Core Viewpoint - The draft of the Medical Security Law has been submitted for review, indicating a significant step towards establishing a legal foundation for medical insurance governance in China, which is expected to lead to high-quality and standardized development in the medical security sector [1] Group 1: High-Quality Development of Medical Insurance - The high-quality development of medical insurance requires comprehensive governance involving multiple stakeholders, including patients, medical institutions, pharmaceutical companies, and the government [2] - Different stakeholders have varying needs, necessitating a coordinated approach to form a consensus for the development of medical insurance [2] - Comprehensive governance is essential to enhance the medical security level and prevent poverty caused by illness [2] Group 2: Risks in Institutional Operations - The operation of the medical insurance system involves multiple stages, each with its own risks, requiring cross-departmental collaboration for effective governance [3] - Risks such as duplicate insurance and fraud can disrupt the sustainable development of the medical insurance system, necessitating data sharing and intelligent monitoring [3] Group 3: Legal Regulation for Comprehensive Governance - Legal regulation is crucial for solidifying the medical insurance system, addressing fragmentation, and ensuring the safety of fund usage [6] - The draft law aims to unify the medical insurance system and provide a framework that balances flexibility and uniformity [6] Group 4: Stabilizing Reform Expectations - The legislation aims to solidify reform achievements and ensure policy continuity, reducing uncertainty in the medical insurance landscape [7] - It establishes clear responsibilities for government, enterprises, and individuals in funding, ensuring sustainable operation of the medical insurance system [7] Group 5: Ensuring Fund Security - The draft law enhances regulatory authority and establishes unified enforcement standards to combat fraud effectively [9] - It aims to eliminate local protectionism and strengthen oversight of fund management [9] Group 6: Normative Behavior of Stakeholders - The draft law includes specific legal responsibilities for all stakeholders involved in the medical insurance system, enhancing accountability [10] - It introduces a combination of economic, qualification, and criminal penalties to deter violations [10] Group 7: Supporting Policies for Law Implementation - The implementation of the Medical Security Law requires complementary policies in areas such as insurance participation, payment reform, and service enhancement [11] - It emphasizes the need for a comprehensive policy framework to ensure the sustainability of medical insurance reforms [11] Group 8: Unified Medical Insurance Directory and Benefit List - The law aims to establish a dynamic adjustment mechanism for the medical insurance directory, ensuring alignment with fund capabilities [12] - It seeks to standardize payment criteria across different types of medical insurance [12] Group 9: Reforming Payment Methods - The draft law promotes the improvement of payment methods, including the implementation of a unified payment standard for common diseases [14] - It encourages the exploration of payment methods that align with the needs of tightly-knit medical alliances [14] Group 10: Strengthening Fund Supervision - The focus is on transforming from reactive recovery to proactive prevention through intelligent monitoring and multi-faceted collaboration [15] - It aims to establish a comprehensive monitoring network utilizing advanced technologies [15] Group 11: Enhancing Public Service Capacity - The goal is to reshape the medical insurance service ecosystem through standardization, intelligence, and collaboration [16] - It emphasizes the need for a unified service network that covers urban and rural areas [16]