Xing Huina:

Thank you, Mr. Zhang. The floor is now open for questions. Please raise your hand if you have a question. Please identify the media outlet you represent before raising your question.

Economic Daily:

We know that the third plenary session of the 20th CPC Central Committee proposed improving the social security system. The public is keenly interested in the development of the medical security system. We have noticed that the NHSA recently proposed to improve the "1+3+N" multi-level medical security system. Could you brief us on the relevant work arrangements? Thank you.

Zhang Ke:

I will answer the question. Health care coverage is a crucial aspect of social security for the people, and they have high expectations for its continuous improvement and development. Our basic medical security system primarily covers three aspects. First is urban employee medical insurance and resident medical insurance that we are all very familiar with, which is included in basic medical insurance. Second, we have medical assistance for people in challenging circumstances. In 2023, we provided assistance to 80.2 million people facing difficulties. People are concerned about how those who have severe diseases but are extremely poor or have no income can apply for medical insurance. You can rest assured that our country cares much about their insurance coverage, providing either full or partial subsidies to help them enroll in medical insurance. Third, we have major disease insurance, a less familiar term. Many friends have asked me whether they should purchase major disease insurance and where to purchase it? Actually, people covered by resident medical insurance do not need to buy major disease insurance, which is included in the basic medical insurance framework. By enrolling in medical insurance for rural and non-working urban residents, one automatically gains access to major disease insurance. The reason people sometimes don't notice it is because we now have a one-stop settlement system. Once the personal expenditure exceeds a certain amount during medical treatment, especially hospitalization, the major disease insurance will be triggered to save more out-of-pocket costs. If we examine hospital discharge settlement slips, we will find the specific amount covered by major disease insurance. These are the three layers of protection within our basic medical security system.

However, the three layers of protection still fall short of meeting the people's growing health care needs, manifesting in three key aspects. First, due to funding constraints, many expensive drugs are difficult to cover under basic medical insurance. This limitation conflicts with the unlimited nature of people's needs. Second, the basic medical insurance system is relatively uniform. This uniformity is in conflict with the varying levels of economic and social development across the country, as well as differences in disease patterns across different regions. Third, the rules and catalog of basic insurance are quite fixed and are not able to be adjusted frequently. It's difficult to include every new drug or technology as soon as it's developed. This also conflicts with fast development and changes in pharmaceuticals, medical devices and technologies. 

How to solve these contradictions? According to the deployment of the CPC Central Committee and the State Council, we have been tasked with building a multi-level medical security system, which in recent years has been clearly required by the CPC Central Committee. In addition to basic medical insurance, what else does this multi-level system include? Primarily, it includes the following aspects: Huiminbao, an insurance with government support; other commercial health insurances, charities, mutual aid through trade unions as well as other funds. The participation of these forces not only meets people's diverse and changing health care security needs but also complements the basic medical insurance system. This composes the relationship of "3" and "N," which means three-tiered protection of basic medical security system and various supplementary sources. 

The "1" in the system refers to the NHSA's promotion of digital and intelligent technologies to provide a basic information platform, ensuring the effective operation of a multi-level medical security system. The platform features the following aspects: "one person, one file," meaning that everyone has a personal health record; "one drug, one code," meaning that every medicine box will have a tracking code, enabling future traceability of each medicine box to ensure that the public has access to safe drugs. It also contains "one claim, one settlement" and "one invoice, one verification." Commercial insurance companies and philanthropic institutions are concerned about whether they can find right recipients and get authentic invoices. The NHSA through big data tech services can provide these necessary conditions for participating organizations in this multi-level medical scheme. On the basis of digitalization, we can cooperate and strive to effectively meet people's increasing needs for health care security. 

That's all for my response to the question about building a multi-level medical security system based on "1" and coordinated by "3+N."