Nkhani

Pa Juni 28, ofesi ya inshuwaransi yachipatala ya Hebei Province idapereka chidziwitso pakuyendetsa ntchito yoyesa kuphatikiza zinthu zina zachipatala ndi zinthu zina zachipatala pamalipiro a inshuwaransi yachipatala m'chigawo, ndipo adaganiza zogwira ntchito yoyesa kuphatikiza zinthu zina zachipatala ndi zogulira zachipatala pakulipira kwa inshuwaransi yachipatala kuchigawo.

Malinga ndi zomwe zili pachidziwitsochi, ndalama zachipatala zomwe anthu omwe ali ndi inshuwaransi pachigawo chachigawo m'mabungwe azachipatala omwe asankhidwa kuchigawo komanso zolipirira nthawi ndi nthawi za omwe ali ndi inshuwaransi pachigawo chachigawo zikuphatikizidwa muzoyeserera.

Chidziwitsochi chikuwonetsa kuti zinthu zolipirira zatsopano ndi zogwiritsidwa ntchito zimawonjezeredwa. Zinthu za 50 zachipatala ndi 242 zogwiritsidwa ntchito zachipatala zikuphatikizidwa mu malipiro a inshuwaransi yachipatala ndipo zimayendetsedwa molingana ndi gulu B. Pazinthu zachipatala zomwe zili ndi mtengo wochepa, mtengo wochepa udzatengedwa ngati malipiro a inshuwalansi ya zachipatala; Pazinthu zogulira zamankhwala zokhala ndi mtengo wochepera, mtengo wocheperawo udzatengedwa ngati mulingo wolipira wa inshuwaransi yachipatala.

Ndikofunikira kulinganiza mfundo yodzilipirira pawokha pakuzindikira matenda a inshuwaransi yachipatala ndi ntchito zochizira komanso zogwiritsidwa ntchito pazigawo. Pamaziko akugwiritsa ntchito mfundo ndi malire amitengo ya kabuku ka matenda ndi zinthu zochizira komanso malo othandizira azachipatala a inshuwaransi yoyambira yachipatala m'chigawo cha Hebei ndi mndandanda wa kasamalidwe ka zinthu zotayidwa zomwe zimaperekedwa padera m'chigawo cha Hebei (mtundu wa 2021), "class a" matenda ndi mankhwala zinthu ndi consumables sizimayika gawo la munthu kudzilipira pasadakhale, ndipo amalipidwa ndi inshuwaransi yazachipatala pasadakhale; Pazinthu za "kalasi B" za matenda ndi mankhwala ndi zogwiritsidwa ntchito, inshuwaransi idzayamba kulipira 10% payekha, ndipo kwa iwo omwe akugwira nawo ntchito yothandizira boma (kapena 10% yowonjezera), anthu ena sayenera kulipira yekha; "Kalasi C" kapena "kudzipangira ndalama" zinthu ndi mankhwala ndi zogwiritsidwa ntchito ziyenera kunyamulidwa ndi inshuwaransi.

Chidziwitsochi chikugogomezeranso kuti ofesi ya inshuwaransi yachipatala idzalimbitsa kuyang'anira ndi kuyang'anira zinthu zachipatala ndi zinthu zomwe zimagwiritsidwa ntchito pachipatala, ndikufunsanso panthawi yake akuluakulu akuluakulu a zipatala zoyenera ndikudziwitsa chigawo chonse ngati kuli kofunikira kuti odwala ambiri azigwiritsa ntchito ndalama zawo, kugwiritsa ntchito mopitirira muyeso zinthu zomwe zimagwiritsidwa ntchito paokha ndi mabungwe azachipatala komanso kugwiritsa ntchito mopanda nzeru zopezera ndalama.

M'mbuyomu, zogulira zamtengo wapatali m'madera ambiri mdziko muno makamaka zidadalira ntchito zowunikira komanso chithandizo chamankhwala pakuwongolera malipiro a inshuwaransi yazachipatala, ndipo ndi zigawo zochepa zokha zomwe zidapanga maupangiri osiyana a inshuwaransi yachipatala malinga ndi mitundu yazakudya. Mu 2020, National Medical Insurance Bureau idapereka Njira Zosakhalitsa zoyendetsera zinthu zachipatala za inshuwaransi yoyambira yachipatala (Draft for comments), ikufuna kutengera kasamalidwe kakatundu kazinthu zogwiritsidwa ntchito.

Mu Novembala chaka chatha, National Medical Insurance Bureau idapereka Miyezo Yapanthawi Yakulipira kwazinthu zachipatala pa inshuwaransi yoyambira yachipatala (Draft for comments), idakonzanso zikalata zomwe tazitchula pamwambapa kutengera malingaliro ambiri amagulu onse, ndipo idaphunzira ndikulemba za kutchula dzina la "inshuwaransi yachipatala" yazinthu zogwiritsidwa ntchito zachipatala ku inshuwaransi yachipatala (Kukonzekera kwa ndemanga).