Core Viewpoint - The new healthcare policy in the city, effective from July 1, will include urban and rural residents in the long-term care insurance coverage, addressing the care challenges faced by disabled individuals and their families [1][2]. Group 1: Policy Implementation - The long-term care insurance (LTCI) aims to provide care support and financial assistance to individuals who are unable to care for themselves due to illness, disability, or old age [1]. - Since the LTCI was officially implemented on October 1, 2023, a total of 3,463 severely disabled individuals have benefited from the program, resulting in over 35 million yuan in financial relief for families [1][2]. - The LTCI fund reimburses care costs at a rate of 50 yuan per day for individuals receiving 24-hour care in nursing facilities, potentially saving families 1,500 yuan per month [2]. Group 2: Service Options and Support - The LTCI offers a variety of care services, allowing families to choose from five types of care based on their needs, including institutional care, family care subsidies, home care services, and specialized care services [2]. - The family care subsidy is set at 10 yuan per person per day, providing financial support to family members who care for their disabled relatives [2]. Group 3: Application Process and Future Enhancements - To ensure smooth implementation of the new policy, the city’s healthcare bureau has optimized the application process, allowing online applications through the "Zhenjiang Long Care" app or in-person at designated service points [3]. - The healthcare bureau will continuously monitor the policy's effectiveness and make necessary adjustments to improve service quality and ensure that severely disabled individuals receive high-quality care [3].

Core Points - The draft of the "Medical Security Law of the People's Republic of China" has been released for public consultation, aiming to formalize recent healthcare reforms into law and allow for further exploration of reforms [1] - A significant provision in the draft allows for temporary adjustments to the basic medical insurance fund's payment scope during major infectious disease outbreaks, with a legal basis established for previous practices like the COVID-19 vaccine funding [1][2] - The draft consists of 7 chapters and 50 articles, outlining the framework of the medical security system, enhancing fund management, optimizing services, and strengthening supervision to ensure the rights of insured individuals [2] Industry Implications - The draft law emphasizes the need for a structured medical insurance system, including provisions for employee basic medical insurance, urban and rural resident basic medical insurance, and maternity insurance, clarifying coverage, funding methods, and benefit guarantees [2][3] - The law promotes provincial-level coordination of basic medical insurance, which could lead to more efficient resource allocation and improved healthcare access across regions [3]

Group 1: AI Integration in Healthcare Services - The rapid development of AI technology is being integrated into healthcare insurance services, enhancing convenience and improving service quality for the public [1][2] - Various local healthcare insurance bureaus have adopted AI models like DeepSeek, enabling instant responses to frequently asked questions regarding insurance policies and reimbursement processes [2] - The AI assistant "依保儿" has been launched in multiple regions, significantly improving service efficiency and user experience, with an average monthly access of 37,500 visits in Hangzhou [2][3] Group 2: Challenges in Fund Supervision - The healthcare fund supervision faces significant challenges due to a lack of personnel compared to the vast number of insured individuals and healthcare institutions [4] - Traditional supervision methods are inefficient, with less than 1% of medical expense documents being manually audited, leading to difficulties in identifying fraudulent activities [4] - The need for modernized supervision through big data and AI applications is emphasized to address the extensive regulatory tasks and improve efficiency [4] Group 3: Smart Supervision Initiatives - The National Healthcare Security Administration has initiated the first batch of intelligent supervision rules and is promoting pilot reforms to enhance fund supervision [5][7] - By the end of 2024, the goal is to achieve full coverage of the intelligent monitoring subsystem across all healthcare institutions, particularly benefiting secondary hospitals and grassroots medical facilities [7] - The intelligent supervision system has been implemented in over 90% of the national healthcare regions, enhancing the monitoring capabilities of healthcare funds [5][7] Group 4: Data Utilization and Analysis - The healthcare sector possesses rich data resources that can optimize resource allocation, fund supervision, and drive innovation in the pharmaceutical industry [9] - In-depth data analysis has revealed unusual patterns, such as male patients receiving gynecological treatments, highlighting the importance of data scrutiny in preventing fund misuse [9][10] - Local healthcare departments are leveraging technology to improve data dissemination and analysis, with initiatives like the "医保高铁" platform in Nanjing, which integrates data from over 2,148 healthcare institutions [11] Group 5: Future Prospects - The application of AI and big data in healthcare is expected to expand, enhancing fund prediction models and improving efficiency [12] - Combining AI with blockchain technology could increase data transparency and traceability, thereby strengthening the credibility of the healthcare system [12] - AI and big data will play a significant role in chronic disease management, telemedicine, and personalized healthcare services in the future [12]

Group 1 - The AFL-CIO report highlights that if the proposed Republican tax reform is passed, approximately 179 million Americans relying on employer-provided health insurance could face an annual premium increase of up to $485 each [1] - The Congressional Budget Office (CBO) estimates that the tax reform could cut federal Medicaid spending by nearly $800 billion over the next decade, affecting over 70 million Americans currently covered by Medicaid [1][2] - The expiration of ACA premium subsidies in 2025, as noted in the report, will lead to an increase in the uninsured population, with projections indicating that 16 million Americans could be without insurance by 2034 [2] Group 2 - The reduction in Medicaid funding is expected to significantly impact hospital operations, as Medicaid accounts for about 19% of hospital revenue in the U.S. [2] - The CBO anticipates that the increase in uninsured individuals will result in an additional $63 billion in uncompensated care costs for the healthcare system over the next decade [2] - Hospitals may face two choices in response to rising uncompensated care: either negotiate higher reimbursement rates from commercial insurers, which would increase costs for employer-sponsored insurance, or operate with reduced margins, potentially leading to closures of struggling rural hospitals [3] Group 3 - The report indicates that 40% of hospitals in the U.S. are currently operating at a loss, and further revenue constraints could exacerbate this issue, leading to reduced services and longer wait times for patients [3] - The healthcare insurance sector reacted negatively to the news, with stocks of major health insurance companies like Humana, UnitedHealth, CVS, and Cigna experiencing declines [3] - The potential implementation of the tax reform could accelerate the differentiation within the health insurance industry, negatively impacting smaller insurers while potentially strengthening the market position of larger commercial insurance giants [3]

智通财经6月17日电，美国参议院税收立法草案将医疗保险供应商的税率下调至3.5%。 ...

日本最早2027年度起，把国民健康保险的滞纳信息用于判断是否更新外国人的居留资格。日本厚生劳动 省数据显示，包括日本人在内的整体国民健康保险缴纳率为93%，而外国人的缴纳率仅为63%…… 日本政府最早2026年度修改系统，以便掌握外国人缴纳国民健康保险的情况。最早2027年度 起，把滞纳信息用于外国人居留资格的审查，作为是否更新居留资格等的判断依据。此举旨 在提高国民健康保险的缴纳率，加强国民皆保险的信任度。 日本的国民健康保险系统分为，国民健康保险中央会的系统和各地方政府独立的系统。政府 将为修改系统而修订标准参数。通过国家补贴等来支付系统修改费用，以便各地方政府能够 在2026年度着手修改系统。 外国人的滞纳信息将在2027年度被纳入日本数字厅的"公共服务网格"，以便入境管理部门在 审核居留资格时进行参考。对于保险滞纳者，将采取不允许更新居留资格等措施。 还将推动日本地方政府修改条例或规章，以便在进行居民注册时要求预付一年保险费用等。 外国人在日本的国民健康保险的总医疗费和高额疗养费支出额中的占比均在1%左右，低于外 国人占整体被保险人的比例。 版权声明：日本经济新闻社版权所有，未经授权不得转载或部分复制 ...

Core Viewpoint - The document outlines the government's opinions on further ensuring and improving people's livelihoods, focusing on addressing urgent and difficult issues faced by the public [1] Group 1: Healthcare Resource Allocation - The government aims to promote the sharing of high-quality healthcare resources [1] - There is a focus on expanding and balancing the distribution of quality medical resources across regions [1] - The document emphasizes optimizing the construction model, management system, and operational mechanisms of regional medical centers [1] Group 2: Insurance and Medication - The document proposes improvements to the basic medical insurance drug catalog adjustment mechanism [1] - It suggests the development of innovative drug catalogs for commercial health insurance to better meet the diverse medication needs of the public [1]

上海市卫生健康委员会等八部门近日印发《2025年上海市深化医药卫生体制改革工作要点》，其中提 出，健全医疗保障制度。健全基本医保参保长效机制，稳步调整基本医保待遇标准。推动实现基本医保 与商保等多层次医疗保障的有效衔接。完善居民医保大病保险办法和经办流程，全面实现直接结算。优 化生育保险政策，实现生育保险报销"免申即享"。全面对接国家建立统一长护险制度部署，调整优化本 市实施细则，进一步规范老年照护需求评估管理。探索开发"个人医疗费用负担画像"，整合各类保障数 据信息，为参保群众提供更加精准的医疗保障。制定定点机构相关人员医保支付资格管理实施细则，加 强参保人员外地就医监管，完善"飞行检查"机制，扎实开展医保基金管理突出问题专项整治。 ...

Core Points - Shanghai's healthcare department has launched a new "no application" service for newborn insurance registration, successfully registering 881 newborns so far [1] - Starting from November 2024, newborns born in designated medical institutions in Shanghai will automatically qualify for basic medical insurance if at least one parent is a Shanghai resident [1] - The average time for insurance registration has been reduced from 30 days to 2 working days, with next-day account activation for newborns [1] Group 1 - The "no application" policy protects the legal rights of all insured individuals and alleviates parenting anxiety for newborns' parents [2] - Parents opting for the family mutual aid network can have the newborn's insurance account activated as soon as the next day after automatic payment deduction [2] - If the family mutual aid network is not established or payment fails, parents must complete the insurance payment through tax department channels, with account activation occurring the next day after successful payment [2]

2025.05. 22 本文字数：2402，阅读时长大约4分钟 作者 | 第一财 经 郭晋晖 过去20多年间，我国医疗保险参保人数从制度起始的不到2000万增加到13.3亿，基本实现医保全民覆 盖，用占GDP2%左右的医保筹资撑起了全世界约六分之一人口的求医问药。 国际劳工组织近日发布的《迈向全民医疗保障的中国经验》（下称"报告"）称，近年来中国致力于建立 健全多层次的医疗保障制度体系。中国基本医疗保障覆盖面实现了从城镇职工扩展到农村居民、再到城 镇居民，覆盖面从小到大，保障水平从低到高的转变。 报告同时也显示，发展中的中国医保依然面临着参保未完全覆盖、参保质量有待提升等问题。中国基本 医疗保险参保率维持在95%左右，5%左右的未参保人口成为中国真正实现全民医保的"最后一公里"。 1998年12月《国务院关于建立城镇职工基本医疗保险制度的决定》出台，国务院正式建立起职工医 保，确定了"属地"原则，2002年覆盖了中国城镇企业和机关事业单位工作人员。 随着新农合和城镇居民医保制度的建立，2007年，中国基本医保参保人数（包括新农合）迅速增加至 9.49亿人，参保率快速提高至71.83%。从参保人数和参保率变化可 ...