Topic: 2023 High Quality Development Seminar of Inclusive Health Insurance
Recently, Sina Finance Zhongguancun The "2023 High Quality Development Seminar of Inclusive Health Insurance" jointly sponsored by the Changce Industrial Development Strategy Research Institute and Sina Health Insurance Research Institute was held in Beijing. Xiong Xianjun, former director of the Medical Service Management Department of the State Medical Insurance Administration, said that there were several issues to consider in the implementation of inclusive insurance.
First of all, what is the purpose of inclusive insurance? The goal of inclusive insurance is to improve ordinary people The level of medical treatment is consistent with the goal of basic medical insurance, but inclusive insurance cannot cover 95% of the people like basic medical insurance. Therefore, we cannot simply think that the implementation of inclusive insurance is for the people's health. This goal is not completely accurate. "As the famous economist once said, we need to make money like bread sellers. Even a non-profit organization needs to make both ends meet."
Secondly, we need to consider the sustainable development of inclusive insurance. We should not only consider the growth of the insurance rate in the first year and the second year, but also consider the possible decline of the insurance rate in the fourth or fifth year. We need to note that the number of patients accumulated in the pool is gradually increasing, and long-term chronic patients, tumor patients and rare disease patients will increase. Therefore, we need to consider the controllability and elimination of risks, as well as the risk accumulation of commercial insurance. We need to make sure that the risk is controllable and can be eliminated to ensure that our investment is sustainable.
The third issue is the need to consider the role of price control. Xiong Xianjun said that after the establishment of the National Health Insurance Bureau, price has become a prerequisite for controlling medical expenses. Some innovative drugs, because there is only one seller, are not competitive in the market. In this case, we need to reduce the price through negotiation to reduce the burden of the people. Therefore, negotiation is the best way to solve the different desires of the supply and demand parties for relative prices.
To sum up, the implementation of inclusive insurance needs to consider its objectives, sustainable development, price control and other issues. It needs to be clear that the goal is to improve the security treatment of the people, and to make money for the purpose of ensuring the balance of income and expenditure; We need to consider the controllability of the risk of inclusive insurance to ensure that our investment is sustainable; At the same time, it is also necessary to reduce the price through negotiations to reduce the burden of the people and the medical insurance fund.
Basic medical insurance has a strong purchasing power in the market and can become the dominant. He led everyone to negotiate with the enterprise and get through the cooperative relationship with the enterprise. But now there is inclusive insurance, which neither cooperates with basic medical insurance nor commercial insurance, resulting in infighting over prices.
"For example, there is only one manufacturer selling shoes. I sold shoes for 14 yuan. I wanted to talk about it, but a man named Pratt Whitney came and said I bought shoes for 14 yuan. This will inevitably affect consumers' choices." Xiong Xianjun said that to avoid internal strife, we should focus on the purpose of high-quality development, ideal choice The negotiation mechanism and other aspects will be discussed to study how to enter the social insurance system. China's medical security system is multi-level, but there must be clear boundaries between insurance types, otherwise it will be difficult to establish multi-level medical security.
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Editor in charge: Wang Jinhe
