**Reimbursed less than 45% for serious illness in children

On July 22nd, the China Institute of Public Welfare of Beijing Normal University released the “Analysis of Medical Care and Social Assistance for Children with Major Diseases in China” organized and organized by the Institute of Chinese Public Welfare at the Second China General Aids Forum. The analysis report shows that one of the challenges still faced by children's medical care for major illnesses is that the actual reimbursement rate of basic medical insurance such as NCMS and urban residents' medical insurance to children's major diseases is limited, and its actual reimbursement contribution is only 20% to 45%.

The analysis report pointed out that, first of all, affected by the medical insurance catalog, the top line and other factors, the basic reimbursement of basic medical insurance to children with serious illnesses is limited, and the reimbursement for children with chronic diseases or major illnesses requiring large outpatient expenses is more limited. The current situation of severe shortage and uneven distribution of pediatric medical resources has led to the widespread illness of children with severe illnesses in different places, and has further reduced their reimbursement ratio. Secondly, the medical insurance system for serious illnesses has not yet been popularized in China. More than 70% of the participating farmers and insured residents are not covered by medical insurance for urban and rural major illnesses that can provide secondary reimbursement for major medical costs. Thirdly, China’s mobile population’s participation in the insurance system is lagging behind. According to statistics in 2012, there are 10.78 million migrant children in China, and its participation rate is only 44%.

The analysis report shows that the government’s medical assistance for children with major illness has a small amount of credit and time lag. In 2012, the average capping line for civil medical assistance was 10,000 yuan, and the ceiling line for the Midwest was 6,000 yuan. According to incomplete statistics, in 2013, a total of 96 charitable organizations in the country implemented 149 child critical illness programs to help 100,000 children with cleft lip and palate, congenital heart disease, cerebral palsy, and leukemia. . According to estimates, charitable organizations have invested more than 5 billion yuan in the relief of children with severe illnesses.

Prof. Li Ling, a professor at the Peking University and a member of the State Council’s medical reform expert advisory committee, pointed out that protecting children’s health is the country’s responsibility. Charitable forces can supplement the state’s financial resources, but it should never be the main channel for child medical care. Brazil, India, and Russia, which are also BRICS countries, have achieved free medical care for children. From the current economic level in China, the state should take more responsibility for child medical security.