为抵御重特大疾病风险构建防线——基于新疆油田建立企业补充医疗保险的实践

To Build Defense Line Countering the Risk of Catastrophic Diseases——Based on the Practice of Xinjiang Oilfield

新疆油田按照"雪中送炭、力所能及、收支平衡、略有结余"的原则,于2007年建立企业补充医疗保险制度。筹资标准以当地职工年均工资的60%—300%为基数,缴费比例由启动时确定的1%调整为2013年的3%;待遇标准实行分段补助:5万元及以内部分补助80%,超过5万元部分补助90%;成立了企业补充医疗保险基金管理委员会,实行制度、政策标准、管理机构、资金使用"四统一"的管理制度。仅2012年就有303名医疗费用20万元以上的重特大疾病患者得到补充医保的补助,其中30万元以上的重特大疾病患者119人,在基本医保报销的基础上,人均享受补充医保补助6万元以上。

Xinjiang Oilfield established enterprise supplementary medical insurance system in 2007 in accordance with the principles of ＂timeliness, manageability, fiscal balance and a slight surplus＂.. Contributing criteria are based on 60% -300% of the local average annual wage of workers, and the premium rate is 3% in 2013 which was 1% when launched .Benefit standards take the form of segmented subsidies. 50,000 yuan and less than can have the 80% subsidy, more than 50,000 yuan can have the 80% subsidy; We established the fund management committee of enterprise supplementary medical insurance, implementing the ＂four unifications＂ management system of institution, policy standards, regulatory agencies and uses of funds. In 2012, 303 patients sufferring from catastrophic diseases with more than 200 thousand yuan medical expenses got supplementary health insurance subsidies, of which 119 people expensed 300 thousand yuan in hospitals. Besides the reimbursements of basic medical insurance,they got subsidies of 60,000 yuan or more from enterprise supplementary medical insurance per capita.