健全多层次医疗保障体系 筑牢民生保障底线——访国家医保局局长章轲

Core Viewpoint - The article emphasizes the importance of establishing a multi-tiered medical insurance system to enhance public health security and improve the accessibility and affordability of healthcare services in China [1][2]. Group 1: Progress in Medical Insurance Reform - Since the 18th National Congress, the reform of the national medical insurance system has significantly improved the quality of insurance coverage, enhancing public satisfaction [2]. - The "1+3+N" multi-tiered medical insurance system has been continuously promoted, with hospitalization reimbursement rates reaching approximately 80% for employee insurance and 70% for resident insurance [2]. - Cumulatively, over 13 trillion yuan has been spent from the medical insurance fund during the 14th Five-Year Plan, benefiting nearly 20 billion patient visits [2]. Group 2: Future Directions for Medical Insurance Development - The 15th Five-Year Plan will focus on strengthening the medical insurance system, addressing gaps, and promoting the participation of various social forces in medical assistance [4][8]. - The plan includes enhancing the coordination of medical, insurance, and pharmaceutical services, utilizing data and funding to support innovation in drug development [5][6]. - A nationwide unified medical insurance information platform will be established to support the construction of a multi-tiered medical insurance system [8]. Group 3: Specific Initiatives and Reforms - The reform will include deepening payment methods, optimizing the use of surplus funds, and enhancing the management of medical service prices [6][7]. - The government aims to improve the efficiency of medical insurance fund usage by expanding immediate settlement and increasing the coverage of medical institutions [9]. - Continuous optimization of drug procurement processes will be implemented to ensure that medications are accessible and affordable for the public [9].