 million employees, to achieve a unified system of policy, participation in the payment of premiums, treatment standards, the handling of processes They will also enjoy the "same" medical services in the future. Nanjing, as the capital of Jiangsu Province, has become the province's last to complete the transfer of public medical care to the basic medical insurance area. It is understood that, according to the relevant provisions of the State and Jiangsu Province, the insured units can participate in the employee health insurance, the establishment of a separate unit of supplementary medical insurance. In addition, for cadres above the "deputy hall level", Jiangsu Province is still implementing the public medical system. In fact, the abolition of publicly-funded medical care is a trend. By the end of 2011, 24 provinces and municipalities had canceled this benefit and included civil servants in the employee health insurance system. It is reported that Shandong Province has been arranged at the end of November this reform. Commercial insurance will become a "supplemental insurance" document, the provisions of the "unit of supplementary medical insurance" has attracted much attention. For the design of this supplemental health insurance, Nanjing Municipal Human Resources and Social Security Bureau, deputy director of the explanation, this is the unit according to their own circumstances set, according to the current experience, some units are the implementation of their own management unit supplemental health insurance, but also with the help of commercial insurance to do supplemental health insurance. It is understood that the Nanjing reform involves the main content is, from January 2013 in the city to abolish the public medical system, institutions all participate in the employee health insurance, the realization of the city's institutions and enterprises employees basic medical insurance unified system policy, unified participation in contributions, unified contribution ratio, unified treatment standards, unified handling process, unified medical services. According to the deputy director of the Nanjing Municipal Bureau of Human Resources and Social Security, in the future, the organization and institution personnel to participate in the insurance and enterprise employees to participate in the same contribution standard. Specifically, the unit to participate in the cost of employee health insurance by the employer and the active employees **** the same monthly payment. Employers should register for employee health insurance with the social insurance agency in accordance with the regulations, and pay 9% of the basic medical insurance premiums according to the contribution base of the active employees. Active employees pay 2% of their own contribution base, and the medical assistance fee for major illnesses is paid according to the stipulated standard. The medical insurance premiums payable by active employees shall be withheld and paid by the employer on behalf of the employees from their salaries on a monthly basis. Currently, retired Nanjing institutions and organizations do not have to pay for the insurance. As early as 1994, the state decided to carry out employee health insurance system, preferred Jiangxi Jiujiang and Jiangsu Zhenjiang to start the pilot, the next year expanded to 50 cities, Jiangsu Suzhou, Wuxi, Nantong, Yancheng and other cities were selected to pilot. 1998, the State Council decided to promote the reform in the country. At the same time, the abolition of publicly-funded medical care became a trend. However, taking into account the special characteristics of the national deployment of institutions, military enterprises, etc., which are different from those of other cities, Nanjing started the pilot program in 2001, while implementing the "dual-track system" in order to stabilize the transition. As of November 2012, Nanjing's basic medical insurance has covered 3.33 million people. Nanjing's Jiangning, Pukou, Liuhe, Gaochun and Lishui districts have already abolished public medical care. A professor from Nanjing Medical University said that the system is more policy-oriented, and currently, as far as Jiangsu is concerned, provincial-level organizations and universities are left without medical insurance. It is reported that in accordance with the relevant provisions of the Measures for Nanjing Urban Social Basic Medical Insurance (Municipal Government Decree No. 265) and the Notice of the Municipal Government on the Abolition of the Publicly-funded Medical Treatment System for Organs and Institutions to Participate in the Employee Basic Medical Insurance (Ning Zheng Fa 2012326), all the staff members and retired staff members of the organs and institutions of the city of Nanjing participate in the Employee Basic Medical Insurance and the Medical Aid for Major Diseases, and enjoy the All staff and retirees of institutions in Nanjing participate in the basic employee medical insurance and medical assistance for major diseases, and enjoy the treatment of employee medical insurance, and establish supplementary unit medical insurance in accordance with national and provincial regulations. The "unit supplementary medical insurance" stipulated in the document has attracted much attention. For the design of this supplementary medical insurance, which is set according to their own units, according to the current experience, some units are the implementation of their own management unit supplementary medical insurance, there are also with the help of commercial insurance to do supplementary medical insurance. The reform also makes it clear that the number of consecutive years of service or years of work in line with national regulations before the insured person is insured can be regarded as the number of years of medical insurance contributions. The part of the retroactive contributions will not be added to the individual account. The basic medical insurance premiums paid by the insured individuals are all transferred to their individual accounts. The integrated fund is transferred to the individual account of the insured person on a monthly basis according to a certain percentage of the contribution base of the active employee or the retirement fee or pension of the retiree in the previous month. The proportion of the account for active employees is: 1% for those aged 35 and below; 1.4% for those aged 35 and above to 45; and 1.7% for those aged 45 and above to retirement. For retirees, the transfer rate is 5.4%. According to the provisions of this reform, after participating in the retirement of the personnel, their employment during the period of payment of employee basic medical insurance premiums for less than 25 years for men and less than 20 years for women, should be in accordance with the provisions of the one-time to make up for the difference in the years of employee basic medical insurance premiums, in order to enjoy the retiree medical insurance benefits. However, the reform also makes it clear that the consecutive years of service or working years before the insured person's participation in the insurance in accordance with national regulations can be regarded as the number of years of medical insurance contributions. The retroactive contributions will not be added to the individual account. After the reform of the public medical system, the insured personnel of institutions and organizations will, like the insured employees of enterprises, hold cards to seek medical treatment and purchase medicines at designated medical institutions and designated retail pharmacies, and enjoy the corresponding treatment according to the relevant policies and regulations of the employee medical insurance and medical assistance for serious illnesses. In addition, insured persons suffering from outpatient chronic diseases, outpatient specific programs, and outpatient mental illnesses are required to go through the procedures for access to the disease types according to the regulations. For those who are permanently stationed abroad, they need to go to the municipal medical insurance agency to apply for the registration procedures for long-term stationed abroad personnel, and the expenses incurred in the local fixed-point medical institutions selected by them will be reimbursed back to the place where they participate in the insurance in accordance with the policy provisions. Four major types of insurance has not yet begun on this occasion only to complete the 200,000 civil servants to join the medical insurance of this link, for maternity, old age, unemployment, work-related injuries, the four major types of urban workers insurance has not yet begun. In Nanjing, an organization working after 80 Wang (a pseudonym) after graduation had worked in an enterprise for a period of time, and later took the civil service, for the abolition of the public health care system she felt that, "compared to the inclusion of medical insurance treatment is certainly to be lowered, may be because I previously participated in the medical insurance, I can accept, but many of the old comrades, may be psychologically still more difficult to accept. " As far as she knows, in addition to the main city of Nanjing, including Jiangning, other provinces and cities in Jiangsu civil servants have participated in the employee health insurance, many other cities across the country also participated in the health insurance, Nanjing City District to participate in the insurance is only a matter of time. "I and my colleagues are from the media to know the news of the reform, before there is no notice, also do not know exactly how to reform, now the news out, can only wait for the unit notice." For this reform news, Wang heart there are a lot of doubts, so this reform is from next year's January implementation, then the insurance procedures need to be completed before the end of December, the base to be calculated, personal data to be prepared, Citizen Card for time, how can all be realized in January? In addition, for civil servants, treatment and how the change, before the public health care, is to go to a designated hospital to see a doctor, their own advance payment, back to the unit to reimburse the proportion of the ratio and the length of service, but also with the prescription of medicines related to the future of what will be the case, will not be like other cities have a medical subsidy? Currently completely unknown. In addition, the enterprise employees to participate in insurance, in addition to medical and maternity insurance, but this time only said to participate in medical insurance, then if the birth costs, how to calculate it? Nanjing Municipal Human Resources and Social Security Bureau of Medical Insurance Settlement Management Center, a staff member said that the city of this work is currently under intense coordination, a lot of specific work with the program is also in preparation. On this occasion only completed 200,000 civil servants to join the medical insurance this link, for maternity, pension, unemployment, industrial injury, the four major categories of urban workers insurance has not yet begun. Wang said, before seeing a doctor can only see in their own designated hospitals, outside the designated need for referral, very troublesome, even if it is a minor illness such as colds, you must register to get medicine, can not go to the pharmacy to buy their own; to eliminate the waste of medicines, once in the hospital to see the special registration to get medicines, taking up medical resources, not to mention, prescribe so much medication, expired and not used up is certainly a waste. "Now we feel that public medical care is a privilege, I remember when I was a child many units are infirmaries, factory hospitals, many units can be reimbursed for the cost of medicine, after the reform and opening up, most of these benefits have disappeared, with the improvement of the social security system, this part of the function of the transfer of the health care system, but in the institutions, institutions this part of the benefits retained. " Wang believes that, looking forward, there is no excuse, looking back is the focus of social injustice, to participate in health insurance is inevitable, to participate in social security is also the trend of future reforms. Can be for the institutions "to reduce the burden" in the past many institutions in the public health care burden is very heavy, and now by the financial unified payment, for these units, this is a good thing. "Nanjing's comprehensive implementation of the reform of the financial system and the reform of the public health care system, aimed at institutional change, for the transformation and development of Nanjing and take the lead in the basic realization of modernization to provide an important institutional support and power mechanism." Dr. Xu Yijun, director of the Institute of Social Development of the Nanjing Academy of Social Sciences, pointed out that public **** finance is a core component of the government's provision of public **** services and the supply of public **** products. This reform of Nanjing's fiscal system will promote basic public **** services among the city's regions, promote equalization including basic education, medical care and health, and enhance the government's ability to provide public **** services. "The key to modernization is the modernization of people, through the reform of the financial system to promote social fairness and justice, so that the people share the fruits of reform and development, will certainly add new momentum for the city to take the lead in the basic realization of modernization." Xu Yijun said, not only that, this financial system reform, but also optimize the urban financial management system, to reform to enhance the vitality and power of the development of districts and counties (parks), will certainly promote the transformation and upgrading of the city of Nanjing, and more entrepreneurial and innovative resources into the power of scientific development. "This can fundamentally realize the medical health or health rights of urban and rural residents, and add another impetus for Nanjing to take the lead in basic modernization." Xu Yijun said that this reform of the public healthcare system, which aims to establish a unified healthcare insurance system in terms of content, population and standards, is a rightful part of Nanjing's progress towards modernization. "Employee health insurance, the new rural cooperative, and residents' health insurance should all gradually come together and integrate urban and rural areas." Publicly-funded medical care is a new system developed by the state in 1979, which is now seen to be gradually replaced. "The people have doubts, why they participate in health insurance, and civil servants are still practicing public medical care; and a part of the civil servants of the existing public medical care is equally dissatisfied, because, according to the national basic drug catalog medication, no medical insurance drug medication selectivity is greater, the individual to get more benefits, so a considerable part of the civil servants are also willing to join the medical insurance, this is a trend And for the thing, but also reflects the whole health insurance system to further improve, increase the strength of the health insurance co-ordination, more consideration of all aspects of the balance." "It is possible that in the future, provincial authorities, including institutions, will also have to take this step." Relevant sources said that many institutions in the past in the public health care burden is very heavy, and now by the financial unified payment, for these units, this is a good thing. It is understood that Jiangsu Province, for the "deputy hall level" above the cadres management authority at the provincial level, is still in the implementation of the public health care system, the place of treatment is generally in the senior wards of the larger hospitals, such as the Jiangsu Provincial People's Hospital, Gulou Hospital and so on. In this regard, Leng Mingxiang said, "deputy hall level" medical reimbursement channels are different from others, belonging to the management of the Dry Insurance Bureau, that is, the cadres of the Health Bureau, because how many years have been so has been managed down, after all, it is a minority, confined to the hall level or above, and can not be completely absolute one size fits all.