新华社北京8月24日电 医保，关系着每个人的切身利益，是民生保障中的重要一环。 以解除全体人民的疾病医疗后顾之忧为根本目的，"十四五"以来，我国医保提质扩面广覆盖，进一步减 轻人民群众疾病医疗负担，守好"看病钱""救命钱"。 全民参保进入新阶段 国家医保局局长章轲介绍，"十四五"期间，全国基本医保参保率稳定在95%左右。2021年至2024年，累 计近200亿人次享受医保报销。 "居民医保是我送给孩子的第一份礼物！"山东济南刘女士产后住院时，便线上为孩子办好了医保。 新生儿凭出生证明就可以参保，参保后即可享受待遇；进一步放开放宽参保户籍限制；创新建立参保缴 费激励约束机制……我国全民参保进入新阶段。 ——扩大生育保险覆盖面。截至2025年6月，有2.53亿人参加生育保险，基金累计支出4383亿元，享受 待遇9614.32万人次。 "目前，全国有近六成统筹地区将生育津贴直接发放给参保女职工。"章轲说，我们将加快新生儿护理、 分娩镇痛等价格项目立项，促进儿科、产科优化服务，积极推动目录内生育医疗费用全报销。 ——完善大病保险、医疗救助制度。"十四五"时期各项医保帮扶政策累计惠及农村低收入人口就医达到 6.73亿人 ...

新华社北京8月24日电 题：织密医疗保障网——我国基本医保制度不断完善 新华社记者彭韵佳、徐鹏航 医保，关系着每个人的切身利益，是民生保障中的重要一环。 以解除全体人民的疾病医疗后顾之忧为根本目的，"十四五"以来，我国医保提质扩面广覆盖，进一步减 轻人民群众疾病医疗负担，守好"看病钱""救命钱"。 全民参保进入新阶段 国家医保局局长章轲介绍，"十四五"期间，全国基本医保参保率稳定在95%左右。2021年至2024年，累 计近200亿人次享受医保报销。 "居民医保是我送给孩子的第一份礼物！"山东济南刘女士产后住院时，便线上为孩子办好了医保。 新生儿凭出生证明就可以参保，参保后即可享受待遇；进一步放开放宽参保户籍限制；创新建立参保缴 费激励约束机制……我国全民参保进入新阶段。 ——扩大生育保险覆盖面。截至2025年6月，有2.53亿人参加生育保险，基金累计支出4383亿元，享受 待遇9614.32万人次。 "目前，全国有近六成统筹地区将生育津贴直接发放给参保女职工。"章轲说，我们将加快新生儿护理、 分娩镇痛等价格项目立项，促进儿科、产科优化服务，积极推动目录内生育医疗费用全报销。 ——完善大病保险、医疗救助制度。 ...

全民参保进入新阶段 国家医保局局长章轲介绍，"十四五"期间，全国基本医保参保率稳定在95%左右。2021年至2024年，累 计近200亿人次享受医保报销。 "居民医保是我送给孩子的第一份礼物！"山东济南刘女士产后住院时，便线上为孩子办好了医保。 新生儿凭出生证明就可以参保，参保后即可享受待遇；进一步放开放宽参保户籍限制；创新建立参保缴 费激励约束机制……我国全民参保进入新阶段。 ——扩大生育保险覆盖面。截至2025年6月，有2.53亿人参加生育保险，基金累计支出4383亿元，享受 待遇9614.32万人次。 "目前，全国有近六成统筹地区将生育津贴直接发放给参保女职工。"章轲说，我们将加快新生儿护理、 分娩镇痛等价格项目立项，促进儿科、产科优化服务，积极推动目录内生育医疗费用全报销。 新华社北京8月24日电 题：织密医疗保障网——我国基本医保制度不断完善 新华社记者彭韵佳、徐鹏航 医保，关系着每个人的切身利益，是民生保障中的重要一环。 以解除全体人民的疾病医疗后顾之忧为根本目的，"十四五"以来，我国医保提质扩面广覆盖，进一步减 轻人民群众疾病医疗负担，守好"看病钱""救命钱"。 跨省共济，只是医保待遇保障"扩容 ...

编辑：赖俊 8月22日，市政府召开第161次常务会议，深入学习贯彻习近平总书记在《求是》杂志发 表的重要文章《促进民营经济健康发展、高质量发展》精神，研究部署我市社会物流降本提 质增效、国家自然资源例行督察和土地卫片执法反馈问题整改、加强医保基金监管等工作。 会议强调，要深入学习贯彻习近平总书记关于民营经济发展的重要论述，坚持和落 实"两个毫不动摇"，扎扎实实落实促进民营经济发展的政策措施，不断提高惠企政策的精准 性有效性，深入开展清理拖欠企业账款、规范涉企执法等专项行动，依法保护民营企业和民 营企业家合法权益，持续营造市场化、法治化、国际化一流营商环境，坚定不移支持民营经 济做强做优做大。要大力弘扬企业家精神，支持引导民营企业加快创新发展、转型升级，不 断提高企业质量、效益和核心竞争力。 会议指出，有效降低社会物流成本，对于发挥武汉交通区位优势、提高经济运行效率、 服务和融入新发展格局具有重要意义。要以深化改革为牵引、数智赋能为支撑，加快重构开 放通道、重塑物流体系，着力推进交通基础设施互联互通，大力发展"铁水公空"多式联运， 进一步优化货物运输结构，补齐大宗商品物流、冷链物流、农村物流等短板，以高效低成本 ...

Group 1 - The core viewpoint emphasizes the importance of strengthening medical insurance fund supervision and combating fraud to ensure sustainable operation of the fund and enhance public access to medical services [1] - The city of Shuozhou has implemented a monthly reconciliation mechanism between the finance and medical insurance agencies to monitor fund inflows and outflows through data comparison and dynamic analysis [1] - A dual regulatory model combining self-inspection and focused verification has been adopted to enhance the effectiveness of fund supervision, with local financial departments conducting thorough self-checks across 616 designated medical institutions [1] Group 2 - The management of medical insurance fund revenues and expenditures has been integrated into a performance management system, focusing on the effectiveness of fund usage and the coverage of benefits to the public [2] - A dual-track model of "key performance evaluation and dynamic process monitoring" has been introduced to assess compliance and effectiveness in fund usage, linking evaluation results to budget adjustments and policy optimization [2]

Core Viewpoint - The article discusses the achievements and future plans of China's medical insurance system during the "14th Five-Year Plan" period, highlighting improvements in coverage, fund management, and the introduction of long-term care insurance [1][3]. Group 1: Medical Insurance Coverage - The national basic medical insurance coverage rate remains stable at around 95%, with a cumulative expenditure of 12.13 trillion yuan, averaging an annual growth rate of 9.1% [1][3]. - By 2024, the number of people covered by basic medical insurance is expected to reach 1.327 billion, with long-term care insurance coverage at 190 million [1][3]. - The direct settlement rate for cross-provincial medical expenses exceeds 90%, and the national medical insurance drug list has been unified, totaling 3,159 types of drugs [1][3]. Group 2: Long-Term Care Insurance - The long-term care insurance system is expected to be implemented nationwide soon, as the current pilot programs have shown positive results [4][7]. - As of June 2025, 253 million people are participating in maternity insurance, with cumulative expenditures of 438.3 billion yuan, benefiting 96.14 million people [6]. - The long-term care insurance aims to alleviate the financial burden of daily care for elderly individuals who have lost their ability to care for themselves, addressing the increasing demand for elderly care services [6][7]. Group 3: Fund Management and Regulation - The medical insurance fund is under increasing pressure, and the focus will be on ensuring fund safety and risk assessment during the "15th Five-Year Plan" period [4][8]. - The reform of payment methods has transitioned from a "post-payment" to a "pre-payment" system, promoting efficiency in medical institutions and reducing patient out-of-pocket expenses by approximately 5% year-on-year [9][10]. - The National Medical Insurance Administration has intensified efforts to combat fraud and misuse of medical insurance funds, recovering 16.13 billion yuan in the first half of the year through inspections of 335,000 medical institutions [10][11]. Group 4: Drug Price Governance - The article emphasizes the importance of drug price governance, with the government supporting market-driven pricing while also maintaining oversight to prevent price manipulation [12][13]. - Since 2018, the government has conducted 10 rounds of centralized drug procurement, covering 435 types of drugs, which has helped lower drug prices and improve accessibility [13][14]. - The National Medical Insurance Administration is committed to ensuring fair pricing practices and encourages public reporting of unusually high drug prices [14].

Group 1 - The National Medical Insurance Administration (NMIA) has intensified the regulation of medical insurance funds by holding individuals accountable for violations, marking a shift from solely punishing institutions to also targeting responsible personnel [1][2] - A case in Jiangxi Province highlighted this approach, where individuals involved in fraudulent activities were penalized with points against their medical insurance payment qualifications, indicating a more stringent accountability system [1] - The introduction of a point-based management system for medical insurance payment qualifications aims to enhance the precision and deterrent effect of regulatory measures, extending oversight to specific individuals within medical institutions [2][3] Group 2 - The regulatory framework emphasizes a balanced approach, combining education and punishment, with mechanisms in place to protect the rights of medical personnel while ensuring accountability [3] - Various provinces have implemented dynamic responsibility recognition mechanisms to ensure that accountability is accurately assigned, preventing generalized or superficial handling of violations [3] - The overarching goal is to ensure the proper and compliant use of medical insurance funds, which are critical for the health and well-being of over 1.3 billion insured individuals in the country [2][3]

Policy Developments - The National Healthcare Security Administration (NHSA) has initiated the 11th batch of centralized procurement, optimizing the selection rules by no longer solely relying on the lowest bid as a reference. Companies with the lowest bids must now justify the reasonableness of their pricing and ensure it does not fall below cost [2] Drug and Medical Device Approvals - Senxuan Pharmaceutical's subsidiary has received approval for the market launch of Ritonavir raw materials, an antiviral drug primarily used for treating AIDS and also utilized during the COVID-19 pandemic [4] - Hengrui Medicine's subsidiary has received a clinical trial approval notice for the injectable HRS8179 drug, aimed at preventing severe brain edema after large-scale cerebral infarction. The project has seen a cumulative R&D investment of approximately 47.4 million yuan [5] Financial Reports - Sino Medical anticipates a 296.54% year-on-year increase in net profit for the first half of 2025, with expected revenue of 240 million yuan, reflecting a 12.53% growth [7] - WuXi Biologics forecasts a revenue growth of about 16% for the first half of the year, with profits expected to increase by approximately 54% and 56% for the company and its equity shareholders, respectively [8] Capital Markets - Lianhuan Pharmaceutical plans to issue up to 500 million yuan in technology innovation bonds to enhance R&D capabilities and optimize its debt structure. The bonds will be publicly issued with a term of no more than three years [10] Industry Developments - The NHSA has reported that over 100 drug varieties have applied to be included in the commercial health insurance innovative drug directory, which aims to incorporate high-value innovative drugs that cannot yet be included in the basic medical insurance directory [12] - As of the end of 2024, the cumulative recovery of medical insurance funds has reached 104.5 billion yuan, with a total balance of 3.86 trillion yuan in the insurance fund [14]

Core Insights - The article discusses the significant advancements and reforms in China's medical insurance system during the "14th Five-Year Plan" period, emphasizing the focus on improving public health and reducing medical costs for citizens [1][2]. Group 1: Medical Insurance Coverage - By 2024, the number of people covered by basic medical insurance is expected to reach 1.327 billion, with a stable participation rate of around 95% during the "14th Five-Year Plan" [1][2]. - Nearly 20 billion medical insurance reimbursements are anticipated from 2021 to 2024, with 2024 figures projected to be 1.6 times that of 2020 [2]. Group 2: Support for Specific Demographics - As of June this year, 253 million people are enrolled in maternity insurance, with cumulative expenditures reaching 438.3 billion yuan, benefiting over 96.14 million instances [2]. - The long-term care insurance system is being established, with 190 million participants expected by the end of 2024, and over 95% of village clinics included in the insurance network [2]. Group 3: Healthcare Accessibility and Efficiency - The number of designated medical institutions for insurance has reached 1.1 million, and the direct settlement rate for cross-province hospitalizations is around 90% [3][5]. - The implementation of a unified national medical insurance information platform has improved service efficiency, with over 1.236 billion people using medical insurance codes for direct settlement [4][5]. Group 4: Fund Security and Regulation - The cumulative recovery of medical insurance funds has reached 104.5 billion yuan during the "14th Five-Year Plan," with a total fund balance of 3.86 trillion yuan expected by the end of 2024 [6][7]. - The National Medical Insurance Bureau has intensified supervision and regulation, conducting inspections on 335,000 medical institutions and recovering 16.13 billion yuan in funds in the first half of this year [6][7].

Core Viewpoint - The article emphasizes the ongoing reforms in China's medical insurance system during the "14th Five-Year Plan" period, focusing on reducing the financial burden on citizens and enhancing the regulatory framework for medical insurance funds [1]. Group 1: Medical Insurance Coverage - The national basic medical insurance coverage rate remains stable at around 95%, with an expected 1.327 billion people insured by 2024 [2]. - Nearly 200 billion medical visits have been reimbursed through insurance from 2021 to 2024, benefiting 3.5 billion low-income individuals through medical assistance programs [2]. Group 2: Support for Vulnerable Groups - Measures have been implemented to enhance support for children and the elderly, including the establishment of a long-term care insurance system, with 190 million participants expected by the end of 2024 [3]. - The maternity insurance program has seen participation from 253 million individuals, with over 96 million enjoying benefits [3]. Group 3: Financial Impact of Medical Insurance - Cumulative medical insurance fund expenditures reached 12.13 trillion yuan, with an annual growth rate of 9.1% [4]. - Spending on innovative drugs has significantly increased, with 2024 expenditures projected to be 3.9 times that of 2020, reflecting a 40% annual growth rate [4]. Group 4: Reducing Medical Costs - Policies have reduced the financial burden on low-income rural populations by over 650 billion yuan during the "14th Five-Year Plan" [5]. - A total of 402 new drugs have been added to the insurance coverage list, and price regulation efforts have standardized over 27,000 drug specifications [5]. Group 5: Enhancements in Medical Services - Cross-province medical services have been improved, allowing for direct settlement of outpatient chronic disease treatments for 10 types of conditions [7]. - The establishment of a "15-minute medical service circle" aims to enhance accessibility, with over 1.236 billion people using medical insurance codes for direct settlement [7]. Group 6: Fund Security and Regulation - The cumulative balance of the medical insurance fund reached 3.86 trillion yuan by the end of 2024, with ongoing monitoring to ensure stable operations [8]. - Innovative regulatory measures, including big data analysis, have led to the recovery of 10.45 billion yuan in misused funds [8][9].