Xiao Zhou is 30 years old this year, and he gets up early and works late every day, which is also a true portrayal of most young people.
Only in the evening after work can he have a good rest, in order to relax and unwind, he will often meet a few of his good buddies at night to drink beer, this is the happiest moment in life.
A few nights ago, Xiao Zhou and his brothers went to a barbecue stall on the street to eat barbecue, and they also ordered several bottles of cold beer.
The next morning, Xiao Zhou woke up with a stomach ache and went to the hospital for examination and found that he had gastroenteritis, and then the doctor gave Xiao Zhou infusion therapy.
During this period, Xiao Zhou also chatted with the outpatient doctor. Xiao Zhou asked: Doctor, if there is no money in the medical insurance card, can I still be reimbursed for outpatient treatment? So what do outpatient doctors say?
First, it is difficult to see a doctor and expensive to see a doctor
In the past, there has always been a problem of difficulty in seeing a doctor in the mainland, and this problem has been bothering the people on the mainland for a long time.
Every time you get sick and go to the hospital for treatment, you will face high treatment costs, resulting in many people not daring to go to the hospital after getting a minor illness, preferring to suffer the pain themselves.
The mainland is a country where the people are the masters of the country, and the state has actively come up with countermeasures after knowing the difficulties of the people, and the medical insurance system was born in this context.
The reason why the state introduced the medical insurance system in the first place was to facilitate the people to see a doctor, so as to completely solve the problem of the people's difficulty in seeing a doctor.
At first, the system did play a positive role, and people were able to spend less money on medical treatment from now on. After all, everyone can enjoy benefits when they see a doctor after participating in medical insurance, because the state will reimburse most of the medical expenses, and people only need to pay the remaining small part.
Even some special drugs have been included in the medical insurance, so the people can afford it now, you must know that these drugs used to be sky-high prices to discourage the people, and generally only those who have money can afford to consume them.
Since then, people are no longer afraid of going to the doctor, but are willing to run to the hospital often. There are more smiles on the faces of the people, and everyone is grateful to the country for thinking about the people and doing practical things for the people.
However, with the passage of time, the old problem of the past seems to have returned in recent years, that is, there is still a problem of difficult and expensive medical treatment across the country.
According to the relevant data released by the mainland government, in the four years from 2015 to 2019, the average outpatient cost of hospitals has risen from 233 yuan to 291 yuan, and the average cost of hospitalization has also continued to increase, from 8,268 yuan to 9,848 yuan.
From January to November 2022, the average outpatient cost of tertiary hospitals in mainland China reached 368.4 yuan, and the average inpatient cost was as high as 13,898 yuan.
Undoubtedly, these authoritative data show that the problem of expensive medical treatment is real and increasingly severe, making the people miserable, and everyone now has to bear a huge financial burden when seeing a doctor.
For example, many hospitals now require patients to make an appointment in advance to see a doctor, which makes it very troublesome for patients to see a doctor.
To make matters worse, even if people book a few days in advance, sometimes they may not be able to make an appointment. After all, there are too many appointments, which makes it difficult to see a doctor.
If people make an appointment, the registration fee that people have to pay is very expensive, after all, it is the experts in the hospital who treat the patients and the fees are not cheap.
It can be seen that the patient has to spend a lot of time and money just to diagnose the disease before the official start of treatment, which is very likely to delay the treatment time and is not conducive to the early recovery of the patient's condition.
These hospitals deliberately do not let the medical insurance system play a role, after all, the purpose of the medical insurance system is to prevent the people from worrying about the problem of seeing a doctor. Xiao Zhou then had this question, can we be reimbursed without money in our medical insurance card?
2. Can I be reimbursed if I don't have money for my medical insurance card?
In response to Xiao Zhou's question, the outpatient doctor immediately told him:
At present, the medical insurance card mainly includes the medical insurance for urban and rural residents and the medical insurance for urban employees. If it is an urban employee medical insurance card and it is divided into personal accounts and overall accounts, everyone thinks that there is no money in the medical insurance card, which actually means that there is no money in the personal account, and there are still expenses in the overall account.
This means that regardless of whether the medical insurance card has money or not, you can still use the medical insurance card to reimburse medical expenses, but you must meet a hard condition: it must be within the scope of reimbursement. Once it exceeds this category, it will naturally not be reimbursed, and everyone must be well aware of this.
Generally speaking, people use a personal account to buy medicines at outpatient clinics or offline pharmacies.
The pooled account is part of the medical reimbursement section, which is related to some expenses such as special outpatient expenses and hospitalization expenses. If you don't have money in your personal account on your medical insurance card, you can't use your card when you go to the pharmacy.
If the reimbursement standard for outpatient clinics in each place in mainland China is different, if it exceeds the upper limit or below the standard line, the patient will have to pay the medical expenses by himself, and the medical expenses must be between the standard line and the upper limit line before they can be reimbursed with a medical insurance card.
If people want to use their medical insurance card to reimburse hospitalization expenses, they must register and hand in their medical insurance card when they are hospitalized. When the patient recovers and is discharged from the hospital, the hospital will deduct the reimbursement of the treatment costs, and the other expenses will of course be paid by the patient.
3. Why do these problems occur?
For example, more and more patients are usually not paying attention to their health problems, and generally only go to the hospital for treatment when their condition deteriorates, so it costs a lot of money to treat some major diseases.
If patients can prevent it in advance, they can avoid getting sick, so that they can save a lot of treatment costs. Therefore, everyone should actively protect their physical health.
For example, develop healthy eating habits, living habits, active exercise, maintain a good mood, etc., only in this way can we keep all kinds of terrible major diseases away from ourselves, and we don't have to worry about the problem of expensive medical treatment, why not?
This is only one of them, the second is that in recent years, the conditions of domestic hospitals have been continuously improved, and more advanced medical equipment has been imported, and the use of these instruments by hospitals to give patients physical examination is naturally more expensive than the past examination costs.
In addition, there are still many specific drugs that have just been marketed and have not yet been included in the medical insurance, which makes it difficult to reduce the price of these drugs, and patients have to bear high medical costs.
It takes several years for a new drug like this to be included in the national medical insurance, which means that patients will suffer during this period, and they will not be cured.
The above two are one of the most important reasons, so we can't put all the blame on hospitals and doctors, after all, they are not all responsible for the problem of difficult and expensive medical treatment.
In fact, many doctors in hospitals work hard every day, they are generally divided into morning and evening shifts, and they often work two shifts, and it is well known that night shifts are very tiring. In addition, even if the doctor himself is sick, he must not ask for leave at will, but continue to stick to his post, which is equivalent to working while sick.
Doctors are tired and tired every day, and once the patient is dissatisfied, they will be abused and blamed, and such multiple pressures are pressed on the doctor, and he can't talk about his grievances.
It is worth mentioning that their salaries are not much higher, only those old doctors and old experts who have been practicing medicine for many years can really get high salaries, and as for young doctors, their monthly salaries are not much.
In this case, we should also be more understanding and tolerant, and there is no need to vent all our anger and resentment on the doctor.
Of course, some of these ill-intentioned hospitals and doctors are indeed to blame, and it is necessary for the state to severely punish these hospitals and doctors, and not let them harm the common people.
We can also see that the problem of difficult and expensive medical treatment is completely different from that in the past, so it cannot be generalized, after all, the situation will be different in each period.
In any case, the health insurance system has also brought many benefits to everyone, such as saving the lives of countless patients, and without the system, everyone would have felt a lot of pressure for many years.
It is gratifying that the country has been constantly adjusting and improving in recent years, and I believe that the medical insurance system will become better and better in the future.
epilogue
The emergence of the medical insurance system is of extraordinary significance, it marks the progress of the times, and also reflects that the country always thinks about what the people think and what the people are anxious about. In recent years, the people have also enjoyed the various benefits brought by the medical insurance system, and everyone has saved a lot of money by seeing a doctor and taking medicine.
You may have a question: If there is no money in the medical insurance card, can I still be reimbursed for outpatient treatment? To this question, the outpatient doctor gives the answer:
There are two types of medical insurance cards, one is the medical insurance for urban and rural residents, and the other is the medical insurance for urban employees. As long as there is money in the overall account, even if the medical insurance card shows that there is no money, it can continue to reimburse the relevant treatment costs.
The state is now actively improving the medical insurance system every year, even if there are problems gradually, especially in recent years, we once again clearly feel that the problem of difficult and expensive medical treatment is becoming more and more serious, and many times, people have not been formally treated just to pay a registration fee, which will waste a lot of time and money.
Some hospitals will even deliberately prevent people from being reimbursed by medical insurance, and the state should strengthen supervision and actively rectify it.
What do you think of some problems in the medical insurance system? Welcome to leave a message in the comment area to discuss.
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Resources:
Dr. Yu's Health Miscellaneous Talk 2023-10-06 "If I don't have money in my medical insurance card, can I still be reimbursed for outpatient treatment?" The outpatient doctor tells you the truth! 》
Dr. Li of the Department of Traditional Chinese Medicine 2024-04-27 Why do many patients feel that "seeing a doctor is expensive"? It turns out that there are 3 major reasons, tell your family to know"
Pen Farming Era 2024-06-12 "Wake Up! It's expensive to see a doctor, it's hard to see a doctor, don't complain about the doctor, don't complain about the hospital, it's you who complain wrong"