中英对照2021国务院办公厅关于健全重特大疾病医疗保险和救助制度的意见.docx

OpinionsoftheGeneralOfficeoftheStateCouncilontheImprovementoftheMedicalInsuranceandReliefSystemforSeriousandCriticalDiseasesDocumentNumber：No.422021of(heGeneralOfficeoftheSlateCouncilAreaofLaw:PovertyAlleviation,DisasterRelief,andRemediesHealthCarereform of the medical security system and improving the social1.evelofAuthority：RegulatoryDocumentsoftheStateCouncilIssuingAuthority：GeneralOfficeoftheStateCouncilDateIssued：10-28-2021EffectiveDate10-28-2021Status：EffectiveOpinionsoftheGeneralOfficeoftheStateCouncilontheImprovementoftheMedicalInsuranceandReliefSystemforSeriousandCriticalDiseases(No.422021oftheGeneralOfficeoftheStateCouncil)Thepeople'sgovernmentsofallprovinces,autonomousregionsandmunicipalitiesdirectlyundertheCentralGovernment;andallministriesandcommissionsoftheStaleCouncil,andallinstitutionsdirectlyundertheStateCouncil:Medicalsecurityforseriousandcriticaldiseasesisameasureofvitalimportancetofurtherreducingtheburdenofmedicalexpensesonpeopleindifficultiesandpatientssufferingfromseriousdiseases,preventingthemfrombeingcausedtofallintoorfallingbackintopovertyduetodiseases,andstrengtheningeffortstoensuretheirbasiclivingconditions.InordertodeeplyimplementthedecisionsandplansoftheCPCCentralCommitteeandtheStaleCouncilondeepeningthe国务院办公厅关于健全重特大疾病医疗保险和救助制度的意见(国办发(2021)42号)各省、自治区、直辖市人民政府，国务院各部委、各直属机构：做好重特大疾病医疗保障，是进一步减轻困难群众和大病患者医疗费用负担、防范因病致贫返贫、筑牢民生保障底线的重要举措。为深入贯彻党中央、国务院关于深化医疗保障制度改革和完善社会救助制度的决策部署，巩固拓展医疗保障脱贫攻坚成果，不断增强人民群众获得感、幸福感、安全感，经国务院同意，现就健全重特大疾病医疗保险和救助制度提出以下意见。reliefsystem,consolidateandexpandtheachievementsmadeinthebattleofmedicalsecurityandpovertyalleviation,andmakeunswervingeffortstohelppeoplefeelsafer,happierandmoresatisfied,withtheconsentoftheStateCouncil,theOpinionsontheimprovementofthemedicalinsuranceandreliefsystemforseriousandcriticaldiseasesareherebyofferedasfollows.I.GeneralrequirementsWithXiJinpingThoughtonSocialismwithChineseCharacteristicsforaNewEraasguidance,effortsshallbemadetocomprehensivelyimplementtheunderlyingprincipleofthe19lhCPCNationalCongressandtheSecond,Third,Fourth,andFifthPlenarySessionsofthe19thCPCCentralCommittee,continuetopursuepeople-centereddevelopmentandmovesteadilytowardcommonprosperity,remaincommittedtoensuringmedicalinsuranceandbasiclivingconditionsforallpeople,andworkpersistentlyandunswervinglytoimprovepeople'slivelihoodinamoresustainedmanner.Focusingonreducingtheburdenofmedicalexpensesonpeopleindifficultiesandpatientssufferingfromseriousandcriticaldiseases,effortsshallalsobemadetoestablishalong-termmechanismforthepreventionandresolutionofsinkingbacktopovertyduetodiseases,enhancetheintegratedsystemofbasicmedicalinsurance,seriousillnessinsuranceandmedicalassistance(hereinafterreferredtoasthe44triplemedicalsecuritysystem"),determinethestandardsofmedicalsecurityforpeopleindifficultiesbasedontheiractualconditions,ensurethatpoorpopulationshaveaccesstobasicmedicalsecurity,andpreventthemfrombeing一、总体要求以习近平新时代中国特色社会主义思想为指导，全面贯彻党的十九大和十九届二中、三中、四中、五中全会精神，坚持以人民为中心，坚持共同富裕方向，坚持应保尽保、保障基本，尽力而为、量力而行，推动民生改善更可持续。聚焦减轻困难群众重特大疾病医疗费用负担，建立健全防范和化解因病致贫返贫长效机制，强化基本医保、大病保险、医疗救助（以下统称三重制度）综合保障，实事求是确定困难群众医疗保障待遇标准，确保困难群众基本医疗有保障，不因罹患重特大疾病影响基本生活，同时避免过度保障。促进三重制度综合保障与慈善救助、商业健康保险等协同发展、有效衔接，构建政府主导、多方参与的多层次医疗保障体系。adverselyaffectedbyseriousandcriticaldiseasesintheirdailylifeorfrombeinggrantedexcessivegovernmentsubsidies.Inthemeanwhile,moreeffortsshallbemadetocoordinatetheintegratedtriplemedicalsecuritysystemwithcharityassistanceandcommercialhealthinsurance,soastobuildamulti-tieredmedicalsecuritysystemthatisledbythegovernmentandinvolvesvariousparticipants.11.Scientificallydeterminingmedicalassistancetargets1. Promptlyandaccuratelydeterminingmedicalassistancetargets.Medicalassistanceshallequallycoverworkersindifficultsituationsandurbanandruralresidentswithaheavyburdenofmedicalexpenses,anddifferenttargetpopulationsshallbeprovidedwithdifferentassistance.Medicalassistanceshall,asrequired,begrantedtopeoplelivingonsubsistenceallowance,theimpoverished,familiesapproachingsubsistenceallowancestandards,theruralpopulationpronetofallingbackintoorbeingcausedtofallintopoverty,aswellaspatientsfallingintopovertyduetodiseaseswhoareincludedinthetargets.Acertainamountofassistanceshallbeprovidedtopatientssufferingfromseriousandcriticaldiseaseswhoarenotpeoplelivingonsubsistenceallowance,theimpoverishedorfamiliesapproachingsubsistenceallowancestandards,butwithextremedifficultiesinbasicfamilylifeduetohighmedicalexpenses(hereinafterreferredtoas“patientsfallingintopovertyduetoseriousdiseases*')accordingtotheiractualconditions.Takingintofullconsiderationofthefinancialsituationsoffamilies,medicalexpensesandpaymentofbasicmedicalinsurance,thecivilaffairsdepartmentsofallprovinces,autonomousregionsandmunicipalitiesdirectly二、科学确定医疗救助对象范围（一）及时精准确定救助对象。医疗救助公平覆盖医疗费用负担较重的困难职工和城乡居民，根据救助对象类别实施分类救助。对低保对象、特困人员、低保边缘家庭成员和纳入监测范围的农村易返贫致贫人口，按规定给予救助。对不符合低保、特困人员救助供养或低保边缘家庭条件，但因高额医疗费用支出导致家庭基本生活出现严重困难的大病患者（以下称因病致贫重病患者），根据实际给予一定救助。综合考虑家庭经济状况、医疗费用支出、医疗保险支付等情况，由省（自治区、直辖市）民政部门会同医疗保障等相关部门合理确定因病致贫重病患者认定条件。县级