Experts share views on health insurance reform

A citizen purchases medications at a pharmacy in Liaocheng, Shandong province, on Dec 22, 2022. [Photo/IC]

Since Jan 1, one province after another has implemented the health insurance reform plan, according to which the personal accounts of the national health insurance fund, which are used to pay for daily outpatient costs of the domestic resident, will shrink in size, while the insurance will cover a wider range.

Rumors arose that “personal interests will suffer”. Is that the case? Three experts share their views.

Wang Zongfan, researcher on health insurance at the Chinese Academy of Labor and Social Security

Previously the personal bank accounts were in a rather awkward position, as those going to the hospital would often find it not enough to pay for their expenses, while those who were rather healthy would find it sleeping in the accounts.

The reform is aimed at balancing the interests of different groups by coordinating with greater efforts, so that those in need of financial support will have more to cover their medical expenses, while those who rarely go to the hospital will have their dormant accounts used.

Of course, you cannot persuade people with words. More conveniences are needed for people to use the coordinated money from their personal health insurance accounts, so that they will benefit both at present and in the long run.

Let time tell people that the reform will benefit them and they will understand it.

Jin Weigang, senior professor doing research on health insurance at Zhejiang University

By coordinating a higher percentage of money from the health insurance participants, the reform better features the redistribution function of health insurance as a social security system.

Everybody might get sick one day and by coordinating more among the accounts, the reform means to benefit the interests of all. To make it more universally beneficial is also the mainstream practice of the world.

Those who rarely go to the hospital might feel some loss from the reform, but one cannot only calculate the short-term benefits. When they get sick and go to the hospital one day, they will find themselves benefiting from the reform, too. We just need to think about it in a longer time span.

Wang Chaoqun, associate professor at Huazhong Normal University

It was in 2010, that then passed, the Social Security Law provided a legal basis for the health fund reform. After 10 years of preparation, the reform on personal accounts was officially launched and has now been implemented in one province after another.

The reform has hit the very points of the personal account. First, the personal account proved not so beneficial as designed to be, because in reality 20 percent of the participants had 75 percent of the surplus money left, worse was that senior participants, who needed more medical care, suffered because they had less money left in theiraccounts.

Second, the money was so little that it could hardly cover medical costs. Data showed that in a metropolis, only 5 percent had more than 10,000 yuan ($1,456) left in their accounts and only 1 percent had more than 20,000 yuan. That money is too little to cope with medical risks one might face in the future.

Third, the past system resulted in too high a hospitalization rate. As many drugs cannot be covered by health insurance funds in out-patient clinics, many patients tend to require doctors to hospitalize them so as to save the money. Research shows that the hospitalization rate for retirees in China is as high as 39.5 percent, which is much higher compared to developed nations.

The reform will help to solve this by raising the coverage rate of drugs, so that more patients can save money without being hospitalized.

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