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Or health insurance fund gap will advance: Chinese personal medical expenses much higher than in developed countries | health insurance | Medical
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Shortly after the message was to investigate the government to pay retiree health care costs of publication, of expenditures MBF once again into public view.
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This time, relevant departments will focus on how to control medical costs unreasonable growth, namely to curb excessive wastage in huge medical aspects of health care costs. The move was interpreted as the respondents with both open throttle.
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"First Financial Daily" in Hangzhou, Jinhua, Yueyang and other places survey found, limited government restrictions on current procurement laws and regulations, the development of the market is also facing the throttle how government agencies purchase services and third-party development bottleneck how to profit .
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Fund Gap or advance
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Since 1998, China in less than 20 years to complete the world's largest health insurance plans, basically to achieve full coverage of 1.3 billion people medical insurance system.
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In recent years, due to the rapid rise in the aging population and medical expenses, medical insurance fund is facing increasingly serious balance of payments situation. Studies have shown that aging does not directly lead to increased medical costs, only increased the cost of care internationally. It is different in China: the Elderly hospitalization rate increase and high proportion of drugs, increasing total health care costs and increase Medicare spending, one of the main reasons.
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Medical Service Governance Research Center, Tsinghua University, one of the latest estimates show that the total health care cost increases China's rapid growth after entering the aging society, with an exponential growth trend. If not controlled, Chinese total health costs from the current 3 trillion to 273 trillion in 2040, which will finance, health insurance funds and individuals can not bear the burden.
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Tsinghua University, said the forecast, the basic medical insurance fund gap will appear in 2024, if added to the aging population, a one-time lump-factors such as the health insurance fund balance of payments gap will appear in the near future.
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The reality is that the health insurance fund is facing open hopeless situation. Interviewed experts believe that even if the Medicare levy fees for retirees, a few hundred million in revenue annually for health insurance fund is also inadequate. Government can do and are doing is only by controlling medical costs unreasonable growth (ie, control costs) to implement throttling.
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Yang Yan Sui, director of medical services Governance Research Center, Tsinghua University, said the retiree health care costs impose health insurance fund is to achieve break-even second best option, the best choice would be through the establishment of comprehensive medical services governance, control the growth of medical costs.
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Yang Yan Sui said control fee not to reduce medical costs, but to establish the growth rate of per capita health care costs per capita GDP indicators linked to health-based big data, out of water from unreasonable medical expenses.
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So, unreasonable medical expenses will occur in the wrong?
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The maximum gap caused by excessive medical treatment
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"First Financial Daily" correspondent in Yueyang City, Hunan Province found that the aging population has become an important reason for the increase Medicare funding is difficult to meet the rapid growth in demand for health care costs.
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Department who issued the "China Social Insurance Annual Report 2014" shows that workers basic medical insurance system for urban workers,peuterey donna, retirees ratio of 2.90, compared with last year dropped by 0.05 percentage points, down 0.07 percentage points compared with 2009. There are 24 provinces in the Employee Retirement ratio lower than the national level.
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Employee Retirement ratio is the ratio of the number of active employees and retired population. According to the existing health insurance policy, retirees do not pay, per capita health care spending is much higher than retirees active employees, retired employees means less than the decline in the Fund's income, increase spending.
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Yueyang city level employee retirement ratio of 1.73,louboutin bottines, a figure far below the national average, pay more and more pressure on the health insurance fund.
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Yueyang City Social Security data show that in 2015 1-8 months, retirees hospitalized 2.26 million times, accounting for 61.9% of the total number of hospitalizations, accounting for 69.6% of total payment fund.
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The city Social Council official said, aging and rising health care costs are two important reasons. Yueyang City,hogan rebel, hospitalization rates as high as 24%, large inspection equipment, a large number of new medical supplies put into use, pushing up medical and hospitalization costs. Individual hospitals adopt illegal means to cheat hanging bed medical insurance fund.
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In November last year, Wei Planning, Development and Reform Commission, Ministry of Finance, Human Resources and Social Department of Drug Administration five ministries jointly issued "Opinions on the control of public hospitals, medical costs unreasonable growth" (the "Opinion"). The "opinions" that the current unreasonable medical expenses increase the total amount of outstanding performance in urban public hospital medical expenses increase faster portion, a larger proportion of drug income, the income share of large medical equipment examination and treatment and medical supplies to increase rapidly, not reasonable medical care and other medical services increases rapidly due to the total amount and the like.
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On the other hand, Medicare and Social Affairs Director Chen Jinfu people last month in a speech at Tsinghua University said health care costs increasing trend is unlikely to change in the short term. Judging from the time range 3-5 years or 10 years, China's medical insurance expenditure will enter a period of risk.
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Public information, employee health insurance funds the country has 225 co-ordinating the emergence of income over expenditure, accounting for 32% of the overall area, of which 22 will be co-ordinating all spent, over the years accumulated surplus in 2013; in terms of resident medical insurance, the National there are 108 regional co-ordination appeared income over expenditure.
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Wei Planning annual statistics published show that in 2014 total health expenditure is expected to reach 3.53789 trillion yuan, of which: government health spending 1.05907 trillion yuan (29.9 per cent), social health expenditure 1.30429 trillion yuan (36.9 per cent), personal health expenditure 1.17453 trillion yuan (accounting for 33.2%). 2586.5 yuan per capita total health expenditure, total health expenditure accounted GDP5.56%.
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Yang Yan Sui said that in 2014 the overall fund medical insurance for urban workers, the accumulated surplus was 553.7 billion yuan, increasing year by year trend looks, in fact, false. If you subtract one-time lump-funds of about 200 billion yuan (including one-time financial subsidies Guantingbingzhuan enterprises, individuals and other funds to pay prepaid),louboutin prix, barely enough to pay the remainder of the more than five months, has not yet reached people provision for at least six months of the requirements specified in the Department.
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The current Medicare system consists of three components. The basic medical insurance for urban residents and the new rural cooperative, in theory, is integrated into the urban and rural residents in the basic medical insurance. This is a voluntary insurance, and government subsidies. The core of the system is the basic medical insurance for urban workers, mandatory insurance, individual rate of 2%, into the personal account; unit rate around 6%, most integrated into the community.
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In recent years, health care workers and residents appear Medicare spending growth greater than revenue growth conditions, an increase in employee health insurance expenditure in 2014 is higher than the income growth rate 1.1 percentage points higher than the residents of Medicare spending growth revenue growth 9.0 percentage points. If this situation continue, the cumulative balance of the health insurance fund will be exhausted quickly.
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How to confirm the part to be controlled
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Although the "opinion" that the public hospitals to control medical costs unreasonable growth as the deepening medical reform important goals and tasks, but as long as health care costs continue to grow, the health insurance fund expenditure would not fall down.
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Management Institute of Tsinghua University Hospital, Professor Qian Qing-wen called the law saw the arrow, the arrow is injured patients,hogan nuova collezione, surgical first amputated, then medical treatment again. Reflected in the health insurance fund, is based on the total amount paid in a way that after the end of the health insurance fund to run out, the hospital no longer willing to accept the patient.
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The basic principle is that the medical insurance fund payments can not exceed the amount collected. The total payment is to be paid to ensure that the health insurance fund balance generated.
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For health care administration, the administrative control expenses can play an immediate effect, such as narrowing the scope of the policy to pay, reduced reimbursement standards,louboutin, etc., which means a practice, when the health insurance fund will soon have a surplus.
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However, once behind the health insurance fund balance was paid a higher proportion of individuals, not only with medical insurance contrary to the original intention, it will increase the conflict between doctors and patients.
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After the goals of social insurance full coverage of medical expenses than ideal conditions should be: social security spending accounted for 50%, mainly to compensate for medical personnel; expenditure accounted for 30%, mainly for the construction of public hospitals; personal spending accounts 20%, mainly for the purchase of drugs and disposal costs.
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But Chinese personal medical expenses has been far higher than the level of developed countries, the proportion of individuals in OECD countries pay an average of 10%, while the proportion of China accounted for 33.2%. Once again increased and expensive become more prominent.
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So,louboutin en ligne, how to achieve health care cost growth and economic and social development in harmony?
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Yang Yan Sui believes that controlling costs is not to reduce medical expenses. Tsinghua University, published "China's aging society Medicare Development Index Report", the growth rate of per capita health care costs reasonable care as the core indicators of governance. Report, the growth rate of per capita health care costs should be 1.16 times the per capita GDP growth rate higher than the rate control part is reduce costs space.
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Some of the top three hospitals in the Midwest and charges in line with Beijing, its growth rate of per capita health care costs per capita GDP growth rate higher than, 10-20 points, the local health insurance fund is difficult to afford to pay the money. Yang Yan Sui suggested that the growth rate of per capita health care costs into the local government assessment, to curb unreasonable medical expenses increase.
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Medicare monitoring system into the best tool
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"China Social Insurance Annual Report 2014" also shows that in 2014, the per capita cost of basic medical insurance for the 708.3 billion yuan, an increase of 15.2% over the previous year, an increase of 421.8 billion yuan over 2009, an increase of 147%.
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Hospitalization costs,hogan interactive, drug costs,loudboutin shoes homme ete, examination and treatment fees, service facilities and other expenses were 190.2 billion yuan, 183.2 billion yuan,marc jacobs occhiali da sole, 42.7 billion yuan and 15.9 billion yuan, accounting for hospital costs were 44%, 42.4%, 9.9% and 3.7%. This shows that hospitalization costs are 86% for medication and tests.
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Health insurance sector to identify what kind of method which is reasonable growth,louboutin à bout ouvert, which is unreasonable growth? Medicare will incorporate intelligent monitoring system whereby the line of sight.
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Last year, the Office of Human Resources and Social Ministry issued a "comprehensively promote the basic medical insurance medical services intelligent monitoring handling procedures" required two years in the national basic medical insurance medical service open intelligent monitoring work towards covering 50% of the year 2015 area. The system is expected to solve the shortage of medical insurance management institutional capacities reality.
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The reporter found that, with the third-party companies to provide professional health care system can greatly improve the efficiency of the document review, and regulatory role of the health care system but also to act in some areas good.
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Chen Jinfu said, meaning that through intelligent auditing information systems into the studio the doctor, further extended to health records. In short, Medicare actually use smart tools to examine the hospital and doctor, the introduction of intelligent auditing system, the establishment of expert database, the rule base is actually Medicare ruler.
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Yang Yan Sui led the research group in the country selected 12 municipalities evaluated the performance of health insurance, she these 12 cities are divided into four categories, one is Hangzhou, Jinhua and other cities entered a stage of comprehensive management, and second parts of Sichuan into intelligent stage audit and control costs, the third is part of the region is still dependent on administrative control costs, four are in the minority areas and poor cost control fund losses.
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Yang Yan Sui believes, which Hangzhou, Jinhua and other cities at the forefront of the country.
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February 2014, Jinhua City and Social Council and Haihong Holdings subsidiary in the public network signed a Medicare audit intelligent platform construction agreement,links bracciali, a monthly fee will be designated medical institutions occurred by a single post audit. December of that year,2013 air jordan, joined the review and evaluation of the quality of medical diagnosis between secondary analysis module, the two modules are included in the 2015 Medicare Zhejiang deepen regulatory Work pilot.
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Deputy Secretary of Jinhua in Zhejiang Province Social Insurance Authority Shaoning Jun Though I think, of course, is not a simple control costs by intelligent auditing system can be solved, but he was optimistic about intelligent auditing and quality evaluation system. This improves the health care sector to speak of scientific and authoritative. He said.
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Jinhua consultation between audit to achieve the real-time behavior of the doctor of medical reminders, feedback immediately. For example, a patient for two consecutive days to a different hospital, the doctor opened the same drugs,cappelli nhl, the system will prompt more than a predetermined amount, which not only reduces the cost of the patient, but also reduce the expenditure of the health insurance fund. More importantly, it will effectively reduce potentially fraudulent behavior.
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Jinhua City Hospital medical insurance Office main Ren Zhouxiu female reporter said, intelligent auditing system just on the line, the hospital issues the documents five six thousand, but only 134 in September last year, the amount of irregularities involving only 2,000 yuan. Week show female that with the health insurance fund will become the main source of hospital income, health insurance office in the hospital's status also from a desk becomes a functional departments, hospital supplies and purchased high priced drugs will do seek health care Views.
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Medicare regulation Jinhua mode the ultimate goal is squeezed out of medical services in the price of water is also necessary to protect the quality of medical services.
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Jinhua has decided to introduce the third-party health insurance fund professionally managed organization while building a medical institution with reasonable medical practice was evaluated as the core of professional third-party review of the data center.
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Shaoning Jun said, Jinhua is explored under the premise of the total amount paid to find the hospital and healthcare management control agencies acceptable cost way to achieve win-win situation constituents including the patients of.
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Third party difficult to profit?
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The specific measures to control costs, the fundamental means to promote the reform of Medicare payment methods.
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At the same time, health insurance intelligent audit also referred to an unprecedented height requirements of the Department who in 2016 co-ordinating all regions must be on-line intelligent auditing system to deter misuse and waste of health insurance funds.
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Department who claim to achieve full coverage insurance intelligent monitoring system within two years, 2015 and 2016, which makes 2015 became the first year of the Medicare intelligent monitoring system for landing.
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Five ministries in November last year introduced the "opinions" mentioned before, but also for intelligent monitoring Medicare plus a fire. "Opinions" to the end of 2017, public hospitals, health care cost control monitoring and evaluation mechanism and gradually establish and improve.
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Market institutions that, in order to reduce the unreasonable medical and pharmaceutical expenses, to vigorously promote policies need to control health care costs, health care costs will accelerate the adoption of control, the potential market size of up to one hundred billion level.
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Listed companies, Haihong Holdings has signed more than 180 prefecture-level cities Medical Insurance Agreement, be controlled Medicare audit fees; Wei Ning Jiankang actively control the layout of the Medicare fee business, has partnered with Shanxi medical center and other places.
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Last year, Wanda information, Neusoft Group, China Ping An, also have to seize the market, with a number of provinces and cities signed an agreement to upgrade health care management system.
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Haihong Holdings, a subsidiary of the public in September 2015 and October respectively Zhanjiang and third-party service Yueyang signed a trust agreement, the two cities the basic fund audit, payment, evaluation, and insured services.
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"First Financial Daily" in Hangzhou,cinture stefano ricci, Jinhua, Yueyang and other places survey found an urgent need for the government to stimulate the potential business opportunities, health care agencies have introduced a professional third-party company, to build a joint platform for intelligent monitoring, without cost to the health care Fund penny under the conditions for the establishment of a reasonable mechanism to control costs and suppressing the moral hazard generated good results.
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However, limited by restrictions related to government procurement laws and regulations, the cost of local finance can pay enough to compensate for the cost of third-party companies, the development of this market is also experiencing a bottleneck how government agencies purchase services and third-party profit model.
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Shangguan Yongqiang Haihong Holdings vice president told reporters,hogan sito ufficiale, established third-party payment assessment center is an important medical layout Haihong the Internet, based on the payer representatives, Haihong using the Internet to reduce the health insurance fund + leaking process, It can also bring benefits to the effective integration of resources the insured person.
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Changjiang Securities,escarpins louboutin, a research reported, Haihong PBM (medical benefits management) a reasonable profit point include: First, control costs Medicare audit assistant service fee depending on the size of the health insurance fund, unit charge prefecture-level city of 500 000 to 300 Manpower Wan annual service fee.
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Second, in Zhanjiang mode, full health insurance fund management butler service charge,hogan outlet online, a conservative expected to deserve the order of ten million years of service charges, etc., business market research report is expected PBM space estimates more than 1.23 billion yuan annual fee income.
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However, third-party insurance intelligent monitoring mechanism facing reality, far from research reports depicted so beautiful.
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Shangguan Yongqiang said that due to the impact of government procurement regulations and policies, Medicare audit and review of third-party payment service fee can not be included in the government budget, the government only on behalf of the construction costs of a one-time software for a small amount, which makes the enterprise on this difficult business profits.
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Shangguan Yongqiang recommended that the third party management services into their daily budgets of public service outsourcing reasonable cost. Meanwhile, for the development trend of diversification of the social security system, the relevant government departments should study a wide range of payment methods and indicators to meet the third-party social organizations in commercial insurance agencies to provide professional management services, making it possible to obtain legitimate business income.
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