The representative suggested that the medical care for the elderly over 60 years old should be reduced or exempted from the response of the National Medical Insurance Bureau.

　　The National Health Insurance Bureau recently replied to the "proposal on reducing or exempting medical care for the elderly over 60 years old".

　　Reply of the National Health Insurance Bureau to Recommendation No.4905 of the Fourth Session of the 13th National People’s Congress

　　On behalf of Hu Meie:

　　Your "proposal on reducing or exempting medical care for the elderly over 60 years old" has been received, and we have consulted with the National Health and Wellness Commission. We hereby reply as follows:

　　The state attaches great importance to the people’s medical security, comprehensively promotes the construction of the basic medical security system, gives full play to the joint efforts of the three systems of basic medical insurance, serious illness insurance and medical assistance, effectively reduces the burden of medical expenses for the elderly, and strives to enhance the people’s sense of acquisition, happiness and security of basic medical security. At present, universal medical insurance has been basically realized, and the participation rate has been stable at over 95%. First, basic medical insurance is fair and inclusive. The reimbursement rate of hospitalization expenses within the scope of employee medical insurance and resident medical insurance policies reached about 80% and 70% respectively, and the maximum payment limit of the overall fund reached about 6 times of the average annual salary of local employees and per capita disposable income respectively. Second, supplementary medical insurance such as serious illness insurance further reduces the burden of high medical expenses. We will continue to promote the implementation of large medical expenses subsidies for employees, improve and perfect supplementary medical insurance systems such as serious illness insurance for urban and rural residents, and further reduce the burden on seriously ill patients by raising the maximum payment limit and giving further protection to individual out-of-pocket expenses. In 2020, on the basis of basic medical insurance, the reimbursement rate of major illness insurance for urban and rural residents will be further increased by about 13 percentage points. Third, medical assistance consolidates the bottom guarantee. For the poor, poor and other needy people, including the elderly, who are still heavily burdened with medical expenses after being reimbursed by basic medical insurance and serious illness insurance, they will be given assistance in accordance with the regulations to consolidate the guarantee. In 2020, the actual reimbursement rate of hospitalization expenses for poor people, including the elderly, will be stable at 80% after the triple guarantee of basic medical insurance, serious illness insurance and medical assistance.The personal burden has been significantly reduced.

　　In the process of establishing and perfecting the medical insurance system, the preferential treatment and care for the elderly are also highlighted in the policy settings such as financing and treatment.First, among the employees participating in medical insurance, if the accumulated payment period reaches the specified number of years when they reach the statutory retirement age, they will no longer pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with state regulations; And give appropriate care and inclination to the way in which retirees’ personal accounts are included and the proportion of individuals who bear medical expenses. Second, on the basis of the steady improvement of the financial subsidy standard for urban and rural residents’ basic medical insurance, some areas also give preferential care to the elderly in financing. Third, combined with the illness status of the elderly, all localities have included some outpatient medical expenses for chronic diseases (special diseases) with long treatment cycle and high medical expenses, as well as family sickbed medical services, etc. into the scope of fund payment to strengthen the protection of medical expenses for the elderly. Fourth, on the basis of medical assistance for the low-income people, the extremely poor people and the poor people in rural areas, including the elderly, the elderly in low-income families are also included in the scope of assistance. In addition, the state has explored the establishment of a long-term care insurance system to solve the care problems of the disabled elderly and reduce the family economic burden of the disabled elderly. At present, it is progressing smoothly and has achieved positive results.

　　With regard to the health service system for the elderly, the state has made great efforts to develop the health service for the elderly, and made great efforts to build a comprehensive and continuous health service system for the elderly covering urban and rural areas. Among them, it is specifically proposed to establish and improve a health service network for the elderly based on primary medical and health institutions, with geriatrics departments in geriatric hospitals and general hospitals as the core and relevant teaching and scientific research institutions as the support.

　　With regard to your suggestion of "moderately reducing or exempting the medical expenses of the elderly over 60 years old", at present, the state has given appropriate care to the elderly. Considering the basic national conditions that China will be in the primary stage of socialism for a long time, the level of medical insurance financing is still not high, and the fund support ability is still insufficient. Medical insurance still needs to adhere to the basic principle of insurance, and it is still necessary for individuals to bear certain medical and health expenditure responsibilities, while the implementation of free medical care is not conducive to the long-term stable and sustainable development of China’s medical security system.Practical experience shows that China’s multi-level medical security system, with basic medical insurance as the main body, medical assistance as the foundation and supplementary medical insurance as the common development, is an institutional arrangement in line with China’s current national conditions. In the next step, we will continue to strengthen the triple security functions of basic medical insurance, serious illness insurance and medical assistance, improve the multi-level medical security system, steadily improve the medical security level of the majority of residents, including the elderly, and continuously improve the quality of medical services for the elderly, so as to provide reliable service guarantee for the realization of medical care for the elderly.

　　Thank you for your concern and support for medical security.