The role of medical insurance
First, it is conducive to improving labor productivity and promoting the development of production. Medical insurance is the inevitable result of social progress and production development. Conversely, the establishment and improvement of medical insurance system will further promote social progress and production development. On the one hand, medical insurance relieves the worries of workers, makes them work with peace of mind, can improve labor productivity and promote the development of production; On the other hand, it also ensures the physical and mental health of workers and the normal reproduction of labor.
Second, saving income differences reflects social equity. Medical insurance is an important means for the government to adjust the income difference and redistribute income by collecting medical insurance premiums and paying medical insurance service fees.
Third, an important guarantee for maintaining social stability. Medical insurance helps sick workers economically, helps to eliminate social instability caused by diseases, and is an important social mechanism to adjust social relations and social contradictions.
Fourth, an important means to promote social civilization and progress. The social system of medical insurance and social mutual assistance reflects the new social relationship of "one party in trouble and all parties support" by sharing the risk of disease costs among the insured, which is conducive to promoting social civilization and progress.
Five, an important guarantee to promote the reform of the economic system, especially the reform of state-owned enterprises. According to the provisions of Article 28 of the Social Insurance Law, the reimbursement conditions meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue medical expenses, and are paid from the basic medical insurance fund in accordance with state regulations. According to the basic requirements of the payment of basic medical insurance benefits in China, the insured person who goes to the medical insurance institution to reimburse the medical expenses incurred by himself for medical treatment generally meets the following conditions:
(1) The insured must go to the designated medical institution of basic medical insurance or to the designated retail pharmacy determined by the social insurance institution with the medical prescription issued by the doctor in the designated hospital.
(2) The medical expenses incurred by the insured in the process of medical treatment must conform to the basic medical insurance drug list, diagnosis and treatment items, the standard scope of medical service facilities and payment standards, and be paid by the basic medical insurance fund according to regulations.
(III) Among the medical expenses that the insured meets the scope of payment of basic medical insurance, the part that is higher than the Qifubiaozhun of the social medical co-ordination fund and lower than the maximum payment limit shall be paid by the social medical co-ordination fund in a unified proportion.