National medical insurance bureau： improve the world’s largest basic medical insurance network, and the national population participation rate is stable at around 95%

　　Cctv newsAt 10: 00 am on May 18th, the State Council Press Office held a series of press conferences on the theme of "Opening by Authorities", introducing the situation of "Implementing the Party’s 20 Major Decisions and Deploying Efforts to Promote the High-quality Development of Medical Insurance" and answering reporters’ questions.

　　Hu Jinglin, director of the National Health Insurance Bureau, introduced that in 2018, the CPC Central Committee with the supreme leader as the core made a strategic decision to set up the National Health Insurance Bureau. Since its establishment, the national medical insurance system has closely revolved around the great political mission of "relieving all people’s worries about diseases and medical care" entrusted by the Supreme Leader General Secretary, and has always adhered to the people-centered principle, overcome difficulties and pushed forward the reform of the system and mechanism, and promoted the historic leap of China’s medical insurance cause, which has played an important role in alleviating the difficulties and expensive medical treatment for the masses, supporting the development of medical and health undertakings, maintaining social harmony and stability, and promoting the realization of common prosperity.

　　In the past five years, we have adhered to the principle of stability and improved the world’s largest basic medical security network. From 2018 to 2022, the national population participation rate will be stable at about 95%, and the reimbursement rate of hospitalization expenses within the scope of employee medical insurance and urban and rural residents’ medical insurance policies will reach about 80% and 70% respectively. The participation rate of rural low-income population and poverty-stricken population has stabilized at over 99%, and medical insurance has helped nearly 10 million poor residents successfully get rid of poverty. The total annual income of the basic medical insurance fund (including maternity insurance) increased from 2.14 trillion yuan to 3.09 trillion yuan, and the total annual expenditure increased from 1.78 trillion yuan to 2.46 trillion yuan. The fund operated smoothly and had a balance. The annual per capita subsidy standard for residents’ insurance payment is increased from 490 yuan to 610 yuan. In 2022 alone, the total financial subsidies will reach 600 billion yuan.

　　In the past five years, we have adhered to the principle of benefiting the people and made efforts to reduce the burden of medical treatment for the masses. Accelerate the pace of medical insurance negotiations, and promote a large number of exclusive varieties of anticancer drugs and drugs for rare diseases, such as Karelizumab and Nocicina, to be included in medical insurance at appropriate prices. In addition, after reimbursement, the cumulative burden of patients has exceeded 500 billion yuan, helping tens of millions of seriously ill patients and their families rekindle their hopes of life. Promote centralized procurement, and the average price reduction of 333 drugs organized by the state is over 50%, and the average price reduction of 8 high-value medical consumables such as heart stents and artificial joints is over 80%; Together with local alliance procurement, the cumulative burden reduction is about 500 billion yuan. We will reform the way to protect residents from chronic diseases, and include outpatient drugs for hypertension and diabetes in the scope of residents’ medical insurance, benefiting 140 million residents with chronic diseases. Continue to open up the bottleneck of medical treatment in different places, and the scale of direct settlement of medical treatment in different provinces has increased from 1.318 million in 2018 to 38.1235 million in 2022, an increase of 28 times. In view of the epidemic situation in COVID-19, we will resolutely implement the "two guarantees" policy, and guarantee the vaccine and vaccination expenses in COVID-19, so as to contribute to the medical insurance for a major and decisive victory in epidemic prevention and control. Continuously expand the pilot scope of long-term care insurance, which has covered 169 million people in 49 cities and benefited 1.95 million disabled people, making their lives more quality and dignified.

　　In the past five years, we have been driven by innovation and promoted the high-quality development of the pharmaceutical industry. Encourage industry R&D and innovation, and establish a medical insurance access and negotiation renewal mechanism with new drugs as the main body. The waiting time for listing new drugs into the medical insurance catalogue has been shortened from the past average of nearly five years to less than two years, and some new drugs have been included in the medical insurance catalogue only half a year after listing. The expenditure of medical insurance on new drugs increased from 5.949 billion yuan in 2019 to 48.189 billion yuan in 2022, an increase of 7.1 times. Expand the sales channels of negotiation drugs, and through the "dual-channel" management mechanism, some medical insurance negotiation drugs that were originally supplied mainly in large hospitals can now be sold in 155,000 designated medical insurance pharmacies nationwide and included in medical insurance reimbursement. Purify the ecology of the pharmaceutical industry, institutionalize and normalize the centralized procurement with quantity, continue to squeeze the inflated price of pharmaceutical consumables, and "take the bottom out" to reduce the space of "selling with gold". The innovation power of pharmaceutical companies is getting stronger and stronger. Among the top 10 pharmaceutical companies with A-share market value, the total R&D investment in 2022 is 2.48 times that in 2018.

　　In the past five years, we have adhered to system integration to help the coordinated development and governance of the "three doctors". Support the improvement of the compensation mechanism for medical staff, and clarify that the surplus funds formed by public medical institutions in the reform of centralized procurement and medical insurance payment methods can be used as a whole for personnel salary expenses. Reform the fund disbursement mechanism, establish a turnover system of medical insurance funds in most overall planning areas, and prepay medical insurance funds to medical institutions at the beginning of each year, thus reducing the pressure on hospitals to advance funds. We will comprehensively establish a dynamic adjustment mechanism for the price of medical services. While substantially reducing the price of pharmaceutical consumables, we will appropriately adjust the prices of hospital services such as surgery and traditional Chinese medicine, which reflect the value and ability of technical services, and support the high-quality development of public hospitals. Actively support the development of primary medical institutions, and guide patients to buy medicines and enjoy health management services at the primary level by increasing the proportion of reimbursement for primary medical treatment and reducing the deductible line for primary medical treatment. Forging a strong and temperature-sensitive medical insurance fund supervision sword, handling 1.543 million illegal medical institutions, recovering 77.13 billion yuan of medical insurance funds and exposing 245,000 typical cases; Medical institutions that take the initiative in self-examination and self-correction shall be lenient in accordance with the law and vigorously promote the norms of diagnosis and treatment.

　　Generally speaking, in the past five years, through the coordinated development and governance of medical insurance, medical care and medicine, a win-win situation of "people enjoy benefits, funds ensure safety, hospitals develop and enterprises grow" is taking shape.