Core Insights - The upcoming "Fifteen Five" period aims to enhance the national medical insurance system to achieve common prosperity and support the development of new productive forces [1][9] - The "Fourteen Five" period has seen significant improvements in medical insurance coverage, with a stable participation rate of around 95% and nearly 200 billion medical reimbursements enjoyed by the public [2][9] Medical Insurance Coverage - By 2024, the national basic medical insurance enrollment is projected to reach 1.327 billion, with annual financial subsidies for residents increasing from 490 yuan in 2018 to 670 yuan [2] - The long-term care insurance pilot program has expanded, covering 190 million people, and the proportion of fund payments for inpatient expenses remains stable at 80% for employees and 70% for residents [2][3] Technological Integration and Employment - The rise of new employment forms, particularly flexible employment, presents challenges for the current medical insurance system, with approximately 200 million urban workers still lacking basic insurance [3][4] - Local governments are exploring pathways for new employment forms to participate in basic medical insurance, with initiatives to encourage platform companies to enroll their workers [4] Fund Management and Expenditure - Since the establishment of the National Medical Insurance Bureau, the cumulative expenditure of the medical insurance fund has reached 12.13 trillion yuan, with an average annual growth rate of 9.1% [9] - The expenditure on newly negotiated drugs has significantly increased, with 2024 spending being 3.9 times that of 2020, reflecting a 40% annual growth rate [9] Cost Control and Efficiency - The total medical expenses for insured employees in 2024 are estimated at 2.06 trillion yuan, a 3.6% increase from the previous year, while resident medical expenses are projected at 2.03 trillion yuan, up 3.7% [7] - The reforms in medical insurance payment methods and the strengthening of fund supervision have contributed to a reduction in personal medical expenses by approximately 5% year-on-year [6][7] Long-term Care Insurance Development - The long-term care insurance system has attracted over 50 billion yuan in social capital investment during the "Fourteen Five" period, with more than 8,800 service institutions established [11] - A nationwide unified long-term care insurance system is expected to be launched within the year, aiming to provide stable funding support for the elderly care and health industries [11]