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一、实行企业医疗保险制度改革的必要性。(一)改革开放以来,云南省经济成份发生了变化。大量集体、外资企业、个体企业的出现,使过去医疗保险只在全民单位实行的情况已不适应经济发展的要求,大批集体企业、外资企业和个体企业的职工缺乏应有的医疗保障。即便是全民企业的职工保险,由于未建立社会保险基金,医疗风险由各个企业独立承担,缺乏相互调剂、互助的机制,往往是效益好的企业对医疗费放手发放,效益一般的企业限制发放,微利亏损企业无钱发放。医疗的社会化程度低、范围狭窄、抵御大病的能力差的问题日趋严重。
First, the implementation of the medical insurance system reform necessity. (A) Since the reform and opening up, the economic composition of Yunnan Province has changed. The emergence of a large number of collectives, foreign-funded enterprises and individual enterprises made it impossible for the medical insurance to be implemented only by universal units in the past to meet the requirements of economic development. The large number of workers in collective enterprises, foreign-funded enterprises and individual enterprises lacks the medical insurance due to them. Even for the employee insurance of all state-owned enterprises, since no social insurance fund has been set up and the medical risks are borne independently by all enterprises, there is a lack of mechanisms for mutual adjustment and mutual assistance. Often enterprises with good benefits are allowed to release medical expenses and limit the issuance of general- Profits and losses companies have no money to pay. The socialization of medical treatment is low, the scope is narrow, and the problem of poor ability to resist serious illness is worsening.