Widened in­surance sys­tem bet­ter serves pub­lic

China Daily (USA) - - CHINA - By DUJUAN dujuan@chi­nadaily.com.cn

China’s crit­i­cal ill­ness in­surance sys­tem has run smoothly since its launch last year, and the cen­tral govern­ment plans to fur­ther pro­mote it, de­spite fac­ing chal­lenges, Huang Hong, vice-pres­i­dent of the China In­surance Reg­u­la­tory Com­mis­sion, said at a news con­fer­ence in Bei­jing on Wed­nes­day.

“In­creas­ing num­bers of peo­ple in China are ben­e­fit­ing from the pol­icy,” he said. “It is an in­no­va­tive ap­proach to health­care re­form, which is a dif­fi­cult task fac­ing many coun­tries world­wide.”

In China, ba­sic med­i­cal in­surance of­fers lit­tle fund­ing or pro­tec­tion, and crit­i­cal ill­nesses can leave a fam­ily broke due to high treat­ment costs.

Since last year, the govern­ment has adopted a pol­icy whereby a small per­cent­age of the ba­sic med­i­cal in­surance fun dis­used to buy com­mer­cial in­surance to in­crease the pro­tec­tion of­fered.

For the first nine months of this year, crit­i­cal ill­ness in­surance pay­outs av­er­aged 7,138 yuan ($1,060) per pa­tient, with the high­est pay­out to­tal­ing about 1.12 mil­lion yuan, Huang said.

“It ef­fec­tively helped poor peo­ple with crit­i­cal ill­nesses to re­ceive proper med­i­cal treat­ment,” he said.

Ac­cord­ing to the com­mis­sion, fund­ing for the in­surance varies from 15 yuan to 60 yuan, de­pend­ing on in­di­vid­ual cases and the re­gion of the coun­try.

At present, 16 in­surance com­pa­nies op­er­ate 605 in­surance projects, cov­er­ing 920 mil­lion peo­ple in 31 prov­inces, au­ton­o­mous re­gions and mu­nic­i­pal­i­ties.

“Many peo­ple can now re­ceive med­i­cal treat­ment that they could not af­ford be­fore,” Huang said.

In terms of su­per­vi­sion, Huang said in­surance com­pa­nies found a to­tal of 436,700 faulty claims and re­jected im­proper med­i­cal ex­pense claims amount­ing to 2.27 bil­lion yuan last year, which contributed to al­le­vi­at­ing the rapid growth of med­i­cal ex­penses and pre­vent­ing ex­ces­sive med­i­cal treat­ment in some ar­eas.

Huang said there are still im­prove­ments to be made to the crit­i­cal ill­ness in­surance sys­tem. For ex­am­ple, lo­cal gov­ern­ments should im­ple­ment re­forms of pay­ment meth­ods and con­trol in­creas­ing med­i­cal ex­penses caused by ex­ces­sive treat­ment.

Huang said most med­i­cal in­surance com­pa­nies re­al­ized mea­ger prof­its, but some of them are op­er­at­ing at ad­eficit.

“Some in­surance com­pa­nies are too con­fi­dent about their own abil­ity and un­der­es­ti­mate the com­plex­ity of the crit­i­cal ill­ness in­surance sys­tem,” he added.

Many peo­ple can now re­ceive med­i­cal treat­ment that they could not af­ford be­fore.”

Huang Hong, vice-pres­i­dent of the China In­surance Reg­u­la­tory Com­mis­sion

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