Medical insurance refers to social medical insurance. Social medical insurance is a social insurance system established by the state and society in accordance with certain laws and regulations to provide workers within the coverage with basic medical needs when they fall ill. The basic medical insurance fund consists of a pooled fund and individual accounts. All basic medical insurance premiums paid by individual employees are included in their personal accounts; basic medical insurance premiums paid by employers are divided into two parts, one part is transferred to the personal account, and the other part is used to establish a pooling fund. Introduction: When seeing a doctor here, doctors often take the patient's medical insurance situation into consideration. Here are some basic knowledge about social medical insurance. The composition of social coordinated medical insurance: the payment base is M: employee salary income + allowance. The unit pays 8% M per year; individual employees pay 2% M per year; the unit pays 8%---6.6% to 7% goes into the overall account (1% to 1.4% goes into the personal account)---hospitalization expenses; individuals pay 2% ---2% goes into the personal account (plus 1% to 1.4% paid by the unit) ---outpatient expenses. Assume: A 30-year-old employee of a certain unit has an annual income of 20,000 yuan. After applying for social medical insurance, the unit pays 1,600 yuan per year; the employee himself pays 400 yuan per year. The personal account consists of two parts: 400 yuan paid by the individual + 1% of the 20,000 yuan of the 8% paid by the unit, that is, 200 yuan of the 1,600 yuan, ***600 yuan; (the percentage is 35 according to the regulations 1% for those under the age of 35; 1.4% for those over 35). Overall account: the remaining 7% of the 8% paid by the unit, which is 1,400 yuan. Note: Hospitalization expenses are reimbursed from the overall account, and the amount is the same for everyone; outpatient expenses are deducted from the personal account (i.e., medical insurance card), and each person is different. It has the characteristics of "low level and wide coverage". The payment is based on the cost that most low-level units and individuals can afford. It widely covers all units and employees in cities and towns. Employees of different types of units can enjoy basic medical insurance. right. After the insured completes the payment period, they can enjoy it for life. Secondly, basic medical insurance has the characteristics of "both parties bear the responsibility and combines accounting"; it is based on the principle of "determining expenditure based on revenue and balancing revenue and expenditure". Advantages: Enjoy treatment according to unified standards. The same access conditions, the same charging standards, and the same benefits, there is no difference between high and low. Employees' outpatient expenses can be deducted from their personal accounts, and after the deduction is completed, the employees will pay by themselves. Employee hospitalization expenses are reimbursed on a proportional basis: 86% of expenses for expenses of 10,000 yuan are reimbursed by tertiary hospitals; 88% of expenses for expenses of 10,000 to 20,000 yuan are reimbursed by tertiary hospitals; 92% of expenses for expenses of 20,000 to 40,000 yuan are reimbursed by tertiary hospitals. If the employee does not fall ill for several consecutive years, the personal account funds can be accumulated and rolled over. Disadvantages: There is a basic deductible for each hospitalization, which is: 500 yuan for first-level hospitals, 750 yuan for second-level hospitals, and 1,000 yuan for third-level hospitals. These expenses need to be borne by the employees themselves. Category A drugs and Category B drugs are reimbursed on a proportional basis. Imported drugs are not reimbursed. If you exceed the coverage limit of 40,000 yuan, you have to pay for it yourself. If medical insurance premiums are not paid for one to three months, the account will be cleared. Medical insurance personal account A medical insurance personal account is a special account established in accordance with the basic medical insurance policy and used specifically to store the medical insurance premiums paid by the insured and the funds transferred in a certain proportion from the employer's payment, and to record medical consumption. The funds in the personal account are used to pay for out-of-pocket expenses for medical treatment and medicine. Social Security Card Social security card is an electronic information card used by medical insurance agencies for insured persons to seek medical treatment and purchase medicines to verify their identity, record and store personal account funds and usage. With their social security cards, insured persons can seek medical treatment at any designated medical institution or purchase medicines at designated retail pharmacies in this city. Medical Insurance for College Students The new medical reform plan that has undergone multiple rounds of revisions will be announced after the "Two Sessions". Among them, the inclusion of college students in medical insurance is a highlight. In most colleges and universities, college students enrolled in the planned enrollment enjoy public medical care, and those who expand their enrollment are covered by commercial medical insurance. The final version of the plan will include college students in urban residents’ medical insurance, which means that in the future, college students will have to pay for it themselves and will no longer enjoy the “benefits” of publicly funded medical care. Incident: In online threads, many current or former college students admitted that they could only treat the smallest and most common diseases at the school hospital, and the doctors also used the simplest diagnosis and treatment and the cheapest drugs. This kind of publicly funded medical care is actually similar to “free medical care”. In 2004, Zhang Chunming, a student at Tsinghua University, went to the school hospital for treatment at least 4 times due to diarrhea. The school hospital diagnosed him with enteritis and refused to transfer him to another hospital. After being delayed for nearly 4 months, Zhang went to Peking University Third Hospital at his own expense and was diagnosed with advanced bowel cancer. Passed away in a coma. According to medical data, if bowel cancer is detected early, there is hope of survival after surgery. Why didn’t the school hospital agree to transfer? This is because of a policy implemented at that time: the government will bear 80% of the publicly funded medical care enjoyed by Beijing college students and transfer it directly to the school. The remaining 20% ​​will be borne by the school and students. The school will decide whether to pay in full or in full depending on its own financial situation. Partial reimbursement. Since the school is concerned that the "remaining 20%" will mainly be spent by the school, and because the government's portion is limited to planned enrollment, the school doctor has to think twice about medication standards and approval of transfers. From this, it is not difficult to see that the “low-standard, all-inclusive” medical security system has long been in need of fundamental reform. Implementation With the help of the new medical reform plan, college students have been included in the scope of medical insurance.

As a result, the level of security for college students has been greatly improved, and the burden on colleges and universities has also been reduced. However, from the perspective of insurance premiums, although we still don’t know the amount of “self-payment”, some college students with poor financial conditions and self-reliance on good health may be resistant to being included in medical insurance due to the burden of payment. Viewpoint If we recognize that medical care is a person’s basic right, then we should also consider how to solve these new problems after college students are included in medical insurance. Inclusion in medical insurance only means that the protection platform has grown from small to large, but it is not a reason for the government to ignore it. Therefore, payment policies must also have the necessary flexibility. Specifically, first, the payment standards should be diverse to allow students to have ample room for choice; second, the government should use this part of the money as medical insurance subsidies on the premise that it is no less than the previous investment in "public medical care for college students". In order to meet the basic medical needs of college students from poor families.