NPC deputy Wang Xinxian and others.
To build a harmonious socialist society, people's livelihood is the first problem to be solved, and the basis of solving people's livelihood problems lies in the establishment and improvement of social security system. The CPC Central Committee and the State Council are taking various measures to fully promote the construction of the social security system. Disabled people, as the most difficult group among the socially disadvantaged groups, are one of the main beneficiaries of social security. Therefore, in the process of social security system construction, we must fully consider the special needs of the disabled and establish a social security system that effectively guarantees the basic life of the disabled.
The preliminary results of the second national sampling survey of disabled people show that the total number of disabled people in China is 82.96 million, and the proportion of disabled people in the total population of the country is 6? 34%, involving nearly 300 million people. Although the disabled are a huge group, their economic situation is generally poor, and with the rapid development of economy and society, the income gap between them and the healthy people is getting bigger and bigger. According to the data in the Blue Book of Society published by China Academy of Social Sciences in 2007, the Gini coefficient of China is 0 through a survey of 7 140 households. 496. The gap between the rich and the poor in China is about 18 times. The living gap between disabled people and ordinary residents in eastern, central and western cities is about 1 to 3 times, and that between disabled people and ordinary residents in rural areas is about 1 to 2 times. According to the survey, in 2005, the per capita income of urban residents in Zhejiang Province was 16924 yuan, that of rural residents was 6660 yuan, that of urban families with disabilities was 4 100 yuan, and that of rural families with disabilities was 1800 yuan. In Zhumadian City, Henan Province, in 2006, the per capita income of urban residents was 7,900 yuan, that of rural residents was 2,906 yuan, that of urban disabled families was 4,300 yuan, and that of rural disabled families was 1.700 yuan. The survey in three counties of Shaanxi Province in 2004-2005 showed that the per capita income of local rural residents was 228 1 yuan, while the per capita annual income of rural disabled families was only 78 1 yuan. In 2006, the per capita income of urban residents in chencang district of Baoji City was 797 1 yuan, while the per capita income of urban disabled families was 2850 yuan. Moreover, disabled people often have many special needs in their daily lives. In addition to the same daily living expenses as healthy people, they also have to pay for rehabilitation, assistive devices and other expenses, such as the daily treatment expenses for the mentally disabled, the purchase of vehicles and the daily maintenance expenses for the disabled with lower limbs. If these special needs of the disabled cannot be fully considered in the process of social security system construction, and the same security measures and standards are adopted for the disabled and healthy people, then the actual quality of life of the disabled is bound to be lower than that of healthy people. Therefore, in the process of social security system construction, a special social security system for the disabled must be established according to the characteristics and special needs of the disabled.
It is suggested that the following key tasks should be done well to effectively promote the construction of the social security system for the disabled:
1? Formulate unified preferential treatment and assistance policies for the disabled in various social insurance systems. For example, formulate preferential and assistance measures for disabled individual industrial and commercial households and freelancers to participate in social insurance; In terms of medical insurance, we will expand the scope of diseases in which disabled people can reimburse medical expenses and increase the proportion of disabled people who can reimburse medical expenses.
2? Improve the minimum living security system for the disabled. Both the urban subsistence allowance system and the rural subsistence allowance system should implement the policy of "classified insurance". According to the degree of disability, economic income and consumption demand, disabled people can enjoy the corresponding minimum living allowance; Appropriately improve the level of protection for the disabled; According to the personal income level of the disabled, rather than the average family income level, as the evaluation basis for enjoying the minimum living allowance, and effectively reduce the family burden of the disabled.
3? Establish a quota subsidy system for the disabled. It is suggested that the state should absorb the mature experience of some places and implement a fixed subsidy system for the disabled, especially the poor disabled, and give corresponding fixed subsidies according to their different degrees of disability as a universal welfare system for the disabled.
4? Establish a maintenance (nursing) system for severely disabled people. The survey results show that at present, about 60% of severely disabled adults and elderly disabled people in China rely entirely on family support, especially severely mentally disabled and intellectually disabled people, which often bring serious economic and psychological pressure to their families. The state and society should not completely transfer this responsibility to their families. Therefore, it is suggested to establish a support system for severely disabled people, give corresponding subsidies to families who support severely disabled people, and give necessary financial support to institutions that provide centralized support for disabled people; At the same time, it is necessary to introduce corresponding preferential support policies and vigorously advocate and encourage social forces to participate.
5? Establish various special social assistance systems for the disabled. In view of the special needs of the disabled, the government provides special assistance funds for medical care and education for the disabled and special subsidies for assistive devices for the disabled, and gradually forms a perfect assistance system for the disabled. In particular, it is necessary to strengthen medical care, education, rehabilitation and life assistance for urban unemployed disabled people, and effectively guarantee their basic livelihood.
Suggestions on taking effective measures to solve the medical difficulties of disabled people
NPC deputy Wang Xinxian and others.
In recent years, the growth of China's medical service costs is not compatible with the level of economic development, and the growth rate of medical service costs exceeds the growth of per capita income. Medical and health expenditure has become the third largest consumption of China residents after family food and education expenditure. Corresponding to the rising medical expenses, the level of medical insurance coverage in China is not high. According to the data provided by relevant departments, at present, the medical insurance coverage of urban residents in China is only over 65.438+0 billion, less than 654.38+0/4 of the total urban population, and the coverage of the new rural cooperative medical system is only 654.38+0.9? 94%, most urban residents and farmers have to pay for medical treatment themselves.
The preliminary results of the second national sampling survey of disabled people show that the total number of disabled people in China is 82.96 million, and the proportion of disabled people in the total population of the country is 6? 34%。 As the most difficult group among the social vulnerable groups, the disabled are generally in poor economic condition, and their average income is generally lower than that of local farmers. Take Zhejiang as an example. In 2005, the per capita annual income of local farmers was 6660 yuan, while the per capita income of disabled families was only 1800 yuan. In Zhumadian City, Henan Province, the annual income of farmers in 2006 was 2906 yuan, while the per capita annual income of rural disabled families was only 1700 yuan. The survey in three counties of Shaanxi Province in 2004-2005 showed that the per capita income of local farmers was 228 1 yuan, while the per capita annual income of rural disabled families was only 78 1 yuan. Faced with the rising medical expenses and the lack of medical security measures, it is very common for many disabled people to endure minor illnesses, delay serious illnesses, become disabled due to illness and become poor due to disability.
The medical condition of disabled people in rural areas is worrying. After the implementation of the new rural cooperative medical system, the medical conditions of some rural disabled people have been improved to some extent. However, because the new rural cooperative medical system is still in its infancy and its coverage is limited, many disabled people have not yet participated in the new rural cooperative medical system. Even where the new rural cooperative medical system is implemented, many disabled people are unable to pay their own expenses, and many medical projects with special needs for disabled people are not included in the scope of reimbursement; Even for items included in the scope of reimbursement, the reimbursement ratio is generally low.
The medical situation of urban disabled people is also not optimistic. Under the current severe employment situation, many disabled people find it difficult to find jobs, and medical care cannot be guaranteed in any form; Even for the disabled who are employed, many people do not enjoy medical insurance for various reasons. According to the survey, about 40% of the disabled people in Qiaokou District of Wuhan suffer from chronic diseases of different degrees, while 83% of the disabled people have no basic medical insurance. More than 60% families with disabilities in Hongshan District of Wuhan are heavily in debt because of paying medical expenses. 80% unemployed mental patients in Wuhan are scattered in the community, and there is no medical security, which has caused a great burden to families and communities.
In view of the medical problems of poor groups, many local governments have introduced some preferential and relief measures, such as reducing the registration fees, outpatient fees and hospitalization fees of poor groups; In view of the difficulties in participating in the new rural cooperative medical system, the individual payment part shall be reduced or exempted by the Finance Bureau or the Civil Affairs Bureau; Some poor patients with major diseases can apply for medical assistance. However, the national and local governments generally lack preferential policies and assistance policies for the disabled in medical care, and have not formed corresponding medical care and preferential systems. Due to the limited range of diseases included in the assistance, high assistance conditions and low assistance funds, the number of disabled people who enjoy preferential treatment and assistance is limited, so the medical assistance provided to poor groups is limited. In some places, there are less than ten diseases included in the scope of medical assistance; In some places, it is stipulated that only when the personal medical expenses exceed 20,000 yuan in rural areas and 30,000 yuan in cities within one year can they apply for medical assistance; In some places, a poor patient seeking help from major surgery is confined to 500 yuan, a patient with severe hepatitis or critically advanced schistosomiasis is confined to 600 yuan, and a patient with severe pancreatitis is confined to 800 yuan. For many extremely poor disabled people, even if they can apply for medical assistance funds, they still face many difficulties in medical care.
The Decision on Several Major Issues in Building a Harmonious Socialist Society adopted by the Sixth Plenary Session of the 16th CPC Central Committee pointed out that it is necessary to "deepen the reform of the medical and health system, strengthen the government's responsibility, strictly supervise and manage, build a basic medical and health system covering urban and rural residents, and provide the masses with safe, effective, convenient and inexpensive public health and basic medical services". And "improve the basic medical insurance for urban workers, establish the overall medical insurance for serious illness of urban residents, and develop social medical assistance." Accelerate the new rural cooperative medical care. "The United Nations Convention on the Rights of Persons with Disabilities, adopted on June 5438+February 65438+March 2006, stipulates that States parties should not only provide free or low-cost medical and health services for the disabled, but also provide special medical and health services for the disabled. To build a harmonious socialist society, the first basic problem to be solved is to help the disadvantaged groups. Disabled people are the most difficult group among the social vulnerable groups, and medical problems are the practical problems faced by disabled people. The solution of medical problems for the disabled will greatly promote the construction and development of a harmonious socialist society.
Therefore, the following suggestions are put forward in the hope that the relevant departments will take practical and effective measures to solve the difficulties and problems existing in medical care for the disabled:
1. It is suggested that the state formulate a unified medical preferential and assistance policy for the disabled to effectively solve the medical difficulties faced by the disabled.
2. Accelerate the coverage of the new rural cooperative medical system, exempt the disabled from individual contributions, and subsidize them from financial expenditures to ensure the participation rate of disabled people; Major diseases related to disability should be included in the reimbursement scope of the new rural cooperative medical system; Expand the medical expenses reimbursement project for the disabled and increase the proportion.
3. Formulate relevant policies and take effective measures to properly solve the medical problems of urban unemployed disabled people.
4. Incorporate special medical projects for the disabled into the scope of medical assistance, lower the threshold for the disabled to apply for medical assistance, and continuously increase the medical assistance for the poor disabled.
Suggestions on preferential policies for the disabled after the reform of rural taxes and fees
Wang Jianlun, Vice Chairman of Social and Legal Committee of China People's Political Consultative Conference.
In June, 2006 165438+ 10, the research group of "Preferential Policies for Disabled People" in the social welfare and social security circles of China People's Political Consultative Conference found that after the abolition of agricultural tax, the economic income gap between rural disabled people and able-bodied people further widened, and special assistance measures were needed.
When the agricultural tax was implemented, relevant regulations on reducing and exempting agricultural taxes and fees for the disabled were generally issued in various places. According to the degree of disability of the disabled, the agricultural tax 100%, 50% and 30% shall be reduced or exempted respectively. Disabled people in rural areas also generally enjoy the relief of "three suggestions and five systems", as well as the relief of accumulated labor, compulsory labor, water conservancy and other labor services and OEM fees. At the same time, village collectives can extract 6% of social and natural disaster relief funds from agricultural tax according to regulations, and generally use part of these funds to subsidize the production and life of disabled people.
After the abolition of agricultural tax, rural disabled people and able-bodied people do not have to pay agricultural tax, resulting in the disappearance of the most important preferential measures for rural disabled people; Healthy people can also get productive subsidies from the government, while disabled people without working ability can't enjoy any subsidies; Village collectives can't continue to extract social and natural disaster relief funds, and the fund chain for subsidizing the disabled is broken. The above reasons lead to the further widening of the income gap between rural disabled people and healthy people. During our investigation in Wuhan, we found that the per capita annual income of rural healthy people can be increased by more than 400 yuan after receiving agricultural tax relief and government productive subsidies. After the abolition of agricultural tax in Huanggang City, the per capita relative income of disabled people decreased by 400-500 yuan. In other places, the research team also got basically the same results.
In view of the general decline in the income of disabled people in rural areas, Hubei and Hunan provinces have taken some measures: first, in places where rural subsistence allowances are implemented, disabled people have priority to enjoy subsistence allowances, and in places where rural subsistence allowances are not implemented, disabled people are included in the scope of social assistance; Second, disabled people who meet the conditions of "five guarantees" in rural areas are given priority in the scope of "five guarantees"; Third, the rural disabled who have the ability to work will be included in the training plan of government-related employment projects. Some cities and counties have also introduced some preferential policies in light of local conditions. For example, Hengyang City, Hunan Province stipulates that disabled people in rural areas are exempted from the "two jobs" burden with disability certificates, and severely disabled people in rural areas who need to take care of their lives are exempted from the "two jobs" burden, which is one of their legal support obligations. Zhihedu Town, Huarong County, Hunan Province allocated 1-2 mu of contracted land for each disabled person to sublease and increase their income.
Hubei province's measures to solve the problems of "food" and "housing" for rural disabled people have certain typical significance. Hubei Province generally gives a fixed subsidy to the poor rural families in the province, each person per year 120 yuan, and the severely disabled people in the province130,000 people, with many disabilities in one household. On the basis of the fixed subsidy, each person will receive a new subsidy of 60 yuan every year, and the required 7.8 million yuan will be borne by the provincial finance and the provincial welfare lottery public welfare fund. Wuhan provides a fixed monthly subsidy of 30 yuan for severely disabled people in rural areas and a fixed monthly subsidy of 20 yuan for slightly disabled people. Hubei Province strives for 1.000 households "Disabled Persons' Federation Special Lottery Public Welfare Fund Rural Poor Disabled Persons Reconstruction Project", and every household in the province supports 1.500 yuan, which is implemented by the Provincial Development and Reform Commission. The Provincial Civil Affairs Department and the Provincial Poverty Alleviation Office respectively listed another 30,000 poor families with disabilities in the "Housing Project for Poor Rural Households" and the "Relocation Poverty Alleviation Project". The renovation project of dangerous houses has been well received by the disabled and the general public. After Li Maosheng, a disabled person in honghu city, Hubei, moved into the project house, relatives and friends wrote "Lifu Building Completed" on the plaque congratulating the completion of the new house. Although Li's new house looks shabby in the shadow of his neighbor's building, he can't help but feel grateful to the government.
In the survey, it is generally reflected that the problem of income reduction of rural disabled people has not been fundamentally solved. In view of the problem that the income of disabled people in rural areas has decreased after the abolition of agricultural tax, the state has not issued preferential policies specifically for disabled people. Although some preferential policies have been introduced in a few places, the preferential contents are too few and the preferential strength is too small to completely make up for the income gap between the disabled and the able-bodied after the abolition of agricultural tax. In the process of implementing the rural subsistence allowance system in the two provinces, the preferential treatment for the disabled has not been fully reflected due to institutional restrictions; Coupled with the uneven level of economic development in various places, this problem cannot be completely solved. For example, among the 22 counties (cities, districts) in Hunan Province/KLOC-0, 36 counties (cities, districts) have not yet established the rural minimum living security system, accounting for 29? 5%。 In areas where the rural subsistence allowance system has not been established, rural poverty alleviation is implemented, and the standard of assistance is only 8 per month. 5 yuan. In counties (cities, districts) that have established the rural minimum living security system, the minimum living security standard is generally low. There are a large number of disabled people who do not meet the minimum living standard or social assistance conditions, wandering on the poverty line, but they do not get any preferential treatment and assistance. In addition, rural disabled people who have children but are underage and their parents have no financial resources cannot enter the scope of "five guarantees".
To this end, we put forward the following suggestions:
First, in view of the problem of the income reduction of rural disabled people after the abolition of agricultural tax, the state should formulate a special unified support policy to give fixed subsidies according to the different disability degrees of rural disabled people, and the source of funds should be shared by the central and provincial finances.
Second, comprehensively solve the housing problem of rural poor disabled people, continue to increase investment in the "lottery public welfare fund for the renovation project of dilapidated houses for rural poor disabled people", and encourage and call on social forces to participate.
Third, speed up the establishment of the rural minimum living standard system, improve the minimum living standard, and provide institutional care and preferential policies for the disabled. The social assistance system should implement the principle of classified assistance and formulate corresponding standards and measures for the disabled.
Fourth, rural disabled people with underage children and parents without financial resources will be included in the scope of "Five Guarantees".
Five, the rural disabled with employability and employment needs should be targeted training, training content and training methods should be able to maximize the employment of disabled people.
Suggestions on solving the special medical difficulties of the disabled
Wang Jianlun, Vice Chairman of Social and Legal Committee of China People's Political Consultative Conference.
From June 5438, 2006 to 2006 10, the research group of "preferential policies for the disabled" in the social welfare and social security circles of China People's Political Consultative Conference found that it was difficult for the disabled to seek medical treatment, and poverty caused by illness and disability was very common.
A survey in Qiaokou District of Wuhan City shows that about 40% of the disabled people suffer from chronic diseases of different degrees, while 83% of the disabled people have no basic medical security. More than 60% families with disabilities in Hongshan District of Wuhan are heavily in debt because of paying medical expenses. 80% unemployed mental patients in Wuhan are scattered in the community, and there is no medical security, which has caused a great burden to families and communities. After the implementation of the new rural cooperative medical system, rural disabled people in Huarong County, Hunan Province have basically entered the rural cooperative medical system, and the problem of medical difficulties has been alleviated to some extent. However, the medical difficulties of urban disabled people in this county have not been properly solved, mainly because most of them have no work units or have been laid off, and the county has not started the basic medical insurance for urban residents.
Many places have established medical assistance systems for poor groups. In 2006, the Department of Finance cooperated with the Department of Civil Affairs to carry out pilot projects of urban medical assistance system in some cities and counties in Hunan Province. At present, urban medical assistance system has been established in 105 counties (urban areas). Yueyang, Hunan and other places have also established a medical assistance system for serious illnesses that integrates urban and rural areas. However, the current medical assistance system has the following problems: First, the scope of diseases included in the assistance is limited, and only 8 diseases in honghu city are included in the scope of medical assistance for serious illness. Second, the rescue conditions are set on the high side and the rescue funds are low. For example, Yueyang City stipulates that if the personal medical expenses exceed 20,000 yuan in rural areas and 30,000 yuan in cities within one year, you can apply for medical assistance for serious illness; Due to the general shortage of financial matching funds in all districts and counties, the standard of assistance amount is low. The upper limit of assistance in some counties and cities is only 500 yuan, a poor patient seeking help from major surgery, 600 yuan, a patient with severe hepatitis or critically advanced schistosomiasis, and 800 yuan, a patient seeking help from severe pancreatitis.
During the implementation of the new rural cooperative medical system, many disabled people were unable to pay the personal expenses of 10- 15 yuan, and some measures were taken to help them. In 43 pilot counties of the new rural cooperative medical system in Hubei Province, it is stipulated that the poor people who participate in the cooperative medical system should be given assistance by the local civil affairs departments. Changsha County, Wangcheng County, Xiangtan County, Hengyang County, leiyang city City, Changning City and other places in Hunan Province exempt disabled people from individual contributions to the new rural cooperative medical system, and the subsidies are paid by the Finance Bureau and the Civil Affairs Bureau. However, the new rural cooperative medical system also has the following problems: first, the new rural cooperative medical system is still in the pilot stage, and many places have not yet developed, and the disabled in these places still lack institutional guarantee. Second, although some areas have preferential policies to reduce or exempt disabled people, the preferential policies do not cover all poor disabled people, and many poor disabled people are still unable to pay the relevant fees. At present, the disabled people who participate in the new rural cooperative medical system in Wuhan only account for 29% of the rural disabled population. 72%。 Third, the scope and proportion of reimbursement expenses of the new rural cooperative medical system need to be improved. Many medical items closely related to the disabled are not included in the scope of reimbursement, and the proportion of reimbursement items included in the scope of reimbursement is generally low. Fourth, the outpatient expenses for serious illness are not included in the scope of reimbursement.
To this end, the research group put forward the following suggestions:
First, expand the scope of medical assistance, especially local high-incidence diseases and epidemics should be included in the scope of medical assistance, and high-cost medical projects closely related to the disabled should also be included in the scope of medical assistance, such as the medical expenses of the mentally disabled. Constantly improving the subsidy standard of the relief fund can effectively reduce the burden of medical expenses for the disabled.
Two, the new rural cooperative medical system is widely implemented in rural areas, and the expenses that poor disabled people should bear are exempted from local finance. Incorporate medical items closely related to the disabled into the scope of reimbursement of the new rural cooperative medical system and increase the proportion of reimbursement. The outpatient expenses of serious illness will be included in the scope of reimbursement.
Three, all localities should standardize the use of rehabilitation funds, improve the efficiency of the use of rehabilitation funds, and effectively solve the urgent rehabilitation needs faced by the disabled.
Proposal on attaching importance to the education of disabled people and their children
Wang Jianlun, Vice Chairman of Social and Legal Committee of China People's Political Consultative Conference.
From June 5, 2006 to 2006 10, the research group of "Preferential Policies for Disabled People" in the social welfare and social security circles of China People's Political Consultative Conference found that the education of disabled people and their children should be paid attention to and corresponding preferential policies should be introduced.
The main preferential measures taken by various localities for the education of the disabled are as follows: First, to ensure that disabled students have priority to enjoy "two exemptions and one subsidy". Hubei Province gives priority to the inclusion of disabled students in compulsory education in the scope of "two exemptions and one subsidy". According to Wuhan regulations, children of low-income households can enjoy education subsidies, including primary school 100 yuan, junior middle school 350-600 yuan, senior high school 200 yuan, and disabled students. Two, to give a one-time subsidy to poor disabled students who have passed the university, Hubei will reward undergraduates 1000 yuan, junior college students 800 yuan. Wuhan subsidized tuition fees for disabled students, and they were admitted to 800 yuan at a price of 1 000 yuan, a secondary school, a junior college and an undergraduate. Three, some places give priority to the poor students in special education schools into the scope of subsistence allowances.
However, due to various reasons such as economic difficulties and external obstacles, the overall education level of the disabled is low. There are 1 120 illiterate people in Pantang Street, Xinzhou District, Wuhan, accounting for 59% of the total number of disabled people. There are 6 13 people with primary school education, accounting for 32% of the total number of disabled people. 3%, less than 50 people with high school education or above. Most disabled people have not received any vocational skills training, and no one has received higher education. The educational situation of school-age children and adolescents who are blind and deaf is even more worrying. There is still a big gap between the enrollment rate of school-age disabled children and the requirements of compulsory education. Twenty to thirty percent of rural school-age disabled children and adolescents drop out of school because of family poverty. The development of special education schools is unbalanced and the layout is unreasonable. Only three of the six remote urban areas in Wuhan have a special education school. The existing special education schools are far from meeting the educational needs of rural disabled children and adolescents in terms of structure, layout, scale and category, school conditions, funds and teachers, and most rural families are unable to send school-age disabled children to boarding special education schools in other districts or central cities. Compared with Wuhan, the education problems faced by disabled people in other parts of Hubei Province are more prominent, and it is difficult to fully and effectively guarantee their right to education.
The education of disabled children is also very prominent. Due to poor families, many disabled children have to drop out of school before finishing primary school, and many disabled children go out to work before graduating from junior high school. The phenomenon that disabled students and children are generally discriminated against in the process of receiving education is still very serious.
Suggestion:
First, according to the special needs of disabled students in compulsory education, special policies are formulated in terms of living expenses and school supplies.
Second, the state should scientifically develop special education and formulate corresponding preferential measures in the construction of special education schools, teacher training, funding guarantee and curriculum setting. To ensure the healthy development of special education schools and meet the special education needs of disabled students.
Three, according to the characteristics of the disabled, to carry out vocational skills training for the disabled, improve their employability.
Four, the state should introduce corresponding preferential measures to ensure that disabled children can receive relevant education.