Whose tragedy is it that 25 million people collectively withdraw from medical insurance a year?
Friends who often read my articles know that I have always been very concerned about medical insurance and social security issues, because these are the underlying issues related to the quality of life of ordinary people.
Not long ago, I paid attention to a new data released by the National Health Insurance Administration, which is quite shocking.
"By the end of 2022, the number of people covered by basic medical insurance in the country will be as high as 1.345 billion, accounting for 95.34% of the total number."
In other words, the mainland has basically achieved universal coverage of medical insurance, which does sound like good news, but in the good news, there is also a bad news hidden:
"The number of insured people in 2022 is 17.05 million less than last year. ”
Source: Internet
What is the situation?
As we all know, medical insurance is divided into employee medical insurance and resident medical insurance.
Among them, the employee medical insurance is mandatory to pay, and there is no such thing as withdrawal, and the number of participants in the employee medical insurance will increase in 2022.
But the problem is that the number of people with medical insurance for residents has decreased by 25.17 million.
This time, the total number of participants in medical insurance is 17.05 million less.
A friend wants to ask: why are there fewer people participating in resident medical insurance?
Resident medical insurance is actually the former New Rural Cooperative Medical System, think about it, who is the most reluctant to buy medical insurance?
There are probably two kinds of people -
The first type: Wealthy people do not need medical insurance at all, or have purchased commercial insurance with a higher amount of insurance at their own expense, but such people are definitely very few in villages and towns.
Most of them are the second type: low-income groups who have little money, do not want to pay for health insurance, or feel that paying health insurance is a loss.
In the past few years, due to the impact of the epidemic and overall economic factors, the income of many low-income groups has decreased, and the expected income has also deteriorated.
However, the cost of resident medical insurance is rising.
In 2003, when NCMS was established, the individual payment standard was only 10 yuan, which was really cheap at the beginning, which can be regarded as a policy to benefit farmers.
But since then, NCMS has been rising all the way, reaching 120 yuan in 2015, 220 yuan in 2018, 350 yuan in 2022, and 380 yuan in 2023.
In the 20 years from 2003 to 2023, personal premiums have increased by 37 times, with an average annual growth rate of 19.78%, which is higher than many wealth management products!
According to this trend, the premium in 2024 is likely to exceed $400...
Source: Internet
Are you going to say a few hundred dollars is expensive? Maybe it's not expensive for most people.
However, you must know that the main contributors of NCMS are still in rural areas, and if one person pays 380 yuan, the family of five will have to pay about 2,000 yuan, which is about to catch up with the monthly income of a farmer.
I watched a program to interview farmers on their views on the NCMS, and some village cadres believed that the current medical insurance premiums are higher than the "three mentions and five unifications" during the agricultural tax period, and the village cadres themselves do not want to participate, let alone ordinary villagers.
Another aspect that is also worth paying attention to is the issue of medical insurance reimbursement ratio.
At present, the resident medical insurance is basically not used for outpatient services, and there is generally a starting line of 500 yuan for inpatient medical treatment, and the reimbursement amount of the tertiary hospital is about 60%. However, in many places, there are restrictions that only cover part of the medical expenses, or do not reimburse certain diseases or treatments.
What does this cause?
Some people have bought medical insurance for a few years and spent thousands of yuan, but they have not used it, so they must feel that they have suffered a loss, and the money they handed over was spent on others in vain, so they simply did not pay...
I believe everyone can understand this kind of thinking of the fellows.
For groups with low incomes, it is never easy to convince them to spend hundreds or thousands of yuan a year, especially hidden expenses such as medical insurance.
But if you want me to give a suggestion, I will still advise the fellows to try to join the medical insurance if they have the ability.
Source: Internet
First, the most fundamental reason is that most ordinary people are low-income groups with little risk resistance
Once you get a serious illness, you don't even have the most basic protection, and you can only go to XX to raise money at that time.
Many people regard medical insurance as consumption, and since they don't usually use it, they can save it. In fact, we might as well look at it from another angle, medical insurance is not consumption, but a kind of "preventive expenditure".
If you have medical insurance, if you have a serious illness and go to the hospital, most of the expenses can be reimbursed. I had a relative in my hometown before, who had a stomach tumor and spent 200,000 yuan, NCMS reported 140,000 yuan, and I only spent about 60,000 yuan in the end. How many years can the reimbursement of 140,000 yuan be covered by medical premiums?
If there is no medical insurance, the family's savings will be "looted".
Second, many people are worried that with the aging process, the pool of medical insurance funds will continue to shrink, and the money for medical insurance will not be enough in the future
This kind of worry is not unreasonable, because at present, the mainland's medical insurance is collected and used at the same time, and the pressure on the capital pool is very great.
Source: Internet
But how to say it, you can worry about this, but don't worry too much, because medical insurance is based on the country's reputation, once this thing has a bug or can't be cashed, there will be a big problem.
In fact, our country's finance has been subsidizing medical insurance, for example, last year, the government subsidized more than 630 billion yuan for residents' medical insurance.
In addition, the factors affecting the capital pool are also more complicated, such as the reduction of social security costs in the past two years, which is the country's order to reduce taxes and fees for enterprises, ensure employment and promote the economy, and wait until the economy recovers in the future, the government can collect more taxes, and can also subsidize the medical insurance fund backhandedly, so in fact, there is no need to worry too much about the problem of the capital pool.
Third, medical insurance is essentially a social welfare, and it is still very cost-effective for fellow villagers to pay it.
Although the premiums of residents' medical insurance have been rising, there are multiple factors, such as rising prices, and the reimbursement ratio has also increased, from 50% at the time of its initial establishment, to 70% later, and then to 80% or even higher this year.
And more importantly, the resident medical insurance and the employee medical insurance share the same medical insurance fund pool, the resident medical insurance is a few hundred yuan a year, and the employee medical insurance has to pay hundreds of yuan every month, no matter how it is calculated and how to pay, the resident medical insurance is actually cheap.
Source: Internet
Of course, I'm not a lobbyist for resident health insurance, so I'm here to persuade everyone to participate.
I just want to tell the real reasons for the decrease in the number of residents participating in medical insurance, so that decision-makers can have the opportunity to optimize after seeing it, such as rationalizing the reimbursement ratio of medical insurance, rebuilding the trust of villagers in medical insurance, etc.;
It also puts the benefits of medical insurance on the table, so that relevant individuals can have more choices after seeing the pros and cons.
Again, none of us can decide on the grand social situation, the only thing we can decide, and the most important, is how each of us should choose.
And in all these important matters, we must listen and watch more, rationally analyze and make decisions based on our own situation, do not blindly follow the trend, and do not make blind judgments, otherwise we can only stage the tragedy of self-abandonment in the end.
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