Is vertical management of medical insurance bureau necessary?

Medical security should be managed vertically. Judging from the information disclosed in the draft social insurance law, it is a trend that the overall level of social insurance needs to be improved. As soon as possible, realize the provincial-level overall planning of endowment insurance, and transfer it to the national overall planning when conditions are ripe. Medical insurance, industrial injury insurance, maternity insurance and unemployment insurance should gradually improve the level of overall planning, and transition to provincial overall planning when conditions are ripe. In the long run, it is very likely that medical insurance will be below the provincial level vertically, and the specific time is difficult to predict. This depends on the specific provisions of the adopted social insurance law and the strength of medical insurance reform.

Second, the difference between provincial vertical medical insurance and municipal vertical medical insurance

1. Designated medical institutions are different. There are more provincial medical insurance than municipal medical insurance designated medical institutions (most provincial hospitals are not municipal medical insurance designated hospitals); 2. Medication and examination for medical treatment and hospitalization are different. The number of medical treatment and hospitalization drugs and inspection items in provincial medical insurance are more than those in municipal medical insurance; 3. There are more drug purchasing outlets in provincial-level medical insurance designated retail pharmacies than municipal-level medical insurance; 4. The provincial medical insurance cost exceeds the municipal medical insurance medical insurance card. 5. The reimbursement rate is different, and the situation varies from place to place. The reimbursement rate of general provincial medical insurance is higher than that of municipal medical insurance. 6. Provincial medical insurance can only be kept by the employees and files of provincial units in the provincial talent agency center, and handled by the provincial pension as a whole, while municipal medical insurance can only be kept by the employees and files of municipal units in the municipal talent agency center, and handled by the municipal pension as a whole.

7. Provincial medical insurance can be hospitalized in any hospital (participated in the designated medical insurance hospital). However, municipal medical insurance can only be treated and hospitalized in municipal hospitals (participating in designated hospitals for medical insurance). The Opinions of the Central Committee of the Communist Party of China and the State Council on Deepening the Reform of the Medical Security System (hereinafter referred to as the Opinions) was officially released. The Opinions give guidance from eight aspects, such as overall requirements, treatment, financing, payment, supervision, supply-side reform, optimization of management services, and organizational guarantee, and define the goals in different stages of 5-year 10, and finally "form a medical security system with basic medical insurance as the main body, medical assistance as the basis, medical insurance, commercial health insurance, charitable donations and medical mutual assistance as supplements, and develop together." On the whole, the Opinions clarified five major trends in the future development of the medical insurance system: improving management level, returning to risk sharing, strengthening safety net, building a multi-component composite payment system, and deepening supply-side reform.