大国五年丨最大医保网，筑牢“健康中国”底盘

Core Insights - The article highlights the advancements and stability of China's healthcare insurance system during the "14th Five-Year Plan" period, emphasizing the establishment of a more equitable and efficient national healthcare network. Group 1: Healthcare Coverage - The national basic healthcare insurance coverage rate remains stable at around 95% during the "14th Five-Year Plan" period, with the number of insured individuals reaching 1.327 billion by 2024 [3] - The payment ratio for inpatient expenses is maintained at approximately 80% for employees and 70% for residents [3] Group 2: Financial Stability - By the end of 2024, the cumulative balance of the healthcare insurance fund is projected to reach 3.86 trillion yuan [4] - The basic healthcare insurance fund expenditure for 2024 is estimated at 2.98 trillion yuan, with a year-on-year decrease of about 5% in patient out-of-pocket expenses [16] Group 3: Long-term Care and Support - Over 8,800 long-term care service institutions have been established, with 300,000 care service personnel available [7][9] - The long-term care insurance system has expanded to cover 190 million people, benefiting over 2 million disabled individuals and reducing their care service costs by more than 50 billion yuan [9] Group 4: Drug Accessibility and Innovation - A total of 402 new drugs have been added to the healthcare insurance directory since the beginning of the "14th Five-Year Plan," with spending on innovative drugs in 2024 being 3.9 times that of 2020 [14] - More than 100 drugs are currently under application for inclusion in the innovative drug directory [14] Group 5: Service Improvement and Accessibility - The initiative to create a "15-minute healthcare service circle" has led to over 1.236 billion people using healthcare codes by June 2025 [24] - The online handling rate of healthcare administrative services has increased from 55% in 2020 to 92% in 2024 [24] - Cross-province direct settlement services for medical treatment have exceeded 500 million instances during the "14th Five-Year Plan" period [24] Group 6: Support for Vulnerable Populations - Since 2018, healthcare assistance has supported 350 million instances for low-income individuals, maintaining a 99% insurance coverage rate for rural low-income and poverty-stricken populations [25] - The reimbursement ratio for rural low-income individuals under the three-tiered support system exceeds 90% [25]