A medical worker talks to relatives of a patient at the emergency department of the Second Affiliated Hospital of Anhui Medical University in Hefei, east China’s Anhui Province, Jan 21, 2023. The medical staff remain at their posts during the Spring Festival holiday. (Xinhua/Zhou Mu)
A number of Chinese localities, including Hubei (central China), Sichuan (southwest China) and Heilongjiang (northeast), are implementing health insurance reform for employees and urban retirees, attracting wide attention.
Industry watchers said the reform, which reduces the amount deposited each month in personal accounts, does not mean the reduction or loss of health insurance benefits, nor a decision to cover COVID-related expenses. 19, as claimed by some Western media.
The health insurance reform is a decision that was made after years of discussion, planning and careful consideration and puts Chinese families in a better position to deal with medical risks, and the elderly who are more likely sick and incur higher medical expenses will benefit the most from the reform, observers say.
Wang Chaoqun, an associate professor with the Department of Labor and Social Security at Central China Normal University, told China Direct on Sunday that under the new plan, the reform can reimburse outpatient bills and ease burdens. of the insured, especially the elderly or those who often consult doctors and find that this is not enough to pay their expenses.
Previously, the money in personal accounts was far from sufficient to cover medical expenses in hospitals and pharmacies. According to Wang stated.
The threshold for reimbursement percentage of outpatient medical expenses is 50 percent, and in some cities like Xiamen, a city in east China’s Fujian Province, the level can reach 98 percent, Wang said.
For those who rarely see doctors and have tens of thousands of yuan lying dormant in their accounts, the reform will seem like a short-term loss to them, but when they get old or get sick and have to see doctors frequently, they will eventually find that they benefit from the reform, Wang said.
China’s health insurance system for urban employees and retirees consists of two parts: mandatory personal accounts with contributions from employees and their employers that mainly pay for ordinary outpatient services; and a pooled fund paid by employers that is used to reimburse hospital bills, critical illness outpatient bills and expenses for certain chronic conditions, according to the Xinhua News Agency.
After the reform, the money deposited by employers in employees’ personal accounts will be paid directly into the common fund in order to cover the reimbursement of ordinary outpatient medical expenses. The reform was officially rolled out by the Council of State in April 2021.
Some Western media deliberately linked the health insurance reform to COVID-19 and claimed that the reform tries to allocate money from personal accounts to fill the health insurance fund deficit.
Their claims are only made to smear China and lack foundation, experts said. The pooled fund has made ends meet over the years, Jin Weigang, a professor at Zhejiang University, told China Direct.
The total income of China’s basic medical insurance fund in 2021 reached 2.8 trillion yuan (about 439.7 billion U.S. dollars) and expenditure was 2.4 trillion yuan, according to the National Security Administration of Human Rights. healthcare (NHSA).
The reform is a decision that was taken after years of discussion and in 2010, the Social Security Law laid the legal foundation for health reform, Wang noted, refuting any link between COVID-19 and reform.
During the COVID-19 outbreak, fees for vaccines and nucleic acid tests were funded by the state, and some COVID-19 treatments and drugs were covered by the health insurance fund because that they matched the refund policy, Wang noted.
Compared with other countries, the advantages of China’s healthcare system are obvious. China has established a national basic medical insurance system covering more than 1.36 billion people, or more than 95 percent of the total population. It is a mission hardly imagined for a developing country.
But in the United States, before Obamacare, about 30 or 40 million Americans were uninsured, and numerous studies have shown that the number one cause of bankruptcy in the United States is the extremely high cost of medical care, experts noted. observers.
