Since 1950s, China has gradually established a medical insurance system with the characteristics of the times, which has played an important role. However, with the development of economy, the defects of the original medical insurance system are gradually exposed. Starting with the disadvantages of the current medical insurance system, this paper analyzes the causes of the problems, and puts forward to deepen the reform of medical insurance and build a medical insurance system with China characteristics. 1 China's medical insurance system The employee medical insurance system in China was established in the early 1950s, including free medical care and labor insurance medical care. This system has been implemented for several decades, which has played an active role in protecting the health of workers, reducing the burden on workers and their families, improving the health level of the whole nation, promoting economic development and maintaining social stability, and has played an important role in China's political, economic and social life. However, with the development of reform and opening up and market economy, the disadvantages of China's medical insurance system are increasingly exposed. Mainly manifested in the following aspects: (65,438+0) The state and enterprises over-package medical expenses, with heavy burden, poor management and lack of effective cost control mechanism, resulting in great losses and waste; (2) The coverage of medical insurance is narrow, the degree of service socialization is low, some employees' basic medical needs are met and medical resources are wasted, and the system of free medical care and labor insurance medical care is not unified. Because the original medical insurance system has not adapted to the requirements of the development of market economy, it has even hindered the further deepening of system reform. Therefore, in February 1998, the State Council issued the decision of the State Council on establishing the basic medical insurance system for urban workers [Guo Fa (1998) No.44] (hereinafter referred to as the "decision"), which was deployed nationwide to comprehensively promote the reform of the medical insurance system for employees, and it was required to be implemented nationwide in 1999. Since the promulgation of the "Decision", all provinces and cities in China have accelerated the construction of the basic medical insurance system for urban workers in accordance with the principle of "low level, wide coverage, burden on both sides and combination of unified accounts" and made significant progress. Basically, all provinces and cities have established the basic framework of basic medical insurance for urban workers, set up social medical insurance agencies (social security fund offices), established social pooling funds and personal accounts of basic medical insurance funds, and the social security fund offices are responsible for reviewing and selecting designated medical service institutions and pharmacies, and drawing up the basic medical insurance drug list, diagnosis and treatment items, standards of medical service facilities and corresponding management measures. In addition to the basic medical insurance, large medical expenses mutual aid system is generally established in all localities to solve the medical expenses above the maximum payment limit of social pooling funds.
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