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【砥砺奋进的五年·人权篇】医疗保险全覆盖助力井冈山市率先脱贫摘帽

2017-09-19 16:17:11   国际在线

国际在线报道(记者王丽、段秀杰):今年2月,井冈山市在全国率先宣布脱贫摘帽,全市4000多个贫困户,如今已步入新的生活。记者在最近的采访中了解到,医疗保险全覆盖为井冈山市的率先脱贫起到了重要作用。近年来,井冈山市响应国家完成脱贫攻坚战的号召,将贫困农民精准识别为“红卡户”和“蓝卡户”,并推出一系列“健康扶贫”新政策,将基本医疗保险覆盖所有建档立卡贫困人口并实行政策倾斜。

据井冈山市医疗保险事业管理局局长刘家余介绍,在整体脱贫之前,当地因病致贫的比例占贫困户的一半以上。2006年,当地开始推行基本医疗保险;2014年推出大病保险和意外伤害保险;2015年专门针对贫困户推出医疗附加险;2016年推出重症疾病保险。由此,井冈山有了“五道保障线”来确保健康扶贫的有序进行,大大加快了当地脱贫的步伐,“井冈山的健康扶贫有‘五道保障线’。第一是基本医疗保险,在各个不同等级的医院看病按照不同比例进行报销。二是大病保险,也是按照比例报销。三是针对贫困户的,经过前面两道保险报销之后,剩余的个人负担的部分就进入第三道保险,包括不可报销的部分、进口的药品、大型的检查,全部按照90%报销。经过这三道保险下来,实际报销的费用已经占到了90%以上,第四个保险是重症疾病保险,大病如恶性肿瘤、肾衰竭、器官移植等,年度内住院医疗费用达1万元以上的,可获得1.5万元护理费补偿,用于解决城乡居民就医过程中产生的交通费、伙食费,护理费等一系列非医疗支出;第五个保险是意外伤害保险,在劳动过程中产业意外伤害,根据不同的致残等级给予不同的报销比例,死亡的情况再额外给予补偿。同时,贫苦农民没有钱看病的话,我们会提前预支钱给他。”

据刘局长介绍,这“五道保障线”不仅解决了医药费用的开支,还解决了非医疗开支和生活开支,让病人可以没有后顾之忧,只需要考虑如何把病治好。

在健康扶贫的过程中,当地领导干部走访农村贫困家庭,了解农户具体情况,并将他们精确地分为“红卡户”和“蓝卡户”。家庭年人均收入低于2736元的农户为“红卡户”,从2015年就开始享受井冈山医疗扶贫的各项措施;家庭年人均收入在2736元左右的其他困难户为“蓝卡户”,则从2016年开始享受这些优惠措施。因患有肾衰竭而陷入贫困的文水村村民张余梅就是一个“红卡户”家庭。

44岁的张余梅原本有一个幸福的四口之家,丈夫做着小生意,两个孩子都在读书。2006年查出其患有肾衰竭,为了治病几年间张余梅就用光了家里的所有积蓄,还借了不少外债。幸运的是,2015年,当地政府专门针对贫困户推出了医疗附加险,并将张余梅列入了“红卡户”。张余梅说,是“五道保障线”让患病的她和她的家庭看到了希望,“到了2015年的时候,(看病)大部分都不用我们自己掏钱了,如果现在让我自己维持的话,我是维持不下去了。今年1月到7月份,我的医疗花了4万4千多,基本医疗保险报了1万3千多,大病保险报了1万3千多,附加险报了1万6千多,重症疾病保险报了1万5千,等于报了5万7千多。现在我看病的火车费、住宿费都有了。以前我看病都不敢让我爱人陪着去上海,因为要花火车费、住宿费、吃饭,我们自己这些不用掏钱了。”

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