Data observation: Where did the money of medical insurance go?

"The new crown vaccination fee hollows out the medical insurance 'life -saving money'" "The medical insurance fund can not be spent in large amount", "Is most of the medical insurance money used to see the elderly," "Why the residents' medical insurance payment rose every year" "After participating in medical insurance for so many years, I ca n’t go to the hospital a few times a year. Is it a loss?" ... Regarding the controversy of the medical insurance fund, you often see the newspapers. Many information is misleading the people's understanding of the medical insurance fund. Some people even question " Where did the medical insurance money go? " The crux of these misunderstandings lies in the "unknown" and "unclear" of the medical insurance fund.

What is the truth of the medical insurance fund expenditure? Recently, the National Medical Insurance Bureau released the "Statistics of the National Medical Security Development Statistics of 2021" (hereinafter referred to as the "Bulletin"). As an official document, the data in this bulletin is very convincing.

The cost of undertaking the new crown vaccine will not affect the operation of the system

In February 2021, the state officially launched a free vaccine vaccine for residents. Vaccination and vaccination costs were mainly shared by medical insurance funds and finance. As of April, my country has vaccinated 3.2 billion doses of vaccine, with a cost of more than 12 billion yuan. This global history of the largest immunization plan is to win the praise of the people, and some people are worried that the medical insurance foundation will be affected by this.

The Gazette shows that in 2021, the total revenue of basic medical insurance (including maternity insurance) funds in the country was 2872.758 billion yuan, an increase of 15.6%over the previous year; the total expenditure was 2404.310 billion yuan, an increase of 14.3%over the previous year. The income growth is slightly higher than expenditure growth. Overall, the medical insurance fund is safe and sustainable. Judging from the cumulative deposits of the Medical Insurance Fund over the years, even if the employee's personal account is removed, the clockwise deposit is 2.44 trillion yuan, and the available monthly number is 12.2 months. According to relevant regulations, the cumulative deposit should ensure the average payment level of not less than 6 to 9 months, so the fund is still above the security line. Compared with the new crown vaccine and vaccination costs of more than 1,200 billion yuan, the medical insurance fund did not "hurt the bones".

The National Medical Insurance Bureau has also responded to this: medical insurance payments for new crown pneumonia vaccines are special moves to deal with special events. The main use of the fund's rolling balance will neither affect the current fund income and expenditure, nor will it affect the people to see a doctor for medical treatment and medical treatment. Treatment guarantee. In the long run, the free vaccination of the new crown virus vaccine for free is conducive to the rapid establishment of immune barriers, maintaining normal production, living order and economic and social health development, thereby providing a strong and powerful economic development foundation for the long -term sustainable operation of medical insurance funds.

At the same time, the National Medical Insurance Bureau also stated that the medical insurance payment cost is by no means simply paying for money, but to make every effort to ensure that the fund's maximum guarantee effectiveness is made to make good use of the centralized band purchases. Make sure that the mass vaccine can be understood, and the medical insurance fund can be clearly paid.

The overall security of the fund, there is pressure in the medium and long -term balance

The "Bulletin" shows that the national basic medical insurance (including maternity insurance) funds currently deposit 468.448 billion yuan, with a cumulative deposit of 3615.630 billion yuan. It should be emphasized that the deposit of 3.6 trillion yuan does not mean 3.6 trillion yuan in balance (Note: The actual deposit of the asset after the deposit refers to the deposit after the checkout; the balance is the remaining after the settlement. . The two statistics are different), let alone this money can be dominated at will.

"There are remaining grains in your hands, don't panic in your heart." As of the end of 2021, the number of basic medical insurance participants in my country reached 1362.97 million, which basically achieved the participation of the whole people. As the world's most covered medical security network, the reason why it can continue to run smoothly is that it has the "reservoir" of the medical insurance fund. The principles of "balance, balance of payments, balanced, and slight balance" will always ensure that the surplus of the "storage pool" has a degree of surplus, and strives to maintain a medical needs of nearly 1.4 billion people to see a doctor.

So, how to evaluate the current status of my country's medical insurance fund?

From a statistical perspective, after the combination of medical insurance and maternity insurance and unified accounting, the fund deposit will include maternity insurance funds. From the perspective of the composition of the medical insurance fund, the employee medical insurance fund cumulatively deposited 2.9 trillion yuan, of which about 40%of the personal accounts, and this part of the money does not participate in coordination and adjustment. In addition, there is a one -time payment of funds to solve the problem of closing the medical security problem of retirees of bankruptcy companies. This part of the funds belong to the pre -payment instead of the balance, but it is only included in the fund account in advance. It can be seen that the medical insurance overall funds are not as many on the surface.

Although overall perspective, the level of deposit of my country's medical insurance funds is in a safe range, from the perspective of various coordinated areas, the regional distribution is very unbalanced. According to statistics from the State Medical Insurance Bureau, the cumulative cumulative concludes of the Six provinces and municipal employees' medical insurance coordination funds in the six provinces and municipalities in the Eastern Provinces accounted for 44.7%of the country in 2010, and in 2021, it rose to 56.6%. In terms of residents' medical insurance funds, the average number of months can be paid in the country in 2020, and 10 provinces are lower than the national level. Essence

In this way, there is no excessive deposit in my country's medical insurance funds, and it is still necessary to conscientiously. It should be seen that my country's economy is facing triple pressure on "demand shrinkage, supply impact, and expected weakness", and the difficulty of increasing medical insurance income; normalization of epidemic prevention and control, population aging, slow diseaseization of diseases, accelerated development of medical technology, medical insurance rigid expenditure expenditure Continuous increase, fund balance pressure continues to increase. Increased payment, and the treatment level "rises and rises"

The Gazette shows that in 2021, the per capita funding for residents' medical insurance was raised by 889 yuan, an increase of 56 yuan compared to the previous year. In this regard, many people question why the medical premiums have risen again? Many grass -roots staff in the survey also reported that some people could not correctly understand the reason for the rise in medical premiums, and to a certain extent increased the pressure on the expansion of the insurance.

In fact, fiscal subsidies have always been the main source of the residents' medical insurance fund compared to personal payment of residents. From 20 yuan in 2003 to 580 yuan in 2021, it increased by 28 times before and after, which is a well -deserved "big head".

Although the premiums have increased, we can see through the "Bulletin" that the level of medical insurance treatment of residents has also been "rising and high", which is mainly manifested in three aspects: First, the reimbursement ratio continues to increase, and the resident's medical insurance policy is hospitalized in 2021 in hospitalization. The cost of expense funds is 69.3%, which is about twice the reimbursement ratio within the policy scope of the new rural co -founding at the beginning of the establishment of the new rural co -founding. Among them, the outpatient clinic was 244 million, an increase of 13.7%over the previous year; the third was that the scope of drug protection continued to expand, and the number of drugs in the medical insurance category had increased from 1535 in 2000 to 2,860 in 2021.

Taking the procedure, the amount of measuring is out. Only by establishing a dynamic adjustment mechanism that is compatible with the level of social and economic development and the level of residents' income, and continuously inject water into the fund's "storage pool" into the water source, can we fully protect the people's growing medical insurance needs.

The aging intensification of the fund raising expenditure brought dual pressure to the seventh national census data carried out in 2020 shows that the population of 60 and over the country in 2020 was 26.4.02 million, accounting for 18.70%of the total population, of which 65 and over the population over or over. It accounts for 13.50%, and the population of 80 and over accounts for 2.54%.

As one of the countries with the fastest population in the world, the aging of the population has become an important trend of social development in my country, and it will also be the basic national conditions of a longer period of time in the future. Specifically in the field of medical insurance, the impact of aging should be paid more attention.

From the perspective of the structure of the insured person, the Bulletin showed that in 2021, 261.06 million employees were employed, an increase of 2.7%over the previous year; 93.24 million retired employees, an increase of 3.3%over the previous year, and a year -on -year growth rate higher than the employee. The on -the -job retirement ratio is 2.80, which means that 2.8 on -the -job employees "support" 1 retirement employee. Compared with the medical insurance statistics of the past ten years, the resignation ratio has been walking between 2.77-3.0, which is also consistent with my country's aging national conditions.

From the perspective of hospitalization rate, the "Bulletin" shows that the in -service employee hospitalization rate in 2021 was 9.9%, an increase of 1.3 percentage points over the previous year; the retirees' hospitalization rate was 39.5%, an increase of 3.5 percentage points over the previous year. On -the -job employees. 39.5%of the hospitalization rate means that of 10 retired workers, 4 people have been hospitalized for treatment average.

From the perspective of medical expenses, the "Bulletin" shows that in the cost of medical institutions, the medical expenses of retirees in 2021 were 746.137 billion yuan, and the medical expenses of employees were 547.508 billion yuan. This data shows that the number of retired employees with a proportion of 26.3%costs 57.6%of the medical expenses.

Expert analysis is that the speed of population aging means that the strategic opportunity period for population aging will die quickly, and the policy preparation period will be greatly shortened. The aging of the population will affect the social economy from the two aspects of "reduction of population capital" and "increased public expenditure". The refraction of the medical insurance field is that the surge in the demand for medical and nursing in the elderly population will bring dual pressure to the fund raising and expenditure (under the design of the current system that retirees does not pay). Prior to the arrival of a deep aging society, the medical insurance party must be prepared for various positive response.

In exchange for the "enhanced version" outplacement of the ledger reform

The "Bulletin" shows that in 2021, the employee medical insurance personal account was currently deposited 171.361 billion yuan, and a total of 1175.398 billion yuan was cumulative. This set of data shows that there is a large amount of precipitation in personal account funds, that is, about 40%of medical insurance funds have not been effectively used. At the same time, patients with insufficient chronic diseases in outpatient clinics, and the burden of dedication to chronic diseases are heavy, and it is difficult to resist the risk of chronic disease at a personal account level of about 3,000 yuan per capita. This is also an important background of the "Guiding Opinions of the General Office of the State Council on the establishment and improvement of the basic medical insurance outpatient protection mechanism" to improve the method of improving personal accounts. The document pointed out that the personal account of the employee is included in the basic medical insurance premiums paid by the individual, and the standards are controlled in principle that the basic medical insurance premiums paid by the unit are included in the overall fund.

At first glance, there is less money in personal accounts, and the rights and interests of the insured seem to be damaged. In fact, equity is only replaced, that is, while reducing the allocation of personal account funds, the outpatient costs of multiple diseases and common diseases are included in the reimbursement scope to improve the overall reimbursement level, and the help of personal accounts among family members. For young people, the money in the previous personal account can only be used by itself, causing the accumulation of deposits on the account, and the family facilities will activate this funds -I and their spouses, parents, and children will seek medical treatment at the designated medical institution. Medical expenses borne by individuals, as well as the cost of personal accounts that are affordable by personal accounts that are afforded by personal accounts that are affordable by purchasing drugs, medical devices, and medical consumables at designated retail pharmacies. It can be said that although the amount of personal accounts of 350 million insured employees seem to have decreased, the actual exchanges are the "enhanced version" outpatient help. After the reform, about 200 billion funds will be used to strengthen outpatient guarantees. This money has become a real fund input, which is actually used for outpatient medical expenses for patients, especially elderly patients,.

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