Reform and Improve the Medical Care System to Enhance the Quality of Life Among the Elderly

Abstract

The basic medical insurance system for urban employees that is currently set up in China marks the official formation of a pattern of primary-level medical insurance which requires the shared responsibilities of the state, the work unit, and the individual. This medical-insurance system, established on the "low-level-and-wide-coverage" principle, is a product of the present stage in the economic development of our country. In this system, special considerations are given to retired employees in such areas as the amount of medical costs entered into their personal accounts, the proportion of medical costs to be paid by them, and the amount of self-pay for basic medical insurance. However, its nature as a form of basic medical insurance limits the role it can play in satisfying the medical and health-care needs of the elderly population—a group of people who tend to be weak in health and vulnerable. As we all know, the elderly population has more needs in terms of medical and health care than people of other age groups, while at the same time they are economically less advantaged than other age groups, and their financial ability to pay for high medical costs is extremely limited. Dealing with the elderly in the same way as other age-group people will inevitably result in some of the elderly people being unable, or afraid, to seek medical treatment when they are sick. The nature of Chinese society determines that the public well-being and welfare constitute the principal attributes of China's medical care system. Ensuring the basic medical needs of the elderly remains the state's responsibility, as well as an important manifestation of social fairness in medical and health-care services. Hence, we must gradually set up and perfect a basic medical-insurance system and, in accordance with economic development, adjust the charges for basic medical insurance and raise the coverage under such insurance. At the same time, we should actively develop various types and categories of supplementary medical insurance for the elderly, such as devising some special ways of dealing with chronic illnesses, major diseases, and serious sicknesses frequently occurring among the elderly, providing appropriate coverage for their medical costs. We should gradually include community health-care services for the elderly within the orbit of employees' basic medical-insurance expenditure, so as to ensure that the elderly receive medical and health-care services that are close by, prompt, convenient, inexpensive, and of good quality. We should also set up an urban-rural medical-relief system to provide medical assistance and basic medical needs for those elderly who are especially hard up. Thus, a multilevel medical-guarantees system for the elderly should be set up, one that is geared toward their medical needs and one that consists of basic medical insurance, medical relief, and supplementary medical insurance targeted at chronic and major illnesses. Nursing for the elderly and care for the dying may be added to the coverage in light of the special medical and health-care needs of the elderly when social and economic development reach a certain stage and the conditions for doing so are present. In sum, in the twenty-first century, the development, contents, and coverage standards of the medical-insurance system for the elderly should conform to the overall objectives and actual state of development of China's national economy and society, and be consistent with the degree of improvement in the people's standard of living.