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商业保险机构经办新农合业务已覆盖140个县市区--亲民维稳网络舆情监测室
2012-09-17

  中新网9月17日电 卫生部副部长刘谦在17日举行的新闻发布会上表示,据初步统计,商业保险机构经办新农合业务已经覆盖了140个县市区,主要是集中在东部地区和部分中部地区。

Beijing, sept. 17 - health vice minister liu qian in 17, said at a news conference,According to preliminary statistics,Commercial insurance agency orgnaization of new agriculture close business has covered 140 wing,Is mainly concentrated in the eastern region and part of the central region.

  刘谦表示,卫生部对商业保险机构参与新农合经办服务工作持积极的态度,支持地方积极探索这种新的工作方式。据初步统计,商业保险机构经办新农合业务已经覆盖了140个县市区,主要是集中在东部地区和部分中部地区。2011年,卫生部在郑州市开展了全面委托商保机构经办新农合业务的试点工作,包括所有的县市区都开展了这项工作。今年4月份,为了更好地落实医改意见中提出的探索以政府购买医疗保险服务方式,委托商保机构经办各类医疗保障服务的要求,在总结各地区试点经验的基础上,卫生部会同保监会、财政部和国务院医改办,联合印发了《关于商保机构参与新农合经办服务的指导意见》,这个《意见》对商保机构参与新农合经办服务提出了工作原则和具体要求。

Liu qian said,The ministry of health to commercial insurance institutions to participate in the new agriculture close handling service work with positive attitude,Support local actively explore the new ways of working.According to preliminary statistics,Commercial insurance agency orgnaization of new agriculture close business has covered 140 wing,Is mainly concentrated in the eastern region and part of the central region.In 2011,,The ministry of health in zhengzhou city to carry out a comprehensive entrusted business insurance agency orgnaization of new agriculture close business pilot work,Includes all the wing is carried out the work.In April this year,In order to better carry out the reform in the exploration of opinions put forward government purchase medical insurance service mode,Business is protected by orgnaization of agency of medical security service requirements,At the conclusion of the regions on the basis of experience of the pilot,The ministry of public health and the circ/The ministry of finance and the cure of the state council to do,Jointly issued by the[About business insurance agencies participate in new farming close handling service instruction opinion],this[opinion]For business insurance agency orgnaization of service to participate in the new agriculture together puts forward the working principles and specific requirements.

  刘谦说,试点工作实践显示,委托商保机构参与新农合经办服务具有多重优点,一是有利于基本医疗保障管理和经办适度的分开,既有约束,又有协同,使服务的质量和效率都有所提高。商保机构有它的信息,还有网络的优势,原来我们基层的机构在经办服务上还用自己的工作人员,委托商保机构以后,就要改变这种形式,由商保机构的人员去经办。

Liu qian said,Pilot work practice display,Entrust business insurance agency orgnaization of service to participate in the new agriculture together with multiple advantages,A favorable to the basic medical insurance management and handling moderate separate,Both constraint,And collaborative,Make service quality and efficiency are improved.Business insurance agency has its information,And the advantage of network,For we grassroots organization in the orgnaization of service with his staff,Entrust business insurance agency later,To change this kind of form,The business insurance agency personnel to handling.

  二是有利于新农合基金的监管能力和统筹层级的提高。我们新农合有一个经办队伍,但是这个经办队伍又要搞经办服务,还要搞监管,人力明显不足,现在经办服务交给了商保机构,新农合队伍更多是搞政策制定和实施监管,所以它的监管力量得到了加强。同时,原来统筹层级的提高也受到经办队伍的限制,大家知道,医保统筹层次越高,共济性越好,但是如果从县里面提到市里面,从市里面提到省里面,那每一级都要建立专门的经办队伍,成本是相当高的。目前来说,如果是委托给商保机构去经办,那我们事实上可以快速提高统筹层级。

The second is to the new agriculture close fund regulatory ability and the improvement of overall level.Our new farming together have a handling team,But the handling team and to make handling service,Will make supervision,Human obvious shortage,Now handling service to the business insurance institutions,New farmers joint team is more make policy formulation and implementation supervision,So its regulatory power strengthened.At the same time,The original overall level increase is also affected by the limitation of orgnaization of the team,As we all know,The higher the level of medical insurance as a whole,In all aid sex, the better,But if from county to city inside it,From inside the city to save it,That each level will establish a special handling team,Cost is very high.For now,If it is entrusted to business insurance agency orgnaization of go,Then we in fact can quickly improve overall level.

  三是有利于方便参合人员,提供这个服务,它的网络是健全的,可能更有利于异地结算。最近六部门也发了大病保障的通知,也委托给商保机构去经办。如果说新农合也在这个平台上,共用一个平台,可以提供一站式服务,要方便得多。用商保机构这个平台,也有利于基本医保和非基本医疗保险的衔接,根据经验,医疗保障不可能完全依靠一个政府主导的基本医保来解决问题,所以跟商业保险产品能够结合,也是非常有效的路径。

The third is to convenient ginseng adds up to personnel,Provide this service,Its network is perfect,May be more conducive to different ground settlement.Recent six departments also made a serious illness security notice,Also entrusted to business insurance agency orgnaization of go.If new farming together and in this platform,Sharing a platform,Can provide one-stop service,Was so much more convenient.The quotient and the insurance agency this platform,Also is helpful for basic medical insurance and the basic medical insurance of cohesion,According to the experience,Medical security may not depend entirely on a government leading basic medical insurance to solve the problem,So with commercial insurance products can be combined,Is also very effective path.

  刘谦表示,下一步,卫生部将积极指导各地结合本地的实际,扩大试点范围,深入探索委托商保机构参与新农合经办服务的工作模式和管理机制。

Liu qian said,The next step,The health ministry will actively teach with all local actual,To expand the scope,Explore the entrusted business insurance agencies participate in new farming close handling service mode and management mechanism.

  刘谦还表示,这里我想说明一下,我们搞商保机构经办服务的试点,不是新农合政策和制度的变化,只是经办方式的变化。新农合的资金依然是封闭运行的,经办服务的商保机构的利益跟新农合基金是没有关系的,不是说他省下钱就变成了商保机构的利益,而是能够充分保障新农合的资金用在保护农民的健康上。

Liu qian also said,Here I want to explain,We do business insurance agency orgnaization of service of pilot,New farmers is not close the policy and system change,But the change of orgnaization of way.New farmers joint capital is still closed operation,Handling service business is protected the interests of institutions with the new agriculture close fund is no relationship,Not to say that he save money becomes a business is protected the interests of institutions,But can fully guarantee the new agriculture together with the funds in protecting farmers' health.

  卫生部部长陈竺补充说,我们在探索商保机构参与基本医保经办工作的时候,也要加强对商保机构的监督,我们要引进竞争机制,避免一家独大的情况。商保机构只能是保本微利,而且它的经费实际上是由政府另行安排的,这是我们一些地方开展试点时的很好的做法。(据中国网文字直播整理)

The ministry of health minister Outlines added,We are exploring business insurance institutions to participate in the basic medical insurance handling work,Also want to strengthen the business insurance supervision,We want to introduce competition mechanism,Avoid monopoly situation.Business insurance institutions can only be break-even meager profit,And it is in fact the funds shall be separately arranged by the government,This is our some local pilot of good practice.(According to China text live finishing)


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