Research report on the city's urban and rural pension and medical insurance according to the CPPCC 2010 annual work arrangements, since March, under the leadership of CPPCC Vice Chairman Zhao Nanjun, the CPPCC Committee of Social and Legal Affairs to organize some of the members, together with the Municipal Bureau of Human Resources and Social Security and other relevant departments, with the urban areas as the focus of the city's urban and rural pensions and health care situation for a thematic study. Thematic research group listened to the human resources and social security, health, civil affairs, finance and other relevant departments briefing; went to the districts and Jiangdu City, held departments and streets (townships), villages (communities) and other grass-roots units in charge of the symposium to understand the city's old-age pension and medical security, listen to the views, and went to the field to study and research. Now the research report is as follows:
One, the city of urban and rural old-age and medical security of the basic status quo
In recent years, the city in the comprehensive construction of a moderately prosperous society, urban and rural development process, adhere to the people's livelihood as the core, and initially set up the core of urban and rural old-age and health care social security system, and strive to make the whole urban and rural residents*** to enjoy the fruits of reform and development, and to promote the economic and social coordinated development, and maintain social stability.
1, the party committee and government attention, urban and rural old-age pension and medical insurance work situation is progressing well. Since 2002, the municipal party committee, the municipal government for nine consecutive years in the form of No. 1 document to focus on people's livelihood, safeguard people's livelihood and improve people's livelihood, the livelihood of people's livelihood issues, including old age, security, medical care, housing, education and other relevant policies and opinions, and gradually build a more comprehensive social security system, the level of protection continues to improve. 2009, the municipal party committee and the municipal government specifically issued the "on the advancement of the urban areas take the lead in the integration of urban and rural areas In 2009, the municipal party committee and the municipal government specifically issued "on promoting urban areas to take the lead in coordinating the implementation of urban and rural development", to accelerate the improvement of the social security system in rural areas, and gradually improve the level of social security for urban and rural residents put forward clear objectives. In the same year, the Wei Yang District Committee and the district government issued the Opinions on Accelerating the Integration of Urban and Rural Social Security in the District, initially forming a social security situation that is full-coverage, multi-level, connectable and convertible. City and counties (cities, districts) public **** financial tilt towards people's livelihoods, rural pensions and medical care investment in financial expenditure in the proportion increased year by year, from the requisitioned land farmers pension subsidies to the basic medical insurance for urban residents, new rural cooperative medical care, new rural social pension insurance, etc., all levels of finance to give each person a certain proportion of the contribution subsidies per year, such as the new rural cooperative financial subsidies from all levels of the year 2003 For example, the financial subsidies at all levels for the New Rural Cooperative Medical Insurance were raised from 20 yuan per capita per year in 2003 to 120 yuan per capita per year in 2010, a gradual increase from nothing to something; according to statistics, in 2009, the financial expenditures of the municipal and district levels for subsidizing the participation of urban and rural residents in the insurance system amounted to 86.59 million yuan. All relevant departments are actively fulfilling their responsibilities, strengthening their services, and actively promoting urban and rural pension and medical insurance. Social security departments continue to improve social insurance policies, expand social insurance coverage and strengthen the collection of social insurance premiums through inspections and services; health departments continue to improve the new rural cooperative medical care service network, fully deploy and promote the networked construction of the New Rural Cooperative Medical Care Information System, and make efforts to supervise the service behavior of medical institutions and coordinate the allocation of health resources and the provision of medical services in order to meet the needs of farmers for medical care services so that more farmers receive the benefits; civil affairs departments strengthen their services to promote the development of medical care services for rural and urban residents. The civil affairs department has strengthened its efforts in social assistance, comprehensively establishing a social assistance system that complements the policies of urban and rural five guarantees, special hardship medical care, temporary assistance and other complementary old-age and medical care, and implementing an old-age subsidy project for the urban and rural "three have-nots" elderly, with the standard gradually being raised and the scope continually being expanded.
2. The urban and rural old-age security system has basically been established and the docking channel has begun to open up. The basic pension insurance for urban enterprise workers, the basic livelihood security for expropriated farmers, and the new rural social pension insurance constitute a basic pension security system that covers both urban and rural areas. The basic pension insurance for urban enterprise workers has been implemented for many years, and the system is relatively perfect, currently covering 321,400 people from all kinds of employers and flexible employment in urban areas, and 92,500 retirees receive monthly pensions, with the pension treatment increasing for nine consecutive years, and the current average per capita in urban areas is 1,395 yuan per month. 2005 began to set up the basic livelihood protection system for expropriated farmers, including old-age pensions, and the rate of protection reached 100%, with the rate of protection reaching 100%, and the rate of protection reaching 50%. The insurance rate reaches 100%, covering 73,000 expropriated farmers in urban areas. "Individual contributions, collective subsidies, government subsidies" tripartite financing, "individual account and integrated account" combination of new rural social pension insurance started in 2007 in our city, 89,000 urban farmers insured. In order to integrate urban and rural development, Weiyang, Jiangdu actively explore, in the urban and rural residents pension insurance docking to establish a channel, the development of agricultural insurance to the city of insurance succession methods, opened up the agricultural insurance and enterprise employees pension insurance conversion channel.
3. The basic medical insurance system covers both urban and rural areas. Basic medical insurance for urban workers, basic medical insurance for urban residents, new rural cooperative medical care and medical assistance constitute the basic medical insurance system for urban and rural residents. The basic medical insurance for urban workers operates in a good state, and the reimbursement treatment has been steadily improved, at the end of 2009, 462,300 employees were insured in the urban area, and the average hospitalization reimbursement ratio within the scope of the medical insurance catalog for the employed workers and retirees reached 80% and 90% respectively. 2007 saw the implementation of the basic medical insurance system for urban residents, and "elderly residents" outside the scope of the employee's medical insurance was included in the system, Special hardship residents, minor residents, general residents" through different contributions, subsidies standard residents' medical insurance, into the medical insurance, urban residents to achieve the full coverage of the medical insurance system, the end of 2009, the urban area of 259,000 people to participate in the residents' medical insurance, including 77,000 college students, the funding level of 400 yuan / year, the reimbursement of directory coverage of 60%. Reimbursement within the scope of the catalog amounted to 60%. New rural cooperative medical care financing level in 2009 for 120 yuan per capita, of which individuals pay 30 yuan, due to the low standard of individual contributions, hospitalization compensation, taking into account the outpatient, the average reimbursement rate of 45%, the reimbursement of major illnesses, the payment ceiling is generally more than 8 times the per capita net income of the local farmers, the maximum of up to 100,000, and thus the majority of the farmers' recognition of the enthusiasm for participation in the increase in the end of 2009, the participation rate of 99.8%, the number of people in the urban areas to participate in the medical insurance system. At the end of 2009, the participation rate reached 99.8%, effectively alleviating the problem of farmers becoming poor and returning to poverty due to illness, and was welcomed by the majority of farmers.
Two, to promote the city's urban and rural pension and medical insurance work needs to be studied and resolved
With the acceleration of urbanization, smooth urban and rural social security channels, promote the development of urban and rural basic pension, medical insurance, expand the scope of the integrated, the implementation of the provincial basic pension insurance co-ordination, has been imminent. The current high-speed social and economic development, to promote the development of urban and rural pension and medical insurance provides opportunities and laid an important foundation, but due to the city's high degree of aging, the population aged 60 years or older accounted for 18.57% of the total population, the financial subsidies increased pressure, and insufficient articulation between the policies introduced year by year, making the promotion of the basic pension, medical insurance is facing a number of urgently needed to solve the contradictions and problems.
1, the coverage is not comprehensive, old-age and medical insurance has not yet fully realized should be insured. Pension insurance: First, after the implementation of the new rural insurance, urban and rural residents, there are still two types of objects are not included in the pension security system, a male 60 years old, female 55 years of age above the age of less than 70 years of urban unemployed residents, one of the land expropriated before 2005 in the farmers of the non-employed, there are still blank spots in the pension system. Secondly, there are still a few enterprises in development zones (parks), highly mobile catering and entertainment service enterprises, and labor-intensive enterprises that have not yet paid insurance for all the insured employees; employees of restructured enterprises that have been included in the old-age pension insurance for urban workers who have been bought out of their working years on a one-time basis, and some of the unemployed who have been disconnected from their insurance policies due to the high standard of contributions for the renewal of insurance policies. Thirdly, although urban jobless residents and some low-income employed people can choose the way of freelance participation in social security, they are outside of social security due to their lack of financial ability. Fourth, the city's new rural social pension insurance has just entered the preparatory stage, and the relevant implementation rules have not yet been issued. In terms of medical insurance: Firstly, due to the fact that people who have participated in enterprise employees' pension insurance (including flexibly employed people) cannot participate in the residents' medical insurance with lower contribution level, which leads to the loss of medical protection for some low-income employed people while it is difficult for them to renew their pension insurance; secondly, some difficult enterprise employees do not have the ability to make up the difference between the minimum number of years of participation in the insurance premiums and the "residual life year" fee in a lump sum at retirement, and face the risk of being disconnected from the insurance system.
2. Uneven development and a wide gap between urban and rural areas in the level of old-age and medical protection. First, the gap between urban and rural basic old-age security treatment has a tendency to expand. Urban enterprise retired workers pension for nine consecutive years at a rate of 10% increment, the current municipal level of enterprise retired workers per capita pension amounted to 1,395 yuan / month. While the rural pension security treatment is lower, participate in the new rural insurance basic pension per capita 60 yuan / month, landless farmers pension subsidies on average only 140 yuan / month, has not yet reached the level of minimum subsistence guarantee. Second, there is a gap between urban and rural medical security treatment. In recent years, although the new rural cooperative medical care has enabled the vast majority of farmers to pay 30 yuan a year to enjoy medical protection, most of the high-quality medical resources are concentrated in the cities, and the reimbursement rate of the New Rural Cooperative Medical Care decreases as the level of hospitals increases, so that most of the costs of farmers going to the city to see a doctor are still borne by themselves, and most areas are not able to see a doctor that can be reported, so that the actual treatment of the medical protection of rural residents is lower than that of the urban residents. As a result, the actual medical insurance benefits enjoyed by rural residents are lower than those enjoyed by urban residents. Third, there is a large gap between urban and rural informatization construction. Urban social security informatization construction investment is relatively high, the foundation is better, the management of social security work is more efficient; while the rural social security informatization construction is still lagging behind, the way of work and management can not be adapted to the real needs.
3, the policy does not converge, social insurance is difficult to effectively continue the conversion. First, the current pension medical insurance work of Weiyang, Guangling, Development Zone has been declared with the city social security center network, the relevant systems and policies are relatively unified. However, the policy regulations of Ganjiang District are not unified with the city, the contribution base, the contribution ratio, the enjoyment of treatment are not consistent with the city, the information and data system is not connected with the social security center of the city, and the municipal integration has not been substantially formed; and no channel has been established for the conversion of agricultural insurance to urban insurance in the region. Secondly, the standard of basic livelihood security for expropriated farmers varies and lacks sustainability. before 2005, there was no basic livelihood security system set up for expropriated farmers, while the basic livelihood security set up after 2005 varies according to the amount of the one-time transfer, with a minimum of 60 yuan/month, a maximum of 230 yuan/month, and other compensation standards of mostly 110 yuan, 135 yuan and 170 yuan/month. As the amount of compensation for the transferred land is limited, it will be unsustainable when it is used up year by year. Third, the social insurance system is self-contained system, the lack of effective convergence mechanism. The city of Yangfu hair [2008] No. 140 "on further expanding the coverage of social insurance to strengthen the views of social insurance premium collection" in the expropriated farmers, farmers and farmers to participate in the agricultural insurance to participate in or transfer to the city insurance, as well as urban workers' health insurance and residents' health insurance into the effective convergence of the principle of the provisions of the city, but the lack of supporting the implementation of the actual operation of the process of the implementation of the rules, there are a lot of funds and technical There are many financial and technical problems, such as how the personal accounts of expropriated farmers can be converted into urban insurance contribution years, how to pay urban insurance fees after converting the contribution years, and how the medical insurance is relatively independent, and the contribution years cannot be confirmed with each other, so it is not possible to realize the real integration and effective connection. Fourth, management resources are scattered, and the policy mechanism is "fragmented". The new rural cooperative medical care is under the supervision of the health department, while the urban workers' medical insurance and urban residents' medical insurance are under the supervision of the human resources and social security department, and social assistance is under the responsibility of the civil affairs department; the relevant policies and regulations and working mechanisms are different, each with a set of disconnected and independent database management systems, and there is a lack of communication and coordination in the introduction of policies, which results in wasted management costs and conflicts between policies. For example, the New Rural Cooperative requires participation in the insurance on a household basis, which leads to duplication of medical insurance for family members working and studying outside the home, while the policy clearly stipulates that there can be no duplication of reimbursement, and for example, employees of township enterprises can participate in the pension insurance for urban workers and the New Rural Cooperative, but they cannot be transferred to the urban residents' medical insurance.
4, the publicity is not in place, the relevant policies are not popularized enough. First, the public *** financial universal urban and rural residents, to accelerate the urgency of urban and rural pension and medical insurance awareness needs to be further improved. Secondly, in recent years, the central to local intensive introduction of a series of laws, regulations and policies, such as the labor contract law, health care system reform program, the new rural pension insurance system, pension insurance nationwide transfers, mobile medical insurance across the region across the system transfer methods and other training and publicity is not yet in place, the research, the community cadres generally reflect a lack of understanding of the specific policies, in the face of the masses of consulting difficult to answer.
Three, to promote the city's urban and rural pension and medical insurance work recommendations
Promote urban and rural pension and medical insurance work, so that all urban and rural residents **** enjoy the fruits of reform and development, is an important element of the creation of a national civilized city is to achieve the municipal party committee "adhere to the people-oriented, building a happy Yangzhou," the goal of promoting the coordinated development of the city's economy and society, and building a harmonious social and economic development. The city's coordinated economic and social development, building a harmonious society is an important foundation. To this end, the research group put forward the following recommendations:
1, increase efforts to realize the pension and medical insurance from the system of broad coverage to the object of full coverage. First, continue to vigorously promote the expansion of social insurance work. According to the basic, broad coverage of the principle of economic and social development from the city's level and conditions, the full implementation of the spirit of the municipal government's document No. 140 of 2008, refine the policy measures, develop supporting provisions to eliminate the blind spots, continue to expand the scope of old-age pension and medical insurance. On the one hand, for the labor-intensive private enterprises, service industry, the low participation rate of the reality, in accordance with the spirit of the municipal government documents, through the phased deferred payment and other ways to encourage participation in the insurance, more employed people into the urban social security system; on the other hand, human resources and social security departments to further strengthen the labor inspections, social security audit and other ways to supervise all the employers to participate in the insurance in a timely manner and pay the contributions in full. Second, the introduction of specific implementation methods to accelerate the urban new rural pension insurance work. To actively raise funds for the new rural insurance fund, to ensure that the funds in place, in places with conditions, the introduction of policies to encourage rural residents to participate in a higher level of pension and medical insurance system. On the basis of continuously expanding the coverage, steadily solve the problem of rural residents have a sense of security. Thirdly, differentiating between objects and putting in place a system of subsidized insurance. Active measures have been taken to promote the participation in social insurance of urban residents in difficulty, so that the social insurance relations of special groups who have had their social insurance relations interrupted can be renewed. For example, for the older, lower income, employment ability deviation of the laid-off unemployed, the introduction of preferential policies, through the conscientious implementation of the city's relevant social security subsidies to encourage participation in the policy; for other historical reasons failed to participate in the marginal groups, increase the insurance assistance, and strive to achieve should be insured as much as possible; suggested that the relevant government departments to study specific policies, the urban jobless residents, in accordance with the conditions of the relevant, into the scope of the basic old-age security to ensure that their old age is well taken care of. To ensure their old age with a sense of security. Fourth, to effectively solve the problem of residents' medical insurance. To break down the barriers between the health insurance system for urban workers and urban residents, and to allow workers in difficulty and flexibly employed people with lower financial capacity to choose urban residents' health insurance by strengthening the audit, so as to solve the problem of their medical insurance from scratch; it was learned during the research that in order to solve the problem of the lack of health insurance for some retired workers in the capacity of flexibly employed people and retired workers from enterprises in difficulty, the Guangling District adopted the "Three-Three System" health insurance program in 2005, and the "Three-Three System" health insurance program has been implemented. The "three-three system" funding model, that is, financial, collective, individual *** with the funding method, a better solution to the problem of all retired workers in the area of medical care, this practice can be promoted.
2, increase investment to narrow the gap between urban and rural pension and medical insurance treatment. First, accelerate the transformation and upgrading of economic development, through the process of industrialization and urbanization, accelerate the transfer of rural labor force, increase financial input and urban and rural residents' income, narrow the development gap between urban and rural areas. The second is to increase rural capital investment, rationalize the allocation of financial resources, establish and improve the mechanism of tilting the focus of public *** financial investment to the rural areas, and gradually increase the new financial expenditure on social security for people's livelihoods, such as pensions and medical care. In accordance with Yangzhou's level of economic and social development, the level of urban and rural pensions has been reasonably determined, and, on the basis of recognizing the reasonable differences in treatment between urban and rural areas, the pension entitlements of rural residents have been appropriately raised, the medical reimbursement ratio for urban and rural residents has been steadily increased, and the urban-rural disparity has been gradually narrowed, so as to achieve an appropriately balanced treatment of urban and rural areas. Thirdly, we are studying the social security of landless and expropriated farmers. This is the current urban areas need to solve the outstanding personalized problems, research has learned that, if the expropriated farmers' pensions and medical and other social security problems are not solved, three to five years will bring a heavy financial burden to the local community, and become a complex social problems and affect stability. It is recommended that the government strengthen in-depth research on landless farmers and expropriated farmers, including the situation of people before the implementation of the system of immediate expropriation insurance, collect information, get a clear picture of the bottom line, and, in view of the actual situation, gradually set up a security system that integrates basic old-age pension, basic medical care, and employment training by increasing the means of financing, and create the conditions for expropriated farmers to be incorporated into the social security system as soon as possible, so as to solve the worries. Fourth, the integration of urban and rural medical security resources. Develop rural public **** health undertakings, establish and improve a stable mechanism to draw high-quality health resources from the city to the countryside, strengthen the construction of medical and health care teams, guide high-level medical and technical personnel to support the countryside, solve the problem of the treatment of rural doctors, improve the level of grass-roots medical technology and service level, add the necessary medical facilities, and strengthen the grass-roots co-management office staffing and informatization construction; increase the medical institutions In particular, the supervision of large hospitals above the municipal level should be increased, and the performance appraisal mechanism of medical and health institutions should be improved. The method of dynamic management of designated hospitals through the signing of the New Rural Cooperative Agreement in Jiangdu City has yielded very good results, and should be taken into account and promoted; procedures for registering, contributing to the fees, declaring, settling, and approving the reports should be smoothed and simplified, so that farmers can enjoy better and more affordable medical resources close to their homes. Fifth, after the implementation of urban and rural residents over 70 years of age old subsidies, according to the financial capacity, the gradual implementation of urban and rural residents aged 60 - 70 years old subsidy system.
3, increase innovation, and effectively realize the effective conversion of different pension medical insurance system. First, it is recommended that the government of the city's different practices for research and categorization, sorting out the remaining problems around the basis of investigation and research, the introduction of relevant guidance, in the city area to gradually formulate the interconnection, mutual coherence, the principle of unity, flexibility and variety of policies and measures. According to the relevant implementation opinions of social insurance provinces and municipalities, around the goal of "unified system policy, unified contribution standard, unified payment items, unified calculation and issuance methods, unified management procedures", as soon as possible to achieve the urban scope of the social security policy, "the same city, the same standard, the same treatment! "First of all, we should solve the problem of Ganjiang District entering into the municipal co-ordination, and create conditions for the transition to provincial co-ordination. Secondly, based on the basic principle of "broad coverage, basic protection and sustainability", we should actively explore ways and means to solve the problem of linking the urban and rural pension and medical insurance systems in our city, and to make the relevant operational rules and regulations in line with the relevant principles and regulations in place, so as to smooth the channels of transferring and continuing the social insurance. It is recommended that we draw on the relevant practices that have already been implemented in foreign countries to gradually break down the status boundaries and establish a unified system of urban and rural pension and medical insurance systems, fully consider the reality of the income gap between urban and rural residents, and, in accordance with the principle of the relative equivalence of rights and obligations, explore the creation of a multiform social security "package system", set up a multi-level contribution standard and a multi-level entitlement option, with the urban and rural populations choosing from a variety of options, and the urban and rural populations choosing from a variety of options. The system is set up with multiple levels of contribution standards and multiple levels of treatment options, so that urban and rural residents can choose their own contributions according to their own needs, ultimately reflecting the difference in treatment between those who pay more and get more and those who pay less and get less. Third, the joint social security conference system should be given full play, and joint conferences attended by relevant departments should be held on a regular basis to strengthen research, study relevant policies, and formulate working measures around outstanding issues in social security. Prior to the introduction of major social security policies involving the immediate interests of the public, such as pension and medical care, the public's right to information and participation is guaranteed in a democratic manner through a variety of channels, such as the "public announcement system" and the "hearing system", so as to genuinely inform urban and rural residents of the benefits of good things and to do good things. Good things are done well and good things are done practically. Clearly identify the leading departments, strengthen the authority of the work, ensure the continuity between the policies introduced, and the convergence of policies between departments, so as to achieve scientific decision-making. Fourth, the establishment of interoperability management information platform to enhance the level of management services. From the practical point of view of the city, with supervision and management in one, rationalize the management relationship between urban and rural pension and medical insurance in the city, avoiding multiple departments and multiple management. Strengthening including new rural insurance, new rural medical information management system construction, including the proposal to use the "Golden Insurance Project" system, the establishment of urban information database, so that the integration of resources, information *** enjoy, insured persons, "the same person, the same city, the same library", medical insurance To realize the "one card", business processes and standardization of services, and gradually realize the urban and rural pension and medical insurance system of mutual conversion and convergence.
4, increase publicity efforts to improve the degree of awareness of the work of old-age and medical insurance and the popularity of the relevant policies. First, leading cadres at all levels should fully realize that to promote the work of urban and rural social security, sound urban and rural pension and medical insurance system, improve the urban and rural pension and medical insurance system, for the promotion of urban and rural development and social harmony is of great significance. It is suggested that the assessment of the performance of leading cadres should not only consider GDP, but also pay more attention to people's livelihood, and the assessment leverage is gradually tilted in the direction of people's livelihood. Second, make full use of radio, television, newspapers, networks and other mainstream media, the creation of social security columns, special editions, special features and other programs, the use of community windows and other forms of active and extensive publicity of all types of old-age medical insurance policy purpose and significance and the specific provisions of the relevant operating procedures, so that the social security policy for the benefit of the people's livelihood, guiding the enterprise workers and other types of employment and all urban and rural residents to understand the relevant policies to support and actively participate in the insurance. actively participate in insurance. Third, to strengthen the training of grass-roots organizations and various types of enterprises and institutions of policy and business knowledge, through the state, province and the city introduced various types of social security policies and regulations such as pensions and medical care, especially the new policies and regulations of in-depth study, to improve their policy and business level, so that they have a deep understanding of the mastery of various types of social security policies, enhance the work initiative, through solid groundwork, to promote urban and rural pensions and medical insurance work on a new stage in our city. Medical insurance work on a new stage.
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