新华社北京12月3日电 题：健全多层次医疗保障体系 筑牢民生保障底线——访国家医保局局长章 轲 新华社记者彭韵佳 医保，关系每个参保人的切身利益。党的二十届四中全会审议通过的《中共中央关于制定国民经济 和社会发展第十五个五年规划的建议》（以下简称《建议》），提出"健全多层次医疗保障体系""推进 基本医疗保险省级统筹"等系列部署。 如何健全多层次医疗保障体系？如何让医保改革成果更好惠及群众健康？新华社记者专访了国家医 保局局长章轲。 破解看病难、看病贵问题取得突破性进展 问："十四五"时期，医疗保障制度改革如何提升百姓获得感？ 答：党的十八大以来，全民医疗保障制度改革持续推进，参保质量明显提升，人民群众医保获得感 显著提高。 国家医保局持续推进"1+3+N"多层次医疗保障体系建设，基本医保、大病保险、医疗救助三重基本 医疗保障制度进一步巩固提升。职工医保、居民医保政策范围内住院费用报销比例分别达到80%和70% 左右，普遍开展普通门诊统筹和门诊慢性病、特殊疾病保障，减轻参保人员门诊医疗费用负担。大病保 险进一步减负，城乡居民大病保险保障水平在基本医保基础上提高10到15个百分点。健全统一规范的医 疗救助制度。 ...

新华社北京12月3日电（新华社记者彭韵佳）医保，关系每个参保人的切身利益。党的二十届四中全会 审议通过的《中共中央关于制定国民经济和社会发展第十五个五年规划的建议》（以下简称《建 议》），提出"健全多层次医疗保障体系""推进基本医疗保险省级统筹"等系列部署。 如何健全多层次医疗保障体系？如何让医保改革成果更好惠及群众健康？新华社记者专访了国家医保局 局长章轲。 破解看病难、看病贵问题取得突破性进展 问："十四五"时期，医疗保障制度改革如何提升百姓获得感？ 答：党的十八大以来，全民医疗保障制度改革持续推进，参保质量明显提升，人民群众医保获得感显著 提高。 国家医保局持续推进"1+3+N"多层次医疗保障体系建设，基本医保、大病保险、医疗救助三重基本医疗 保障制度进一步巩固提升。职工医保、居民医保政策范围内住院费用报销比例分别达到80%和70%左 右，普遍开展普通门诊统筹和门诊慢性病、特殊疾病保障，减轻参保人员门诊医疗费用负担。大病保险 进一步减负，城乡居民大病保险保障水平在基本医保基础上提高10到15个百分点。健全统一规范的医疗 救助制度。 以"减负、提质、便民"为导向，多举措强化保障实效。"十四五"期间，医保基 ...

下面，首先请陈晓东先生作介绍。 陈晓东：女士们、先生们，新闻界的朋友们，大家上午好！ 周颖：女士们、先生们，大家上午好！欢迎出席省政府新闻办新闻发布会。 今天我们举行高质量完成"十四五"规划系列新闻发布会第八场。我们非常高兴邀请到：省委教育工委委员、省教育厅副厅长吴振磊先生，省民政厅新闻 发言人、副厅长戈养年先生，省人社厅副厅长陈晓东先生，省卫生健康委副主任、省疾控局局长彭飞先生，省医疗保障局新闻发言人、副局长史文君先生， 请他们介绍陕西"十四五"时期民生保障和社会建设成效并回答大家关心的问题。 首先，非常感谢大家长期以来对人力资源和社会保障工作的关心关注和长期支持。 "十四五"时期，全省人社系统深入学习贯彻习近平总书记关于人力资源和社会保障工作的重要论述和历次来陕考察重要讲话重要指示，按照党中央、国 务院决策部署和省委、省政府工作安排，以人力资源有效开发利用为主线，以"人社工作进园区"为牵引，千方百计稳就业、强技能、促增收、防风险，推动 就业创业、社会保障、人事人才、劳动关系等人社领域各项事业高质量发展。下面，我从四个方面，和大家分享这一阶段的主要成果。 12月2日10时，陕西省人民政府新闻办公室举办"高质 ...

Core Viewpoint - The recent rumor claiming that only 2% of approved drugs are included in the medical insurance catalog has been clarified, revealing that 3,159 drugs are listed, accounting for approximately 63% of the total market drugs [1] Group 1: Medical Insurance Catalog - The medical insurance catalog has been continuously expanded, with 835 new drugs added in recent years, enhancing the basic medical insurance coverage [1] - The catalog reflects a response to public medication needs, with updates ensuring better coverage for cancer treatments, rare diseases, and children's medication safety [2] - The adjustment mechanism for the medical insurance catalog has become regularized and scientific, aiming to improve the quality and structure of clinical medication [2] Group 2: Multi-layered Medical Security System - The need for a multi-layered medical security system is emphasized, as basic medical insurance alone cannot meet diverse health demands [3] - The "14th Five-Year Plan" suggests optimizing drug procurement and insurance payment policies to support a multi-tiered medical security framework [3] - The introduction of a commercial health insurance innovative drug catalog aims to enhance the multi-layered medical security system, even though basic medical insurance does not cover these drugs [3] Group 3: Commitment to Public Health - The focus is on ensuring that every penny spent on health maximizes benefits rather than just purchasing expensive drugs, maintaining the principle of "basic protection" [4] - The ongoing reforms aim to alleviate the healthcare burdens of the population, reflecting a commitment to improving public health and well-being [4]

Core Insights - The article discusses the efforts of Yiwu City in Zhejiang Province to address issues related to the management and use of medical insurance funds, focusing on combating corruption and ensuring proper fund utilization [1][2] Group 1: Regulatory Measures - Yiwu City has established a collaborative mechanism involving multiple departments such as medical insurance, health, public security, and civil affairs to enhance the management of medical insurance funds [1] - The city is utilizing big data analytics through a provincial smart medical insurance supervision platform to monitor key risk points dynamically, improving the precision of regulatory efforts [1] Group 2: Case Studies and Findings - A specific case was highlighted where a warning from the big data analysis model indicated potential fraudulent behavior at a rehabilitation hospital, leading to a prompt investigation that prevented duplicate payments from the civil affairs system [1] - The city has mandated the rehabilitation hospital to improve internal management and has conducted multiple inspections to address violations related to "bed occupancy" practices, identifying 88 patients who were not actually hospitalized [2] Group 3: Financial Recovery and Oversight - An expert review group has been formed to conduct quarterly cross-reviews of hospitalization records, resulting in the review of 4,143 cases this year, with 403 cases identified as having inadequate admission criteria, leading to the recovery of over 1.57 million yuan in medical insurance funds [2] - The article emphasizes the importance of medical insurance funds as critical financial resources for insured individuals, highlighting ongoing efforts to strengthen oversight and enhance the effectiveness of governance in the healthcare sector [2]

去医院就诊，发现忘带医保卡？没有智能手机无法扫码支付？没关系，刷脸就能全部搞定！ 11月14日，记者从自治区医疗保障局获悉，全区将从12月1日起，全面应用医保便民支付结算方 式。参保人员在定点医药机构就医购药时，选择扫医保码（医保亲情账户）、人脸识别、实体社保卡 +社保卡密码等其中一种安全核验方式，即可完成医保基金结算。 刚在南宁某社区医院体验医保刷脸结算的张阿姨表示，不管是挂号、缴费还是取药，只要在医保终 端前露个脸，"实名+实人"核验瞬间通过，全程不用摸手机、掏卡片，老年人操作也毫无压力。 刷脸支付安全吗？记者了解到，医保刷脸支付，依托国家医疗保障局认证的医保业务综合服务终 端，以医保码（电子凭证）为核心，采用"人脸识别+实名+实人"安全核验技术，保障个人信息安全。 没有激活过医保码的用户，可在结算时直接在刷脸设备上完成激活。 目前，全区已有2303家定点医疗机构、4033家定点零售药店提供医保刷脸结算服务。此外，从12月 1日起，医保平台将不再支持仅凭身份证号码进行无密码验证的结算操作。本人就医购药时，需提前准 备好医保码，也可以选择医保刷脸终端快速刷脸结算；如为家人代办，需提前绑定好家人的医保亲情账 ...

Group 1 - The core issue is the implementation of daily reimbursement limits for medical insurance in Xinxiang, with residents capped at 50 yuan and employees at 150 yuan, effective from June 13, 2025 [2][4] - The Xinxiang Medical Insurance Bureau stated that without these limits, the insurance fund could face a deficit by the end of the year, emphasizing the need for efficient fund management [4][6] - The adjustment aims to prevent fraud in the medical insurance system and to standardize medical practices in hospitals and clinics, with the bureau asserting that typical outpatient expenses are around 100 to 200 yuan per visit [7] Group 2 - The bureau clarified that the new limits are not indicative of a funding shortfall but are a preventive measure against fraudulent claims [6][7] - Patients needing to exceed the daily limit are encouraged to self-pay the excess amount, as splitting large expenses over multiple days is not compliant with insurance regulations [7]

Economic Impact - The ongoing government shutdown has the potential to negatively impact overall economic growth, with the Congressional Budget Office estimating a decrease in the annual GDP growth rate by 1 to 2 percentage points in Q4 2023, translating to a loss of $7 billion to $14 billion depending on the duration of the shutdown [4][6] - Consumer confidence is expected to be directly affected, as federal employees face delayed wages and contractors experience payment delays, which could impact the traditional holiday shopping season if the shutdown persists [4][6] - The shutdown has already caused significant disruptions in various sectors, including aviation, with over 3.2 million travelers affected by flight delays or cancellations since the shutdown began [3][4] Aviation Sector - Approximately half of the major air traffic control facilities in the U.S. are experiencing staffing shortages, particularly in the New York area where nearly 90% of air traffic controllers are absent [3] - The Department of Transportation has warned that if the shutdown continues, it may have to close certain airspaces due to staffing and safety pressures, potentially leading to longer wait times at airports during the busy Thanksgiving travel season [3][4] Healthcare and Food Assistance - The shutdown has halted the distribution of funds for the Supplemental Nutrition Assistance Program, affecting over 40 million Americans, with emergency funds being utilized to cover only part of the month's assistance [3][4] - The inability to pass a temporary funding bill has led to significant increases in health insurance premiums, with estimates suggesting an additional $1,000 per year for individuals without government subsidies [2][4] Political Stalemate - The political deadlock between the Republican and Democratic parties continues, with no clear resolution in sight, as both sides appear to be using the shutdown as a political tool rather than seeking a compromise [7][8] - Recent attempts to advance a temporary funding bill have failed to secure the necessary votes, indicating a deepening divide and a lack of urgency to resolve the crisis [7][8]

Core Points - The U.S. federal government shutdown has entered its 34th day, nearing the record of 35 days set in late 2018 to early 2019, with significant impacts on various sectors including aviation, food assistance, and healthcare [1] - The ongoing political polarization between the Republican and Democratic parties is exacerbating the situation, with both sides using the shutdown to further their political agendas without signs of compromise [1] Aviation Industry - Approximately 13,000 air traffic controllers and 50,000 airport security personnel are working without pay, leading to staffing shortages and increased flight delays across the country [2] - The Federal Aviation Administration reported that nearly half of the major air traffic control facilities in the U.S. are experiencing staffing shortages, with nearly 90% of controllers in the New York area absent [2] - On November 2, nearly 4,300 flights were delayed and over 550 flights were canceled due to the staffing crisis [2] Food Assistance and Healthcare - The federal food assistance program, the Supplemental Nutrition Assistance Program, ceased operations on November 1 due to funding exhaustion, affecting 42 million Americans, or about one-eighth of the U.S. population [3] - The Affordable Care Act's enrollment for the new year began on November 1, with 24 million expected to enroll, but rising premiums are anticipated due to a lack of agreement on government subsidies [3] - The Congressional Budget Office estimates that the shutdown could reduce the annual GDP growth rate by 1-2 percentage points in Q4, translating to economic losses of $7 billion for a 4-week shutdown, $11 billion for 6 weeks, and $14 billion for 8 weeks [3] Political Stalemate - The shutdown is primarily due to a deadlock between the two parties over healthcare spending, with neither side showing urgency to resolve the issue [4] - The Trump administration has been attempting to significantly cut spending and reduce federal employment, with expectations that over 10,000 federal positions may be eliminated due to the shutdown [5] - Both parties are leveraging the shutdown to solidify their political positions, with Democrats aiming to portray themselves as advocates for low-income groups while Republicans focus on reducing government spending [5]

Core Insights - The article emphasizes the importance of establishing a multi-tiered medical insurance system to enhance public health security in the context of China's 14th Five-Year Plan [2][3] Group 1: Medical Insurance System - The provincial medical insurance bureau aims to implement the central government's decisions and focus on key reforms in medical insurance payment and drug pricing to improve service levels [2][3] - The bureau will enhance budget and operational management of the medical insurance fund to ensure its sustainable operation and strengthen regulatory frameworks to combat fraud [3][4] - The integration of artificial intelligence in the medical insurance sector is planned to optimize services and improve efficiency for the public [3][4] Group 2: Healthcare Development - The medical insurance system will support the collaborative development of healthcare, medical insurance, and pharmaceuticals, including the implementation of a new drug list and direct settlement with pharmaceutical companies [4] - The bureau aims to create a more equitable and adequate medical insurance benefit mechanism and extend services to grassroots levels [4][5] Group 3: Education Sector Improvements - The article highlights significant investments in educational infrastructure, with over 15 billion yuan allocated to improve conditions in compulsory education schools, resulting in the addition of 1620 new student places [5][6] - The province has implemented various student aid programs, distributing approximately 96.835 billion yuan to support over 74 million students across different educational levels [6][7]