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Zhang Jiashi thinks that there is a very reasonable sentence, that is, sharpening knives without cutting wood, and vigorously developing the medical system under the corresponding foundation, which is of great help to the development of the military system of the Qin Empire and the development of national health care. The pen % fun % pavilion www.biquge.info romance debut

It's a pity that Zhang Jiashi is faced with a lack of foundation, and he has to think that this is not a problem that can be solved in a few years, or even more than ten years.

What Zhang Jiashi did not expect was that even after gaining the initiative in the future because of the war against the Xiongnu, the strategy, including the development system of medical personnel, was gradually implemented, but the development of the medical system in the Qin Empire, the real foundation was laid after Yingxiu succeeded to the throne.

Although Zhang Jiashi and the monarchs before Yingxiu did not make no progress in this regard, because of many factors, including the two monarchs before Yingxiu, their investment in this aspect was frozen, and finally the development of the medical system, which had already begun to take shape, could only be truly laid during the Yingxiu period.

And in this regard, in fact, it is not possible to blame too much for the central class of the Qin Empire at that time, because even Zhang Jiashi has not thought of what kind of concept the investment in this aspect is.

The Qin Empire wanted to develop a more extensive health care system, and the cost input ratio was in fact much higher than that of later generations.

This was mainly due to the large amount of expenditure on personnel training costs and medical costs at that time, which eventually made the financial pressure on the Qin Empire in this regard more and more huge.

In the same way, because of some additional problems, such as some people's exploitation of loopholes, and even collusion with some officials to encroach on their own resources in this regard, which is not too sufficient, eventually led to the Qin Empire having to freeze its investment in this area for a long time.

In fact, it happens that the development of the Qin Empire in this area is just a relatively primitive start, otherwise, the Qin Empire's choice to freeze its investment in this area may cause more problems. Eventually, the Qin Empire, after nearly two hundred years of medical system development, would be destroyed.

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Perhaps on the other hand, Zhang Jiashi's way of thinking was too jumpy, because even if Zhang Jiashi made corresponding guidance in this aspect and successfully created a precedent, the situation of the Qin Empire was not as good as that of later generations, and on the other hand, Zhang Jiashi ignored the need for another help in order to develop health care more effectively.

That's health insurance.

Medical insurance, in the traditional sense, refers to the management of medical insurance funds by specific organizations or institutions, through mandatory policies and regulations or voluntary contracts, among a certain insured population in a certain area.

Medicare originated in Western Europe and can be traced back to the Middle Ages. With the success of the bourgeois revolution, the cottage workshop was replaced by big industry, and the modern industrial contingent appeared. Due to the harsh working environment, the occurrence of epidemic diseases and industrial accidents makes workers demand appropriate medical attention. However, their wages are low, making it difficult for individuals to pay for medical expenses.

As a result, workers in many places organized themselves to raise a part of the money to cover expenses in case of illness. But this form is not very stable, and it is small-scale, and the ability to resist risks is very low. At the end of the 18th century and the beginning of the 19th century, private insurance developed in Western Europe and became an important way for the state to raise medical funds.

This situation can be said to be a prototype of medical insurance.

However, the medical insurance of later generations has the basic characteristics of social insurance, such as compulsory, mutual aid and sociality. Therefore, the medical insurance system is usually legislated and enforced by the state, and a fund system is established, the expenses are jointly paid by the employer and the individual, and the medical insurance premium is paid by the medical insurance institution to solve the medical risks caused by the illness or injury of the worker.

In later generations, there are five main models of medical insurance, and the pros and cons of these five models are relatively obvious.

The first is the German social insurance model:

Germany is the first country in the world to establish a medical insurance system, which is characterized by the social pooling of medical insurance funds, mutual assistance, mainly paid by employers and employees, and subsidized by the government as appropriate.

The medical insurance system refers to the system in which a country or region raises, distributes and uses medical insurance funds in accordance with the principle of insurance to solve the problem of disease prevention and treatment for residents. It is an effective financing mechanism for residents' health care, a relatively progressive system that constitutes a social insurance system, and a health expense management model that is widely used in later generations.

In later generations, the establishment of social insurance systems in Western countries mostly started with medical insurance. Medical insurance began in 1883 with the German Law on Occupational Sickness Insurance, which made it mandatory for workers in certain industries to be paid less than the limit to the Medical Insurance Fund, which made it mandatory for workers and employers to contribute to the fund. This decree marked the creation of health insurance as a compulsory social insurance system.

And because after the world economic crisis, the legislation of medical insurance has entered a period of comprehensive development, and the legislation of this period not only stipulates the object, scope and treatment items of medical insurance, but also legislates and regulates medical services related to medical insurance. At present, all developed countries and many developing countries have established health insurance systems.

After that, German nationals pay a certain percentage of their income, with high-income earners paying more and low-income earners paying less, and no matter how much they pay, they can be treated if they are sick. For workers earning less than DM 610 per month, the insurance premiums are fully covered by the employer, while the health insurance premiums for the unemployed are mostly covered by the labour department. Non-income persons under the age of 18 and those with a household income of less than a certain amount are exempt from out-of-pocket expenses for certain items.

According to the corresponding data, this model was relatively the most extensive, with more than 100 countries adopting and implementing it at that time.

The second is the commercial insurance model in the United States:

The main characteristics of this model are the freedom to participate in insurance, flexibility and diversity, there is money to buy high-end, no money to buy low-end, suitable for multi-level needs.

The United States implements a profit-oriented system based on liberal health insurance, operating according to market rules, and often refuses to accept insurance from residents with poor health conditions and low incomes, so it is less fair.

This model has also led to an out-of-control total health care cost of 14% of GDP, the highest in the world, while still 30 million people do not have any health care.

The third is Canada's universal coverage model:

The characteristics of this model are that the government directly organizes medical insurance, the people pay taxes, the government allocates funds to public hospitals after collecting taxes, and the hospitals directly provide free or low-cost services to residents. The insurance covers all necessary medical services, with proper separation of medicines. Except for special provisions, the public is entitled to all other basic medical insurance free of charge.

At the same time, the country also encourages the development of commercial supplementary medical insurance covering non-government insurance programs. All non-government insurance programs are freely invested by employers, and their employees are entitled to supplementary health insurance programs free of charge.

However, Canada's National Health Insurance System is also currently facing reform. According to the report, in 1991, Canada's share of health expenditure in GDP reached 101, ranking second in the world. The Canadian government is plagued by a waste of health resources and an indefinite increase in health costs.

The fourth is Singapore's savings insurance model:

This model is characterized by a high degree of coercion and relative equality.

This is because according to Singapore law, a part of the personal consumption fund must be converted into a medical insurance fund in the form of savings personal provident fund. This part is paid at a rate of 40 per cent of the employee's gross salary, which is paid separately by the employer and the employee. The state has set up a central provident fund to share part of the costs.

In addition, the Government has allocated funds for the establishment of a health trust fund to help poor citizens pay for their services. All nationals of Singapore have a unified healthcare system, with senior government officials and general employees receiving the same healthcare services.

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In later generations, Zhang Jiashi traveled through the country where he was before, and also had his own set of medical security system.

In the early fifties, China established publicly-funded medical care and labor insurance medical care, which are collectively known as social medical insurance for employees. It is an important part of the national social security system and one of the important items of social insurance.

China's basic medical insurance for urban workers is one of the components of the country's medical insurance (medical insurance for urban employees, medical insurance for urban residents, and new rural cooperative medical care), which is a social insurance system established to compensate workers for economic losses due to the risk of disease.

This type of medical insurance is mainly through the employer and individual payment, the establishment of a medical insurance fund, after the insured person is sick and incurs medical expenses, and the medical insurance agency to give a certain amount of economic compensation, so as to avoid or reduce the economic risk borne by the worker due to illness and treatment.

Over the past 40 years, China's medical insurance has played a positive role in ensuring the health of employees and maintaining social stability. However, with the establishment of the socialist market economic system and the continuous deepening of the reform of state-owned enterprises, it is difficult for this system to solve the problem of basic medical security for workers under the conditions of market economy.

In 1988, the Chinese government began to reform the publicly-funded medical care system for government agencies and institutions and the labor insurance and medical care system for state-owned enterprises. In 1998, the Chinese Government promulgated the Decision on the Establishment of a Basic Medical Insurance System for Urban Workers, and began to establish a basic medical insurance system for urban workers throughout the country.

The basic medical insurance system implements the principle of combining social pooling with individual accounts, organically combines the two modes of social insurance and savings insurance, and realizes the organic combination of "horizontal" social mutual aid security and "vertical" individual self-protection, which is not only conducive to giving full play to the advantages of social pooling and mutual aid, but also conducive to giving full play to the advantages of personal accounts having an incentive and restraining role, which is more in line with China's national conditions and is easy to accept by the majority of workers. This medical insurance model is in line with China's national conditions and is a social medical insurance system with Chinese characteristics.

In principle, the basic medical insurance fund shall be coordinated at the prefectural and municipal levels. Basic medical insurance covers all urban employers and their employees, and all enterprises, state administrative organs, public institutions, and other units and their employees must fulfill the obligation to pay basic medical insurance premiums. The employer's contribution ratio is about 6 of the total salary, and the individual contribution ratio is 2 of the employee's salary. Part of the basic medical insurance premiums paid by the unit are used to establish a pooled fund, and part of it is transferred to the individual account, and the basic medical insurance premiums paid by the individual are included in the personal account. The pooled fund and the individual account bear different responsibilities for the payment of medical expenses. The pooled fund is mainly used to pay for hospitalization and outpatient treatment of some chronic diseases, and the pooled fund has a minimum payment standard and a maximum payment limit, and the personal account is mainly used to pay for general outpatient expenses.

In order to ensure that insured workers enjoy basic medical services and effectively control the rapid growth of medical expenses, the Chinese Government has strengthened the management of medical services, formulated a list of basic medical insurance drugs, diagnosis and treatment items and standards for medical service facilities, and recognized the qualifications of medical institutions and pharmacies that provide basic medical insurance services and allowed insured employees to choose. In order to cooperate with the reform of the basic medical insurance system, the state has also promoted the reform of medical institutions and the drug production and circulation system. Through the establishment of a competition mechanism among medical institutions and a market operation mechanism for the production and circulation of medicines, efforts will be made to achieve the goal of "providing relatively high-quality medical services at a relatively low cost."

In addition to basic medical insurance, a system of mutual assistance for large medical expenses has also been established in various localities to solve medical expenses above the maximum payment limit of the social pooling fund. The State has established a medical subsidy system for civil servants. Enterprises with conditions may establish supplementary medical insurance for their employees. The State will also gradually establish a social medical assistance system to provide basic medical security for the poor.

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Zhang Jiashi did not know the details of the medical insurance system, and in a certain sense, wishful thinking was undoubtedly a mistake to rely on the state finance as the main body of protection. Because for a long time after that, the Qin Empire paid a completely disproportionately high price for this.

In the end, because of this, in the eyes of the two monarchs before Yingxiu, the Qin Empire was finally frozen, and it was understandable.

What Zhang Jiashi didn't expect was that in a sense, in the history of the Qin Empire in this world, Yingxiu, who was evaluated as almost the same as him, was called the Ming Jun, and after resuming his investment in this area, he finally chose a medical insurance method that nearly crossed his previous time, and finally successfully developed a medical insurance system, and then let Zhang Jiashi's conception in the health care system really get the foundation for development, which can be regarded as an indispensable existence.

If Zhang Jiashi knew such a situation, maybe he would have some helpless thoughts about his cognition. (To be continued.) )

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