4年200亿人次报销，未来五年全民医保如何升级

Core Viewpoint - The article discusses the advancements and future plans of China's medical insurance system during the "14th Five-Year Plan" and the upcoming "15th Five-Year Plan," emphasizing the need for equitable access, improved quality, and efficiency in healthcare services [3][4]. Group 1: Achievements During the "14th Five-Year Plan" - The basic medical insurance coverage rate remained stable at around 95%, with nearly 200 billion medical reimbursements enjoyed by the public over four years [5][6]. - The per capita government subsidy for residents' insurance increased from 490 yuan in 2018 to 670 yuan in 2024, with rural low-income and poverty alleviation populations maintaining a coverage rate above 99% [5][6]. - By 2024, the number of insured individuals reached 1.327 billion, with medical assistance benefiting approximately 80 million people annually [5][6]. - The total expenditure of the medical insurance fund reached 12.13 trillion yuan during this period, with an average annual growth rate of 9.1% [11]. Group 2: Innovations and Reforms - The "14th Five-Year Plan" saw significant reforms in medical insurance, including the introduction of a multi-tiered medical security system and the establishment of a dynamic adjustment mechanism for the medical insurance drug list [8][9]. - The number of drugs added to the insurance list reached 402 since the beginning of the "14th Five-Year Plan," with 2.8 billion reimbursements for negotiated drugs in 2024 [9][11]. - The implementation of a long-term care insurance system has expanded, with over 8,800 designated service institutions and 300,000 care service personnel, marking a growth of over 50% since the start of the "14th Five-Year Plan" [13]. Group 3: Future Directions for the "15th Five-Year Plan" - The upcoming "15th Five-Year Plan" aims to enhance the medical insurance system to support common prosperity and adapt to high-quality development needs, balancing fairness and efficiency [3][5]. - The focus will be on expanding coverage for flexible employment workers, addressing gaps in the current insurance system [6][7]. - The integration of new technologies and digitalization will be emphasized to improve the efficiency and accessibility of healthcare services [6][12].