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《中国的医疗卫生事业》白皮书(中英对照)I

发布时间: 2018-04-03 09:04:13   作者:译聚网   来源: 国新网   浏览次数:



    ——基本医疗保障制度覆盖城乡居民。截至2011年,城镇职工基本医疗保险、城镇居民基本医疗保险、新型农村合作医疗参保人数超过13亿,覆盖面从2008年的87%提高到2011年的95%以上,中国已构建起世界上规模最大的基本医疗保障网。筹资水平和报销比例不断提高,新型农村合作医疗政府补助标准从最初的人均20元人民币,提高到2011年的200元人民币,受益人次数从2008年的5.85亿人次提高到2011年的13.15亿人次,政策范围内住院费用报销比例提高到70%左右,保障范围由住院延伸到门诊。推行医药费用即时结算报销,居民就医结算更为便捷。开展按人头付费、按病种付费和总额预付等支付方式改革,医保对医疗机构的约束、控费和促进作用逐步显现。实行新型农村合作医疗大病保障,截至2011年,23万患有先天性心脏病、终末期肾病、乳腺癌、宫颈癌、耐多药肺结核、儿童白血病等疾病的患者享受到重大疾病补偿,实际补偿水平约65%。2012年,肺癌、食道癌、胃癌等12种大病也被纳入农村重大疾病保障试点范围,费用报销比例最高可达90%。实施城乡居民大病保险,从城镇居民医保基金、新型农村合作医疗基金中划出大病保险资金,采取向商业保险机构购买大病保险的方式,以力争避免城乡居民发生家庭灾难性医疗支出为目标,实施大病保险补偿政策,对基本医疗保障补偿后需个人负担的合规医疗费用给予保障,实际支付比例不低于50%,有效减轻个人医疗费用负担。建立健全城乡医疗救助制度,救助对象覆盖城乡低保对象、五保对象,并逐步扩大到低收入重病患者、重度残疾人、低收入家庭老年人等特殊困难群体,2011年全国城乡医疗救助8090万人次。



The basic medical care systems cover both urban and rural residents. By 2011, more than 1.3 billion people had joined the three basic medical insurance schemes that cover both urban and rural residents, i.e., the basic medical insurance for working urban residents, the basic medical insurance for non-working urban residents, and the new type of rural cooperative medical care, with their total coverage being extended from 87% in 2008 to 95% in 2011. This signaled that China has built the world's largest network of basic medical security. Medical care financing and the reimbursable ratio of medical costs have been raised, and the government subsidy standards for the new rural cooperative medical care system were increased from 20 yuan at the beginning to 200 yuan per person per year in 2011, benefiting 1.315 person/times in 2011 as against 585 person/times in 2008. The reimbursement rate for hospitalization expenses covered by relevant policies has been raised to around 70%, and the range of reimbursable expenses has been expanded to include outpatient expenses. Real-time reimbursement has been adopted for medical expenses, making it more convenient for people to have their medical costs settled. Reform has been carried out in respect of the forms of payment to include payment by person, payment by disease and total amount pre-payment, enabling medical insurance to play a better restrictive role over medical institutions as well as to control expenses and compel the medical institutions to improve their efficiency. Critical illness insurance has been included in the new type of rural cooperative medical care system. By 2011, some 230,000 patients of congenital heart disease, advanced rental diseases, breast cancer, cervical cancer, multidrug-resistant tuberculosis and childhood leukemia had been granted subsidies for major and serious diseases, with the actual subsidies accounting for 65% of their total expenses. In 2012, lung cancer, esophagus cancer, gastric cancer and eight other major diseases were included in the rural pilot program of insurance for the treatment of major diseases, and the reimbursement rate reached as high as 90%. Critical illness insurance has been introduced for both urban and rural residents, in which certain amounts of money are earmarked in the medical insurance fund for non-working urban residents and that of the new type of rural cooperative medical care to buy critical illness insurance policies from commercial insurance companies, aiming to relieve urban and rural families of the heavy burden of catastrophic medical spending. The policy of subsidy for critical illness insurance, which covers no less than 50% of the actual medical costs, provides a guarantee for the compliance costs to be shouldered by the individual after reimbursement from the basic medical insurance. This has effectively reduced the financial burden of individuals. An urban-rural medical assistance system has been established and improved, which at first covered urban and rural subsistence allowance recipients and childless and infirm rural residents who receive the so-called "five guarantees," and is now extended to cover those who are severely ill and have low comes, the severely disabled, senior citizens from low-income families, and some other groups with special difficulties. In 2011, the urban-rural medical assistance was granted to 80.90 million cases across the country.


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