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2002年,新型农村合作医疗保障制度出台并开始试点实施。2007年,我国又建立了城镇居民医疗保险。虽然全民医保的基本框架已经建立,基本实现全面覆盖,参保率超过95%,但是,看病难、看病贵的问题仍然没有得到根本的解决。据统计,我国覆盖8.3亿人的新农合和2.2亿人的城镇居民医保,最高的报销额度仅为3—10万元。大病仍可威胁家庭经济,这依然是医保制度的短板。2012年8月出台的大病医保新政,瞄准新农合和城乡居民群体,要求针对一些特别贵的大病,在基本医保报销的基础上,再次给予报销,且实际报销比例不低于50%。不过,这一新政如何兼顾公共服务与商业权益,仍有待实施效果的检验。而在此之前,我国部分城市已经开始探索大病医保的商业模式,并形成了三大模式。
In 2002, the new rural cooperative medical insurance system was introduced and started pilot implementation. In 2007, our country also established the urban residents medical insurance. Although the basic framework for universal health coverage has been established and basically comprehensive coverage has been achieved, the coverage rate of insurance coverage has exceeded 95%. However, the problems of difficult access to treatment and expensive medical treatment are still not fundamentally solved. According to statistics, the coverage of 830 million people in China’s NRCMS and 220 million urban residents Medicare, the highest reimbursement of only 3-10 million. Serious illness can still threaten the family economy, which is still the short board of the health insurance system. In August 2012, the New Deal for serious illness and medical insurance was introduced. It aimed at the NCMS and urban and rural residents. They were required to reimburse them for some extremely serious illness based on the basic medical insurance reimbursement. The actual reimbursement rate should not be less than 50%. However, how this new deal takes into account the public service and commercial rights and interests remains to be tested. Prior to this, some cities in our country have begun to explore the business model of serious illness and health insurance and formed three major modes.