[Viewpoint] Where is the medical insurance “National Roaming”?

On December 21st news, the doctors directly settled in different places, and this long-awaited dream is closer to the people. The Ministry of Human Resources and Social Security and the Ministry of Finance recently issued a notice to clarify the timetable for direct settlement of medical treatment in different places: the national network of medical insurance will be basically realized by the end of this year, and in 2017, the direct settlement of the medical expenses for retirees in different provinces will be gradually settled. The medical expenses for medical treatment in the off-site of the person who meets the referral regulations are directly settled.

Many people have been deeply affected by medical insurance to “govern the borders and govern”: to seek medical treatment across provinces, first to open a referral certificate; medical expenses must be raised in advance and pre-admitted; eventually reimbursed from medical insurance, short months, long spans In the year, there were fewer hops and hops. In different places, the drugs that are included in medical insurance are different, and the medical treatment items are different. It also makes the medical practitioners entangled: the medicines in the medical insurance medical insurance catalogue are sometimes not in the catalogue of the participating areas, they want to cure the disease, they cannot use medicine, and they use medicine. It is not reimbursable. There are also many retired elderly people who live with their children in different places. Even if they have obtained the hukou of their living place, the cost of taking medicine and going to the hospital must still be reimbursed back to the original job. It is hard to run a year and add a lot of trouble. This contradiction has become increasingly prominent as people move more and more frequently.

医保“全国漫游”难,主要难在平衡各地利益

Where is the “national roaming” of medical insurance? Not difficult in technical support. Social security card holders have exceeded 900 million. Relevant institutions have long argued that improving the "portability" of social security including medical insurance does not solve the problem that cannot be solved technically. It is not difficult to arrange in the system. In the international arena, national co-ordination is the mainstream and can provide a lot of policy lessons.

Medical insurance "national roaming" is difficult, and it is difficult to balance the interests of all places. At present, there are great differences in the payment period, payment rate and enjoyment of medical insurance in various places. Direct settlement of medical treatment in different places actually involves the re-adjustment of interests between “insured places” and “medical places”. The place where high-quality medical resources are concentrated is worried that if “national roaming”, people in economically underdeveloped areas have a serious illness, they may pile up in places with good medical conditions and high reimbursement levels. Retired elderly people living in different places do not pay, and medical expenses are relatively high. If the reimbursement for medical treatment is concentrated on medical treatment, the medical treatment will definitely not be enough. For this reason, it is often difficult to operate when it comes to direct settlement of medical treatment in different places, where the level of economic development is high and medical conditions are good. After all, some places have considered their own small calculations too much, putting local interests in front of the immediate interests of ordinary people, and putting their own convenience and convenience in front of the convenience of ordinary people.

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MLPA ( Multiplex Ligation-dependent Probe Amplification) method detects multiple copy number changes of genes or loci sites. Nowadays, MLPA is used to check large numbers of hereditary disorders and tumour profiling.Since Dutch Scientist Jan Schouten first invented it, the MLPA method was first published in 2002 'Nucleic Acid Research'. The principle of the MLPA is to apply the specific probe design targeting a region of interest on each sample DNA. MLPA method consists of the following steps:


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Mlpa Principle

PCR reaction consists of the three steps: denaturation, primer annealing and primer elongation. Those steps of PCR amplification are repeated many times. The fluorescence-labeled primers, which will go through the capillary electrophoresis to pass a detector, are incorporated into the size of the amplification products. The measured fluorescence was visualized as a peak pattern, the so-called electropherogram. The raw data from the capillary electrophoresis analyzer forms the input of the MLPA analysis.


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