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Medical insurance systems integrated to benefit all people

Updated: Aug 31,2016 1:42 PM’s Daily

China started medical reform this year to establish a unified urban and rural basic medical insurance system, which will integrate the basic medical insurance system for urban residents and the new rural cooperative medical care system.

The move is aimed at eliminating inequality between the urban and rural medical care systems and making medical insurance accessible to all.

So far, 18 provincial regions, including Tianjin, Zhejiang, and Shandong, have implemented the reform.

Urban and rural equality

Prior to the reform, three separate medical insurance programs — basic medical insurance for urban workers, basic medical insurance for urban residents, and the new rural cooperative medical care — constituted the nation’s basic medical insurance system that tried to cover 1.3 billion people.

Despite their major roles in providing medical care for different groups of people, the three separate programs caused inequality between urban and rural residents, as they paid almost the same but received different medical care services.

“With the integration, the medical insurance system will become fairer. Insured residents, urban or rural, will be covered by a unified urban and rural medical insurance system and enjoy fair basic medical insurance services,” said an official from the Ministry of Human Resources and Social Security.

Better medical care services

The integration of urban and rural medical insurance systems will provide better medical care services.

For one, reimbursement rates have been increased.

In Ningxia Hui autonomous region, for example, prior to the integration, reimbursement rates for insured urban and rural residents were 57 percent and 53.59 percent, respectively. After the integration, the reimbursement rate was raised to 66 percent for both insured urban and rural residents.

In addition, the reimbursement cap has been lifted.

For example, there will be no limits in reimbursement of hospitalization costs for rural residents of Shanghai.

Previously, rural residents covered by the new rural cooperative medical care system could be reimbursed for only up to 120,000 yuan ($17,973).

“People are most concerned about treatment and services. After the integration, people can have more costs reimbursed. This reduces their financial burdens and provides benefits for urban and rural residents,” said Chu Fuling, a professor at the Central University of Finance and Economics.

More medical choices

With the new reform, people can have more options for medications and medical institutions.

This will bring benefits for insured residents, especially rural residents, as the new system offers more choices for reimbursable medicines than the new rural cooperative medical care system.

According to statistics, insured people under the new rural cooperative medical care system could only get reimbursed for 1,100 medicines. Now, the number is 2,400.

In addition to expansion of the medicine reimbursement list, the new integrated system will cover more medical institutions, which means patients will have more choices when they need to go to hospitals.