Summary of the medical insurance work experience exchange meeting

Comrades:

The medical insurance work experience exchange meeting has been completed by the delegates for nearly two days. The main meeting agenda has been successfully completed. According to the meeting arrangement, I will make a simple summary.

The meeting was the first national medical insurance work deployment and experience exchange meeting held since the establishment of the Ministry of Human Resources and Social Security. The directors, directors and agencies from the 31 provinces and the Xinjiang Production and Construction Corps in charge of medical insurance. More than 140 representatives of the responsible comrades attended the meeting.

At the meeting, 15 provinces and municipalities such as Fujian and Xiamen made exchanges of experience in the conference, and introduced experiences from urban and rural planning, outpatient planning, prefecture-level coordination, and urban residents' basic medical insurance. In terms of urban and rural integration, Guangdong, Jiangsu, Fujian and Xiamen explored the implementation of a unified medical insurance system. In some places, based on the urban workers' basic medical insurance information system, a unified medical insurance information system was integrated. Cities such as Tianjin and Hangzhou have achieved the unification of urban and rural medical insurance management systems. In terms of land-level planning, many cities have implemented land-level coordination in accordance with the requirements of policy unification, standard unification, fund unification, and management. Some cities have adopted a combination of unified management and adjustment of funds to fully mobilize the enthusiasm of districts and counties. In terms of outpatient coordination, the cities explored generally insisted on starting at a low level, and the level of treatment was reasonably determined according to local conditions. For example, Qingdao’s reimbursement started from 30%; Xiamen City set up a deductible line. In the medical management, we insist on making full use of the community and grassroots health service institutions. In some places in Guangdong, we have adopted a method of paying a fixed amount according to the number of people served. In terms of residents' participation in insurance, all localities make full use of the community and schools to increase their expansion. For example, Haikou City makes full use of all aspects of mobilizing forces to implement responsibilities at all levels; Beijing and education departments jointly issued a document to clarify that schools collect medical care. insurance. The construction of community labor security platforms and information systems has been generally strengthened throughout the country. For example, Hunan Province adopts the centralized development of the province's resident medical insurance information system, avoiding redundant construction. These good experiences and good practices have a good reference for actively exploring and steadily promoting the medical insurance system.

During the meeting, the delegates held a group discussion. Vice Minister Xiaoyi presided over the discussion of the directors of the department. They exchanged views on the work and main experience of the first half of the year, and analyzed the current situation and tasks of the medical insurance work. The next step in medical and maternity insurance work has put forward many good opinions and suggestions. Just now, Vice Minister Xiao Yi made an important speech. It is widely reflected that although the meeting was not long, the content was rich in content and focused, reaching a unified mind, recognizing the situation, strengthening confidence, and clarifying the intended purpose of the task. Below, I will talk about three aspects.

First, earnestly study and implement the spirit of the speech of Vice Minister Xiaoyi

Vice-President Xiao Yi’s speech stood at the height of implementing the scientific development concept, focused on the overall situation of economic and social development, objectively summed up the achievements in the medical and maternity insurance work in the first half of the year, thoroughly analyzed the situation of medical insurance work, and clarified the future three. The main tasks of the annual medical insurance work were to arrange the key tasks in the fourth quarter of this year and put forward the requirements for the cadre team. The whole speech is summarised objectively, with thorough analysis, outstanding emphasis, and clear requirements. It is an important guiding file for medical and maternity insurance work in the near future. Studying and implementing the speech of Vice Minister Xiao Yi, I personally understand the following points:

Deeply understand the current situation and tasks of basic medical security work. In his speech, Vice Minister Xiaoyi pointed out that whether it is from the social security system reform or the medical and health system reform, the medical security undertaking has entered a new historical stage of moving towards covering all urban and rural residents. 2010-2019 will be a crucial period for the development of medical insurance. We must focus on four major tasks: First, expand coverage of medical insurance, and the participation rate should reach over 90%. The second is to gradually improve the level of medical security. The third is to make good connections between policies and solve problems such as the continuity of medical insurance and other factors such as turnover of people and changes in status. The fourth is to strengthen the management of medical insurance. Improve the level of overall planning and gradually achieve the level-level coordination. Explore integrated management resources to achieve unified management. Make full use of and develop community labor security platforms.

Implement three key tasks. In his speech, Minister Xiaoyi put forward clear work requirements for the three key tasks to be implemented in the fourth quarter: the number of people participating in basic medical insurance for urban residents reached 100 million, laying a solid foundation for the comprehensive opening of next year; local policy Closed bankrupt state-owned enterprise retirees were all included in the scope of medical insurance before the end of the year, breaking the barriers of “closed operation”; implementing the special management requirements of social insurance funds, and standardizing the entrusted management of medical insurance. All three tasks have been deployed by the State Council. We must raise awareness of the importance of these three tasks, and follow the requirements of Minister Xiao Yi’s speech to achieve results and complete tasks on time.

Actively explore three overall plans. Urban and rural co-ordination, outpatient co-ordination, and prefecture-level co-ordination are major issues involved in the construction of the medical security system. Urban-rural integration mainly solves the current medical insurance system planning and inter-system linkage problems; outpatient coordination is the key to improving the level of protection and expanding the benefits; the level-level coordination helps to improve the support of medical insurance funds and achieve greater mutual assistance. In his speech, Vice Minister Xiaoyi deeply analyzed the main problems that need to be solved to explore outpatient and outpatient planning, prefecture-level planning, urban and rural planning, and pointed out the direction of the next step. All localities should, in accordance with the requirements of Minister Xiaoyi, adjust their work ideas and directions in a timely manner, and increase their efforts to make the three overall plans gradually open nationwide.

Strengthen management capacity building. In terms of management philosophy, we must establish a service-oriented thinking and test the quality and effectiveness of the work with the satisfaction of the client. In terms of infrastructure construction, it is necessary to strengthen the construction of information systems and technical standards systems, and provide technical support for the rapid expansion of coverage and the refinement of management. In the management system, strengthen the internal control system and manage the business process with a strict system to ensure that the medical insurance fund maintains a good operating state. In terms of management capabilities, it is necessary to improve analytical capabilities, evaluate the operation of relevant systems, and adjust policy measures in a timely manner. At the same time, it is necessary to improve emergency response capabilities, properly handle various emergencies, and ensure information security and personnel safety.
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Strengthen the construction of cadres. In the new historical stage of basic medical security, Vice Minister Xiao Yi put forward new requirements for the medical insurance cadre team: to be far-sighted, diligent in thinking, to be a good assistant to the party committee and the government; to be brave in innovation, to reform consciousness, reform The spirit of the work, promote the in-depth development of medical insurance work; demand true and pragmatic, meticulous and perseverance to implement, make the scientific decision of the Central Committee and the State Council better and faster into the real welfare of the people; Promote the rationality of work; to clean up the integrity, cultivate the ranks of the medical insurance cadre team, be open-minded, and be quiet.

After everyone goes back, we should report the spirit of the meeting to the party group and the local party committee government as soon as possible, and organize the labor security department and the staff of the medical insurance agency to seriously study the spirit of the speech of Vice Minister Xiaoyi. According to the spirit of the speech of the leaders of the ministry, we should further emancipate our minds, combine local conditions, adjust and improve our work ideas, do a good job in the fourth quarter of this year, and plan for next year and the next three years.

Urban residents' basic medical insurance work

As of the end of July, the number of people participating in basic medical insurance for urban residents reached 62.38 million. The 88 cities piloted in XX are calculated according to the number of people insured reported by the localities, and the average participation rate is 36.3%. In Jiangxi, Gansu, Qinghai and other provinces, the number of people participating in the province has exceeded 50%. There are 10 cities with a participation rate of less than 20%, and some cities have not yet reported the number of participants. Of the 229 new pilot cities added in 2019, all have been implemented. There were 141 officially launched and officially reported to the insured through statistical reports, accounting for 62%. By the end of July, there were 26.8 million insured residents in the newly-built pilot cities, accounting for 36.5% of the 73.9 million insured residents in the cities at the end of the year. The participation rate was calculated to be about 19% according to the number of insured persons reported by local governments. At present, there are 88 cities that have not reported the number of participants, mainly in Hebei, Henan, Liaoning, Shaanxi and other provinces.

We have carried out a serious analysis of the reasons why the current development of residents' medical insurance expansion is not ideal. First, some localities tend to over-report the plan, hoping to make more financial subsidies, but the work is not implemented enough. Second, the policy was introduced in the early stage, but the organization management and service services were insufficiently prepared, and the policy was difficult to implement. Third, excessively relying on policy expansion, organizational insufficiency of work, lack of targeted propaganda, community, school and other mobilization is not enough. The unsatisfactory speed of expansion has brought a lot of passiveness to the work. For example, in XX, the central government allocated 226 million yuan to 88 pilot cities. According to the Ministry of Finance's local commissioner's office, the actual amount of subsidies reported was 106 million, and the settlement balance was 120 million. This year, if the residents' medical insurance subsidy funds have a large balance, we will be difficult to explain to the State Council, and it will directly affect the central and financial departments' efforts to solve other problems such as historical issues.

According to the work arrangements of the State Council and the medical insurance work meeting at the beginning of this year, the participation rate of pilot cities in XX should strive to reach 70%. In 2019, the participation rate of new pilot cities will reach 50%, and the total number of participants will be 100 million. At present, there is a big gap between progress and goals. To achieve the goal at the end of the year, the time is tight. In the fourth quarter, it is necessary for all localities to recognize the grim situation. According to the request of Vice Minister Xiao Yi’s speech, they are really doing a good job:

The first is to catch the community. Residents can not rely on the agency to participate in the insurance, can not wait for residents to come to the door. We must play the role of a community platform, serve the community, serve home, and serve people.

The second is to promote publicity and training. Where the pilot work has been carried out for a period of time, it is necessary to collect typical cases of residents' benefits from participating in the insurance and publicize the benefits of participation. For the place where work has just begun, it is necessary to widely publicize the policy and make it a household name. It is important to do a good job in training the grassroots staff so that they can play a role in policy presentation, work management, and service delivery.

The third is to catch the school. Students in the school are highly organized, and they can take one. Students must fully mobilize the enthusiasm of the school to participate in the insurance, must strive for the support of the education department and the school, and turn the school into an extension of the agency.

Finally, it is emphasized that it is necessary to strengthen the scheduling and count down the work. Put forward a slogan: "Working hard for three months, and participating in insurance breaks 100 million." The leaders of the Guangdong Provincial Department have already completed the task of dying, completing the task of not participating in the insurance, and the director is laid off. Now Guangdong's participation in the insured work is scheduled for one week, and is summarized in January. I hope that all provinces will learn from them. At the meeting, the number of people insured in the provinces and the number of tasks at the end of the year have been sent to the delegates' rooms. I hope that after you go back, one will find the gap with the task and further strengthen the work measures. The second is to break down the tasks. In the pilot cities, the responsibility is implemented to people, the dispatching is strengthened, supervision is strengthened, and tasks are implemented.

Incorporate local policy bankrupt enterprise retirees into medical insurance

On July 30th, the Ministry of Finance and the Ministry of Finance and the State-owned Assets Supervision and Administration Commission jointly held a video conference on the medical security of retirees of state-owned enterprises in the country, and deployed the retirees of local policy-closed state-owned enterprises to participate in the basic medical insurance for urban employees. The provincial party committees and government leaders attached great importance to this, and generally established a joint working group involving labor security, finance, and state-owned assets. All departments worked closely together and the work progressed smoothly. At present, the 28 provinces and municipalities that have been subsidized by the central government have all signed the "Working Goals Agreement", and the central government's 8 billion yuan subsidy funds have all been allocated;