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【砥砺奋进的五年·人权篇】江西吉安依靠“四重保障线”打造健康扶贫示范县
国际在线报道(记者 王丽 段秀杰):56岁的肖美兰是江西省吉安县永和镇超果村人,丈夫仇云苟在村子里做泥瓦工,每天挣170元贴补家用,日子虽不富裕,但也幸福快乐。然而,一场突如其来的噩耗让这个本就不富裕的家庭几乎倒塌。2016年5月,肖美兰不幸被查出患有白血病。昂贵的治疗费用让这个家庭几乎一贫如洗。当时,肖美兰觉得生活几乎看不到希望:“做完第一次化疗回来,就花了差不多将近20万元了。我以为第一次化疗完就好了,结果还让我回去继续化疗。我不懂,那时候我根本不知道这种病的严重性。后来治着治着就没钱了,那时候真的很困难。”
在得知肖美兰的情况后,村委会立即通过村民主评议将肖美兰一家评为贫困户,使其能够及时接受吉安县“四重保障线”医疗保障救助。在“四重保障线”的救助下,肖美兰继续接受了另外五次化疗,现在身体已经康复。从确诊到康复,肖美兰共花费43万余元,经过四次报销后,她只需要承担2万多元的费用。肖美兰的激动之情溢于言表:“现在什么都好了,是我们国家的政策好,给我报(销)了好多,我自己才花了两万多一点点,真的是要感谢党的政策好,还有扶贫小组、村干部,没有他们,我真的没办法,不是这四道保险,我现在怎么能坐在这里和你们说话。一个农村家庭,那么多医药费,谁能付得起?”
肖美兰所受益的“四重保障线”医疗保障救助体系是江西省吉安县为防止因病致贫、因病返贫现象发生采取的有力举措。今年以来,吉安县进一步健全完善医疗保险制度,对建档立卡贫困户中患大病、重病人群实施医疗救助,即患者住院费用经基本医疗保险、城乡居民大病保险、商业补充保险后,对医疗救助范围内个人自负部分实施医疗救助,形成了医疗保险、大病保险、商业保险、医疗救助“四重保障线”的医疗保障救助体系,让贫困群众“看得上病,看得起病,看得好病”。中国人寿保险公司吉安支公司经理邵百强以10万元医疗费用为例,介绍了“四重保障线”的报销过程:“首先是基本医疗(保险),根据住院在县内或县外的类别进行报销,在乡镇卫生院的住院可以报销90%,县城医院住院可以报销80%,市外非定点医院住院可以报销50%,主要看在哪里住院。基本医疗封顶线是6万,如果一笔医疗费用是10万,那就是还剩下4万,这4万元根据(第二道)大病保险进行报销;大病保险的起付线对非贫困户是1万5千元,对贫困户是7500元,那么在4万元的基础上减去7500元,再按照大病保险的补偿比例进行分段的比例补偿。如果还有剩余的费用,再经过第三道商业补充保险报销。最后是第四道防线,如果达到民政救助的相关标准,再按照标准报销。经过这四道防线下来,报销可以达到9万5千元以上。”
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