Résumé
The paper summarized the compound medical insurance payment system under a ceiling control with Shenzhen characteristics.This practice features ceiling control,prepaid at year beginning,multiple payment methods,monthly payment,year-end closing,and reward for surplus.The following measures have been implemented,namely controlling the total amount,compound payment mode,setting up the scientific and reasonable payment standards and establishing a perfect supervision system.This reform has achieved such outcomes as accessibility of the insured people to primary medical insurance,balance for the medical insurance fund,curbing of rapid rise of medical expenses,progress in the policy of first contact in the community health organization,promoting the development of the health system and raising satisfaction among the insured people year by year.
Résumé
In order to set up a medical security system suitable for laborers and solve for them the problem of inadequate and expensive medical services,the city of Shenzhen started on March 1,2005(apilot) cooperative medical care for laborers in the four neighborhoods of Buji,Longgang,Longhua and Shajing on the basis of an earlier model.The new model,which stipulated that each person paying 12 yuan each month,with the employer paying 8 yuan and the individual laborer paying 4 yuan,was entitled to both outpatient and inpatient medical services,was popular with both businesses and laborers.At present the number of people participating in the new model of cooperative medical care for laborers exceeded 1 million,the number of designated medical institutions was gradually increasing,and medical expenses were put under control.