Daily life
Tianjin has formed a unified basic health insurance system for both the urban and rural residents due to its efforts, realizing the goal of full coverage of basic medical insurance in rural and urban areas.
The Basic Medical Insurance System for Urban Employees in Tianjin has gradually set up three medical insurance platforms featuring “integrating the publicly raised fund with individual accounts”, “comprehensive arrangement for serious disease” and “medical assistance”, which better satisfy the needs of different groups of people.
As the rural residents have been covered by basic medical insurance, the health and sanitation conditions in rural areas have been significantly improved. Besides the improvements on medical insurance system and the construction of the medical insurance systems for rural and urban residents, the city insists an important rule, i.e., make the vulnerable groups able to afford it and enjoy it.
In order to ease the individual patients’ burden and improve their medical treatment, Tianjin has rolled out a group of policies such as lowering the proportion of the self-paid medicine and the deductible line of medical insurance, and raise the capping line of reimbursement for outpatient expenses, enabling the elderly, the sick and the infirm, as well as seriously ill patients’ financial burden on health care to be reduced year by year.
There is a com mon problem with the implementation of China’s medical insurance system, that is, the loss-making enterprises can’t afford the medical insurance. In 2004, Tianjin took the lead in China to carry out the “comprehensive arrangement for serious diseases” policy for employees in loss-making enterprises. These companies can receive government subsidies according to their economic capabilities and provide their retirees with comprehensive arrangement for serious disease system.
In 2009, local government increased the subsidies to offer medical treatment insurance on outpatient services for those who have been covered by the comprehensive arrangement for serious disease system. During the process of establishing the medical insurance system, Tianjin highlights the role of public finance in offering social insurance for the vulnerable groups. The government not only provides subsidy for retirees in loss-making enterprises but also for another ten vulnerable groups, including the older laid-off workers involving reemployment in public welfare sectors, unemployed people involving flexible way of employment, laid-off workers, the disabled and single mothers.
In April, 2009, the city issued the Regulations of Tianjin Municipality on Basic Medical Insurance for Urban and Rural Residents, which has come into effect since Jan 1, 2010. And the payment for the year 2010 started from Sept 1, 2009.
The most notable feature of this policy is that it unified the basic medical insurance treatment for urban and rural residents, and enabled the residents from urban and rural areas to have access to the unified system involving scope of coverage, individual payment, government subsidy and treatment. It realizes the unification of the urban-rural medical insurance system and ensures that the rural and urban residents have equal share of economic and social development benefits.
According to the regulations, the severely disabled, people enjoying the minimum-living guarantee, members from impoverished families and people over 60 years old from low-income families can receive full-pay allowance from the government and they themselves don’t need to pay any fees.
In addition, the insured students and children can enjoy the additional insurance for accidental injury. From Jan 1, 2010, all the unemployed people who are receiving unemployment insurance have been covered by the basic medical insurance system for urban and rural employees and enjoy the same reimbursement rate as the urban and rural employees in large sum of medical fee for outpatient service and emergency treatment, hospitalization expenses treatment and outpatient service for special diseases, as well as large sum of medical assistance fees.
From Jan 1, 2011, Tianjin took the lead in China to carry out the full-coverage additional insurance system for accidental injury. With a government subsidy of 15 CNY per person, the insured can enjoy the benefits of the system and become more capable to resist risks without paying any fees.
In recent years, in an effort to construct a fair and sustainable social security system, Tianjin has developed a characteristic “six plus four” mode of social security: endowment, medical, unemployment, employment injury, maternity, and accidental injury insurance for town workers; endowment, medical, maternity and accidental injury insurance for urban and rural residents. The basic establishment of an extensive network of social security constitutes a solid step towards the goal of “universal access to basic social security”.
At the end of 2015, 6,860,000 and 10,540,000 citizens of Tianjin were covered in basic endowment insurance and medical insurance respectively, 1,620,000 and 980,000 more over the end of the 11th Five-Year Plan period. In 2015, the total revenue and expenditure scale of five insurance funds for urban workers reached 172.8 billion yuan, a twofold increase over 2010.
