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　　On June 12th, 2021 Chongqing Rural Revitalization and Cultural Tourism Industry Development Summit Forum was held in Chongqing International Expo Center. Experts from all over the country and practitioners of rural revitalization shared cutting-edge observation and practical experience. Among them, located in Guanzhong Plain, yuanjiacun, Liquan County, Shaanxi Province, which is known as the "super IP of rural tourism in China", is worth dissecting. In this forum, Zaijianwei, the leader of China Rural Revitalization yuanjiacun Research Group, brought a case study of yuanjiacun’s "Rural Life Complex Boosting Rural Revitalization".

　　Rural revitalization, Chongqing has great development potential. How to do a good job of rejuvenating the countryside and draw a magnificent picture of the countryside? In this issue of Weekly, we will take yuanjiacun as a case, interpret its key to success, analyze its development experience, and explore what enlightenment Chongqing rural revitalization can get from it.

　　Yuanjiacun’s Three Keys to Development

　　Yuanjiacun, Yanxia Town, Liquan County, Xianyang City, Shaanxi Province, is a small village with only 62 households and 286 people. It used to be a "rotten village" with "no oil for lighting, no cattle for farming, and no success in work", and almost no young people were seen.

　　There is a street in the east and west of the village, with two rows of houses in the north and south. There is neither the beauty of green mountains nor the style of the old town. Since 2007, yuanjiacun, with villagers as the main body and villages as the carrier, has devoted itself to urbanization, scenic spots and commercialization, fully restored Guanzhong folk customs and rebuilt rural life. Tourists experience rural life in all directions, from zero distance and from multiple angles, and truly realize the "integration of village and scenery", thus forming a unique super IP and well-known brand of rural tourism. The total number of tourists exceeds hundreds of millions, and the annual per capita of farmers purely exceeds 100,000 yuan. "yuanjiacun Model" provides vivid samples and examples for rural construction, development and revitalization in other places, and has become a rare phenomenon in rural areas of China in recent decades.

　　The first key—

　　Build a complex of rural life and show the original ecological lifestyle and traditional customs.

　　Yuanjiacun has successfully built a complex of rural life, which is one of the secrets of its success.

　　"Can you show and reflect the traditional customs of the countryside and the daily life of the villagers? This is an invisible but real-time resource among us. Yuanjiacun succeeded. We didn’t rely on natural resources or artificial resources, and we didn’t spend a lot of money to build a garden. Instead, we took the villagers as the main body to restore rural life. " Zhai Jianwei said that rural tourism in yuanjiacun includes villages and villages, but mainly farmers, so it can give different experiences to urban people. "You can’t move villagers out for tourism, which is a big discount on the tourism experience."

　　Yuanjiacun takes the traditional customs of the countryside and the daily life of the villagers as resources, and makes tourism out of nothing. The village is the scenic spot, and the home is the scenic spot. The village and the landscape are integrated, and the whole people participate. We will resolutely put an end to fancy sculptures and landscapes. The simple, sincere and lively faces of the villagers are the most unique resources.

　　It is worth mentioning that by implementing the strategy of "going into the city and going out of the province", yuanjiacun has implanted the rural lifestyle of yuanjiacun into the city, so that urban residents can experience rural life at their doorsteps. At the same time, through "going out", yuanjiacun has built a rural life complex project with local folk culture and historical characteristics. At present, more than 10 provinces and cities, including Shanxi, Henan, Beijing, Hubei, Qingdao and Jiangsu, are under construction.

　　The second key—

　　The third industry brings the second industry to promote the first industry, so that everyone can make money if they have business.

　　Zai Jianwei said that the second secret of yuanjiacun’s success lies in two local initiatives: first, it has engaged in an innovative model of rural tourism, integration of three industries; The second is to innovate the organizational model and let all villagers participate, thus putting an end to disorderly and vicious competition in the industry.

　　In addition, yuanjiacun has built a platform for farmers’ entrepreneurship, training villagers to become the main body of management and entrepreneurship, making them the bosses and shareholders, so that every family can have business and everyone can earn money. At the same time, market-oriented, reverse development, promote one production with three industries and two industries, and realize the integrated development of three industries.

　　For example, yuanjiacun has a historical tradition of making spicy seeds. Guo Zhanwu, secretary of the village party branch, restored the folk scene in this pass through creative design: under a dirt slope in Kangzhuang Old Street, yuanjiacun, an old ox, a stone millstone and a peasant woman splashed the ground chili pepper with boiled rapeseed oil, and the street was full of fragrance. This kind of experience is not only delicious food and beautiful scenery, but also memories and homesickness. Tourists buy while watching, and the products are in short supply.

　　The village then guided the villagers to build workshops to expand the production capacity of oil-pungent seeds and gradually industrialize them. Transforming an experience scene of tertiary industry into a processing project of secondary industry, a bottle of oily pepper, from the initial annual turnover of less than 100 thousand yuan, to the operating income of more than 8 million yuan in 2018.

　　The third key—

　　Give full play to the advantages of the village collective, so that the interests of all villagers are shared.

　　Yuanjiacun adjusts income distribution by means of joint-stock cooperation, avoids polarization, successfully solves the problem of increasing the income of all villagers, and fundamentally ensures the sustainable development and rural revitalization of yuanjiacun, which is also the third secret of the success of "yuanjiacun Model".

　　Take the pepper professional cooperative led by the village collective as an example. At first, a farmer in yuanjiacun used yellow cattle to grind peppers, which was very popular with tourists and promoted the sales of peppers. According to the past practice, when villagers see which industry is profitable, many industries will emerge overnight, which will lead to similar industries and homogeneous competition of products. However, in order to protect this industry, we should explore ways to build cooperatives through villagers’ shareholding, realize the healthy development of the industry and drive the villagers’ income. Today, through this model, the sales of pepper industry has exceeded 15 million yuan.

　　To put it simply, yuanjiacun’s success has solved three problems: first, how to get people to come; second, how to make money; and third, how to divide the money.

　　Learning from yuanjiacun, Chongqing can exert its strength in these aspects.

　　Dialogue guests > > >

　　Researcher, Chongqing Academy of Social Sciences, Ding Zhongbing

　　Director of Rural Industry Division, Agricultural and Rural Committee of Aifeng City

　　Wu Wencong, Party Secretary of Dashi Township, Dianjiang County

　　Secretary of the branch of Hejiayan Village, Huatian Township, Taotao Youyang

　　The development of rural industries should pay attention to exploring the multiple functions of agriculture and rural areas.

　　Chongqing Daily: yuanjiacun first sold a kind of homesickness, a way of life, and then developed a variety of industries. So how can we jump out of the industry to develop industries when developing rural industries?

　　Ding Zhongbing: The development of rural industries should pay attention to exploring the multiple functions of agriculture and rural areas. In China, the countryside is not only a production space for agricultural products, but also a living space full of homesickness and returning to nature. It is an activated display space for Chinese traditional excellent culture and a long-standing farming civilization, and an ecological space for people to live in harmony with nature. Especially in the background of increasing urban population and people’s income level, the functions of production, life, ecology and culture in agriculture and rural areas increasingly show their scarcity of resources and unique value.

　　At the same time, although many mountainous villages in Chongqing do not have comparative advantages in grain production and bulk agricultural products production, their natural ecological environment is generally good, their folk customs are simple, and their traditional production and life forms are well preserved. We can learn from the experience of industrial development in yuanjiacun, Shaanxi Province, and strive to build a rural life complex to attract people from the city to experience life in the countryside, so as to build rural tourism into a leading industry and leading industry for the revitalization of rural industries.

　　Ai Feng: Chongqing also has a similar local rural industry of "integration of three industries". For example, Fuling mustard tuber, Jiangjin pepper, Tongnan lemon, etc., all of which have a good industrial base, have developed a whole industrial chain from seedling raising to planting, processing, cold storage, sales and transportation, and integration of agriculture and tourism. The biggest common point in the cultivation and development of these industries is to jump out of the industry itself to develop.

　　Compared with industrial development, in fact, we should learn from yuanjiacun’s ability to develop, cultivate and make a name for itself through village collective stock cooperation. Combined with the actual situation, Chongqing put forward the idea of building industrial clusters in different levels for the development of rural industries. Based on the extension of industrial chain and the expansion of industrial functions, a number of rural advantageous industrial clusters with hundreds of millions of towns and villages, tens of billions of districts and counties, and hundreds of billions of modern mountainous high-efficiency agriculture were built. At the same time, according to different business entities, we should create corresponding industrial alliances and industrial consortia to solve various problems in the development of the whole industrial chain of rural industries, and then promote the high-quality and efficient development of rural industries.

　　Wu Wencong: Dashi Township and yuanjiacun have similar historical and folk cultural resources. We can learn from yuanjiacun’s practice of showing local people’s original ecological life and traditional customs to develop rural tourism. As a national intangible cultural heritage, Dashi bamboo weaving has been included in the rural revitalization plan. Dashi Township has a historical tradition of bamboo weaving, and some villagers still have the skills of weaving Dashi bamboo weaving. We can learn from yuanjiacun to show the living conditions of these people to tourists, and at the same time, we will force the scale and industrialization of the secondary production of Dashi bamboo weaving through tertiary tourism. In addition, with the help of the planning of agricultural cultural tourism, Dashi bamboo weaving will "go out" and become a national-renowned cultural tourism product.

　　Tao Tao: Hejiayan Village has become a well-known "online celebrity Village" with terraced fields and Gong Mi. We must also learn from yuanjiacun how to create unique homesickness symbols, such as how to attract tourists to spend deeply with the original ecological Tujia diaojiao building and original traditional farming culture.

　　The development of rural industries needs to be transformed and upgraded from product economy to experience economy.

　　Chongqing Daily: In the process of development, yuanjiacun’s industry has undergone transformation and upgrading. What enlightenment does this have for the development of rural industries in Chongqing?

　　Ding Zhongbing: The development of rural industries should strive to realize the transformation and upgrading from product economy to experience economy. Experience economy is an economic type that relies on service and makes consumers leave a deep impression or rich feelings on something or phenomenon through feeling and memory.

　　At the same time, in the process of developing rural tourism, yuanjiacun does not simply provide tourists with sightseeing products, agricultural special products and tourist souvenirs, but focuses on providing rural life experience, farming experience and holiday and leisure experience for urban people, leaving a good feeling for people to go and want to go, thus realizing the sustainable development of rural tourism. Many villages in Chongqing can learn from yuanjiacun’s industrial development experience, vigorously develop in-depth experience-based rural tourism, expand the profit space, and enhance the ability of sustainable development.

　　Tao Tao: At present, with the help of the municipal rural revitalization and assistance team, Hejiayan Village has realized the integrated development of agriculture, literature and tourism with the resources of terraced fields, traditional farming culture and ancient villages, and has transferred more than 50 sets of idle farmhouses through the village collective to build rural villagers’ houses. At the same time, through land transfer, the village collectively built 10,000 mu of terraced fields, which promoted the villagers to increase their income through multiple channels while expanding their industries.

　　The village also signed an agreement with Youyang Tourism Investment Company on the overall development and construction of Hejiayan rural tourism, preparing to build a camping base and a landscape glass plank road to create a boutique rural tourism product. At the same time, the Huatian terraced fields and the Cangpugai prairie backed by them will be bundled and planned to build a demonstration zone for leisure and cool. We will also build a 26-kilometer-long rural tourism loop, where tourists can not only taste the Gong Mi and local honey, but also visit the alpine grassland, enjoy the scenery and enjoy the cool, and have a leisure holiday.

　　At the beginning of this year, many places began to start the reform of employee outpatient mutual aid security. This system, which concerns the interests of 354 million medical insurance participants, requires that the payment of benefits be tilted towards retirees. By the end of 2021, there were 93.24 million retired employees in the basic medical insurance system for employees.

　　At present, 31 provinces, autonomous regions, municipalities directly under the Central Government and Xinjiang Production and Construction Corps have issued documents to improve the mutual aid guarantee mechanism for local employees’ medical insurance clinics. Among them, many provinces and cities stipulate that the outpatient payment limit and payment ratio of retirees are higher than those of on-the-job employees.

　　Even so, among the public opinions received by local medical insurance departments, retirees think that "after the reform, the level of treatment has decreased due to the reduction of the amount of personal accounts", accounting for the majority.

　　In the policy explanation, the medical insurance departments in many places clearly stated that after the reform, the personal accounts of most insured persons will be reduced in the current period. At the same time, they also used specific data and cases to explain to the public that for retirees who suffer from chronic diseases at their own expense, the benefits of outpatient mutual aid far exceed the reduction of personal accounts, often by reducing hundreds of yuan, reimbursing thousands or even thousands of yuan.

　　Medical insurance bureau, Hunan Province, said in "Interpretation of Policies on Improving Personal Accounts of Retired Workers" that the outpatient mutual aid mechanism is to use the law of large numbers to resolve the risks of social groups. The number of personal accounts for medical insurance is different from that of individuals at present, but in terms of system, mutual aid guarantee has a more risk prevention function. Workers’ medical insurance is not only a personal account and general outpatient co-ordination, but also a series of policies such as outpatient treatment of chronic and special diseases and hospitalization treatment, which constitute a complete security system.

　　A few days ago, CBN interviewed many experts in the industry on the hot issues of personal account reform of medical insurance that the public cares about. Experts generally believe that the medical insurance personal account has completed its historical mission for more than 20 years and its limitations are gradually becoming prominent. It is the general direction to gradually replace the personal account with outpatient mutual aid according to the principle of "rights replacement".

　　This is a reform that affects the whole body. In the long run, the insured will benefit from the reform, but in the short term, the interests of some people will be damaged. How to improve the supporting mechanism to make the insured more sense of acquisition is a key issue that must be paid attention to in the next step of reform.

　　CBN also learned from relevant departments that some targeted measures are being introduced one after another, for example, in order to facilitate patients to enjoy treatment nearby, support patients to settle accounts and dispense medicines in designated retail pharmacies with prescriptions, enjoy the same reimbursement treatment as those in medical institutions, and explore the inclusion of qualified "internet plus" medical services in the scope of protection to improve the convenience of enjoying treatment.

　　Q: At the beginning of this year, the reform of outpatient mutual aid was launched in many places. In some areas, retirees reported that the funds in personal accounts of medical insurance were reduced, which affected the daily cost of buying medicines. The reform of outpatient mutual aid is inclined to the elderly, but why do the elderly think that their interests are damaged?

　　Zhu Minglai (Director, Health Economy and Medical Security Research Center, Nankai University)The original intention of this reform is to hope that the sick and the elderly with poor health can have more benefits, rather than harming their interests.

　　It is believed that only a part of the elderly people have their interests damaged, which does not mean all the elderly people. Different groups of people have different demands. At present, people who feel that their interests are damaged are mainly elderly people who usually have minor illnesses. The funds in personal accounts can cover their daily expenses for buying medicines and seeing a doctor. If the funds in personal accounts decline, it will have an impact on their daily medical payment; However, for the elderly who suffer from chronic diseases, need to take medicine for a long time and go to the clinic for medical treatment, the funds in his personal account are not enough. According to the previous policy, after spending the funds in his personal account, the outpatient expenses have to be paid at his own expense. Therefore, for the elderly with higher outpatient expenses, the benefits will not be damaged, but a higher reimbursement level will be obtained.

　　It is also mentioned in the policy interpretation of "Detailed Rules for the Implementation of Wuhan Employees’ Basic Medical Insurance Outpatient Mutual Aid Security" that the insured Zhou, a retired person, is 68 years old, with an annual pension income of 50,000 yuan. Before the reform, his personal account was transferred to 2,400 yuan every year. Suffering from cerebral infarction, I went to the outpatient department of a tertiary hospital for medical treatment. This year, I incurred a reimbursable expense of 7,150 yuan. If I reimbursed according to the outpatient co-ordination policy, excluding the threshold fee of 500 yuan, I can reimburse (7,150-500) yuan * 60% = 3,990 yuan according to the reimbursement ratio of 60% in tertiary hospitals. Although Zhou’s personal account was less than 1404 yuan after the reform, he enjoyed more than 2586 yuan.

　　twoQ: In April 2021, the State Council issued the guiding opinions on the reform of outpatient mutual aid, and the local authorities received many public opinions when formulating implementation rules and popularizing policies. For example, the Hunan Provincial Medical Insurance Bureau said that the public opinions received recently focused on reflecting that "the level of treatment after the reform has declined", especially for retired employees whose original personal accounts were included in the annual level of more than 2,900 yuan. In your opinion, what problems do retirees’ concerns about the reform of outpatient mutual aid reflect?

　　Lou Yu (Professor, School of Civil and Commercial Economics, China University of Political Science and Law, Director of Institute of Social Law)Since the basic medical insurance system for employees was fully implemented in China in 1997, personal account has been an important medical insurance system. Not only have many structural systems become path-dependent, but the reform of one of them will "affect the whole body", and in the short term, the reform will harm the interests of some people. How to make reasonable compensation for those who have lost interests is also a major event related to the success or failure of the reform.

　　The reform plan of outpatient mutual aid is to reduce the funds remitted by retired insured persons into their personal accounts every month, and the saved funds are used for outpatient serious illness co-ordination. This plan is in line with the development direction of medical insurance, and its original intention is very good, but it is very important to consider the details comprehensively in implementation, which may affect the insured persons’ acceptance of the reform and the effect of the reform. The first thing is that publicity must be in place. After all, personal accounts have existed for more than 20 years. Although the nature of their personal property has not been written into the law, it has formed a basic consensus in the whole society. Secondly, supporting measures must be kept up in time, such as increasing the allocation of common diseases drugs in primary medical institutions, making insured people run less, improving the convenience of the system and reducing personal burden.

　　threeQ: Some netizens said that "the personal account has been transferred less, ‘ Lose money ’ ",for individuals, medical costs will increase because of this reform?

　　Liao Zangyi (Associate Professor, School of Politics and Public Administration, China University of Political Science and Law)Generally speaking, for individuals, their medical costs will not increase because of this reform. Everyone should calculate both small accounts and big accounts. After the reform, the overall planning fund has been strengthened, and after illness, it can be reimbursed through the overall planning fund. Everyone helps each other and the protection will be more adequate. It is necessary to calculate both immediate accounts and long-term accounts. Everyone is old and sick sometimes. Although young and healthy people don’t see many doctors now, the economic risks brought by diseases exist for a long time. Everyone should also look at the difference between income mechanism and insurance mechanism rationally. Under the big framework of social medical insurance, the funds in personal accounts are "medical expenses", not salary income or welfare. When people are old and sick, it is always limited to rely on personal accounts and personal accumulation. All of them need solid and sustainable medical insurance to realize social mutual help and help to resolve the disease risk, and they will benefit from this reform in the long run.

　　Guangdong Medical Insurance Bureau mentioned a case in the Q&A on the reform of outpatient mutual aid guarantee mechanism, which showed that Hua Jie, a retired employee, paid more than 480 yuan for lung CT in November 2022, and paid for it in full. After the implementation of outpatient mutual aid in Guangzhou, Sister Hua recently went to the hospital for CT and found that she only had to pay more than 140 yuan for the same project, and the overall fund paid 70%.

　　According to the calculation of Hunan Medical Insurance Bureau, after the reform, the maximum payment limit of the on-the-job employee pooling fund is 1,500 yuan, and the maximum payment limit of the retirees pooling fund is 2,000 yuan. In 2021, the province’s annual per capita personal account fund income was 1,727 yuan/person, and the personal account fund expenditure was 1,438 yuan/person. At present, the payment limit determined by the general outpatient co-ordination policy, plus the amount transferred from the personal account, can basically meet the outpatient medical needs of the insured.

　　Four questions: China’s personal accounts have existed for more than 20 years. Why should we start the reform of outpatient security including personal accounts recently?

　　Lou Yu:The original intention of the medical insurance personal account system design is to hope that the insured can share the risk of outpatient expenses through long-term accumulation, that is, pay more to the personal account when they are young, but not when they are old, and the medical insurance account is used to pay for outpatient expenses. However, this original intention has not been well realized in practice: the insured people tend to be short-sighted, and a large amount of funds have accumulated in their personal accounts, which has caused high moral hazard, which not only doubled the pressure of supervision, but also limited funds in each insured person’s account, which can only be used to pay small outpatient expenses, and the high outpatient expenses cannot be paid, which is also inconsistent with the principle of "ensuring the big but not the small" in medical insurance, and unfair to insured patients who really need to rely on the medical insurance system to solve high expenses. Therefore, there are many criticisms about personal accounts in medical insurance practice, and all sectors of society are actively seeking reform plans for accounts.

　　Once any system is fixed, it will be very difficult to reform, because any reform is a redistribution of interests. It is easy to reform a specific system, but a comprehensive and comprehensive evaluation of the system and a systematic solution to the problem test the wisdom of the reformers. No matter from the medical insurance practice in China or the system implementation in other countries, it is difficult for a purely accumulated personal account to play the role of the law of large insurance numbers, and it is impossible to share the disease risk and help the funds in a larger scope. It has reached a social consensus that personal account funds should be used for the overall planning of high outpatient expenses, which should be the general direction of reform. However, this reform needs a systematic system design, and necessary supporting measures must be introduced in time to reduce the proportion of medical insurance account allocation.

　　Five questions: The reform of outpatient co-ordination is a systematic project, in which reducing the funds allocated by personal accounts should be the simplest to operate, but if the supporting policies can’t keep up, there may also be cases of damage to rights and interests. In your opinion, the outpatient mutual aid system should really protect the interests of the insured, which supporting reforms are indispensable?

　　Zhu Minglai:I think one of the important reasons why some retirees are concerned about the reduction of personal account funds is that some supporting policies have not kept up in time. The biggest supporting policy of outpatient mutual aid reform is medical care and medicine, such as the accessibility of medical services. Some elderly people have reported that things that could be solved by taking medicine and swiping cards at pharmacies are now going to the hospital. If he does not trust the first-and second-level hospitals, he may have to queue up for a long time at the third-level hospitals. And sometimes when you get to the hospital, the hospital may be short of medicine, and you have to go to the pharmacy to get medicine. This will add a lot of burden to the elderly in running errands.

　　This is also the direction to further improve the supporting policies. Specifically, efforts can be made in three aspects: First, support patients to settle accounts and dispense medicines in designated retail pharmacies with external prescriptions, enjoy the same reimbursement treatment as in medical institutions, and give full play to the convenience of designated retail pharmacies. The second is to explore the inclusion of qualified "internet plus" medical services in the scope of protection, so as to improve the convenience of enjoying treatment. The third is to explore and promote the circulation of electronic prescriptions to better solve the needs of drug purchase settlement.

　　Six questions: The level of economic development and welfare varies from place to place, so does the level of outpatient co-ordination. If the overall level of outpatient service in a region is relatively low, can it make up for the welfare loss caused by reducing the funds in personal accounts?

　　Liao Zangyi:Local governments will encounter some difficulties in establishing outpatient co-ordination. First, the medical insurance information system should keep up, and all designated pharmacies in the co-ordination area should be opened to ensure that patients can enjoy real-time settlement without manual reimbursement. Secondly, medical insurance supervision and intelligent audit should keep up. After the outpatient service is improved, many people will definitely try their best to gain benefits by reselling drugs, which puts forward higher requirements for the refined management and intelligent monitoring of medical insurance.

　　For the welfare loss that may be caused by the low level of overall planning, we can start from three aspects. First, after the implementation of the outpatient mutual aid system, the deductible line for outpatient reimbursement should be appropriately reduced, and the proportion of reimbursement can be appropriately increased. This needs to be dynamically adjusted by the medical insurance department through actuarial science to effectively enhance the people’s sense of gain; Second, the coverage of outpatient mutual aid should be improved, from the existing two diseases, renal dialysis, outpatient radiotherapy and chemotherapy, etc., and gradually expanded to most diseases can enjoy reimbursement treatment to reflect fairness; Third, we can refer to the guarantee policy of hospitalization treatment. If the insured person’s annual outpatient expenses exceed a certain proportion, it can be classified as large medical expenses, and should be guaranteed twice or matched with the corresponding bottom-up mechanism.

　　Seven questions: Many retirees are used to going to designated retail pharmacies to buy medicines. After implementing outpatient mutual aid, what support measures are there for designated retail pharmacies?

　　Zhu Minglai:The reform puts forward that the drug guarantee service of qualified designated retail pharmacies should be included in the scope of outpatient service, and the payment of the overall fund should be extended to qualified designated medical insurance pharmacies, with the purpose of facilitating patients to submit reimbursement nearby and reducing the cost burden. Insured patients can only use personal accounts to pay for drugs purchased at designated retail pharmacies. After the reform, they can use personal accounts or enjoy reimbursement from the overall fund with external prescriptions. According to the relevant data, since the implementation of the reform, the scale of personal accounts used in designated retail pharmacies has increased, which also shows that pharmacies have benefited from the reform measures such as personal accounts helping families and expanding the scope of personal accounts.

　　However, we can’t ignore the violation of laws and regulations in the operation of designated retail pharmacies. For example, it is very common for some city pharmacies to use medical insurance funds to pay for health care products and daily necessities. We must strengthen supervision over this kind of misappropriation and application of medical insurance funds.

　　Eight questions: after the implementation of outpatient mutual aid, will it increase the number of hospital outpatients and labor costs?

　　Liao Zangyi:In the short term, it may increase the number of outpatients in hospitals, such as many minor illnesses such as colds and coughs. Before the reform, many patients will carry on and recover by their own immunity, which can save money after all. After the reform, considering that medical insurance can be reimbursed, some people will have the mentality of "not spending money and not spending money", and there is indeed a risk of increasing the number of hospital outpatients and labor costs in the short term, but with the passage of time, after the market gradually returns to rationality, this phenomenon will gradually fall back to the state before the reform.

　　Question 9: What is the nature of the funds in the medical insurance personal account?

　　Lou Yu:According to the Decision on Establishing the Basic Medical Insurance System for Urban Workers promulgated by the State Council in 1998, the combination of social pooling and individual accounts is the basic principle of basic medical insurance for employees. The principal and interest of individual accounts are owned by individuals and can be carried forward and inherited. This is the basis for the general public to believe that the legal nature of personal accounts is personal property. However, this decision has a low legal rank, and it is not an administrative regulation with external legal effect. It is only a normative document for building a medical insurance system within the administrative organs of people’s society, and it has only guiding significance for the provisions on the nature of individual accounts. The Social Insurance Law promulgated in 2010 didn’t stipulate the unified account as the financing principle of basic medical insurance, and didn’t stipulate the legal nature of individual account, which is considered that legislators don’t recognize the financing rules and payment methods of individual account, leaving enough room for future reform.

　　Question 10: The Social Insurance Law promulgated in 2010 did not mention the personal account of medical insurance. Does it mean that the general direction of future reform is to replace the personal account with the outpatient mutual aid guarantee mechanism?

　　Liao Zangyi:The general direction of future reform can consider gradually reducing personal accounts until they are cancelled. On the one hand, gradually reduce or stop the proportion of unit contributions to individual accounts; On the other hand, gradually abolish the regulation that individual contributions are transferred to individual accounts, and include individual contributions in the overall fund, such as establishing outpatient mutual aid system. Although there may be great resistance in actual operation, in fact, some areas have already tried this method and achieved good results.