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怎样才能既减轻企业负担,又充分发挥生育保险的保障功能;既有效地控制生育医疗费用的过度膨胀,又尽快地实现基本医疗费的实报实销?这是当前各地生育保险实践普遍存在的难点问题,也是关系到全国生育保险改革能否健康发展的“瓶颈”问题。 青岛市在这方面所作的尝试给我们提供了新鲜经验。 一、基金结余返还企业,减轻企业负担 青岛市从1995年10月实施生育保险社会统筹,基金提取率为工资总额的0.9％;医疗服务费按定额支付,具体标准由各区、县确定,超定额的由企业兜底。 实施1年后,市内4个区收缴基
How can we not only reduce the burden of enterprises, but also give full play to the guarantee function of maternity insurance; not only effectively control over-expansion of maternity medical expenses, but also realize the actual reimbursement of basic medical expenses as soon as possible? This is a ubiquitous and difficult problem of maternity insurance throughout the country, It is also a “bottleneck” problem that concerns the healthy development of the national maternity insurance reform. Qingdao City in this area to try to give us a fresh experience. I. Return of Fund Balances to Enterprises and Relieving Enterprises’ Burden The city of Qingdao carried out social pooling of maternity insurance from October 1995, with a fund extraction rate of 0.9% of the total wage. Medical service fees were paid at fixed rates, with specific standards determined by districts and counties and over-quota From the corporate backpackers. After the implementation of 1 year, the city’s four districts collection base