文章來源：考核(he)分配局 發布時間：2020-10-12
《關于提高國(guo)有企(qi)業病退職工(gong)待遇修改相(xiang)關條款的建議》（第1977號）收(shou)悉，經商人力資源社會保障部、財(cai)政部，現答(da)復如(ru)下：
一、基本情況
黨中央(yang)、國(guo)務(wu)院(yuan)歷來高(gao)度重(zhong)視(shi)人民群眾的(de)(de)(de)(de)醫(yi)(yi)療保(bao)(bao)(bao)(bao)(bao)障工作(zuo)，《中共中央(yang) 國(guo)務(wu)院(yuan)關于(yu)深化醫(yi)(yi)藥衛生體(ti)制(zhi)改(gai)革的(de)(de)(de)(de)意見》（中發(fa)(fa)〔2009〕6號(hao)）提出，要(yao)加快建(jian)立和完善(shan)以(yi)基(ji)(ji)本(ben)(ben)醫(yi)(yi)療保(bao)(bao)(bao)(bao)(bao)障為(wei)主體(ti)，其(qi)他多種(zhong)形式補充醫(yi)(yi)療保(bao)(bao)(bao)(bao)(bao)險和商業(ye)(ye)(ye)健(jian)(jian)康(kang)保(bao)(bao)(bao)(bao)(bao)險為(wei)補充，覆蓋城鄉居民的(de)(de)(de)(de)多層次(ci)醫(yi)(yi)療保(bao)(bao)(bao)(bao)(bao)障體(ti)系。《國(guo)務(wu)院(yuan)關于(yu)印發(fa)(fa)“十三五”深化醫(yi)(yi)藥衛生體(ti)制(zhi)改(gai)革規劃(hua)的(de)(de)(de)(de)通知》（國(guo)發(fa)(fa)〔2016〕78號(hao)）規定，要(yao)按照保(bao)(bao)(bao)(bao)(bao)基(ji)(ji)本(ben)(ben)、兜底線、可持續的(de)(de)(de)(de)原則，建(jian)立起較為(wei)完善(shan)的(de)(de)(de)(de)基(ji)(ji)本(ben)(ben)醫(yi)(yi)保(bao)(bao)(bao)(bao)(bao)、大(da)(da)(da)病(bing)(bing)保(bao)(bao)(bao)(bao)(bao)險、醫(yi)(yi)療救(jiu)助、疾病(bing)(bing)應急(ji)救(jiu)助、商業(ye)(ye)(ye)健(jian)(jian)康(kang)保(bao)(bao)(bao)(bao)(bao)險和慈善(shan)救(jiu)助銜接互(hu)(hu)動、相互(hu)(hu)聯(lian)通機制(zhi)。健(jian)(jian)全(quan)重(zhong)特(te)大(da)(da)(da)疾病(bing)(bing)保(bao)(bao)(bao)(bao)(bao)障機制(zhi)，在全(quan)面(mian)(mian)實施城鄉居民大(da)(da)(da)病(bing)(bing)保(bao)(bao)(bao)(bao)(bao)險基(ji)(ji)礎上，采(cai)取降低起付線、提高(gao)報銷比(bi)例、合理確(que)定合規醫(yi)(yi)療費用(yong)范圍等(deng)措施，提高(gao)大(da)(da)(da)病(bing)(bing)保(bao)(bao)(bao)(bao)(bao)險對困難群眾支(zhi)付的(de)(de)(de)(de)精準性。完善(shan)職工補充醫(yi)(yi)療保(bao)(bao)(bao)(bao)(bao)險政策，全(quan)面(mian)(mian)開展重(zhong)特(te)大(da)(da)(da)疾病(bing)(bing)醫(yi)(yi)療救(jiu)助工作(zuo)，將低收(shou)入救(jiu)助對象以(yi)及(ji)因(yin)病(bing)(bing)致貧家(jia)庭重(zhong)病(bing)(bing)患者納(na)入救(jiu)助范圍，發(fa)(fa)揮(hui)托底保(bao)(bao)(bao)(bao)(bao)障作(zuo)用(yong)。在國(guo)家(jia)規定的(de)(de)(de)(de)政策范圍內，各省（區(qu)、市）也出臺了城鄉居民醫(yi)(yi)療保(bao)(bao)(bao)(bao)(bao)障方面(mian)(mian)的(de)(de)(de)(de)政策規定。這些(xie)政策也適(shi)用(yong)于(yu)國(guo)有企業(ye)(ye)(ye)職工，對提高(gao)國(guo)有企業(ye)(ye)(ye)職工醫(yi)(yi)療保(bao)(bao)(bao)(bao)(bao)障水平(ping)，解決(jue)因(yin)病(bing)(bing)致貧等(deng)問題(ti)，具有積極作(zuo)用(yong)。
二、關于國有企業病退職工待遇的(de)有關問題
（一）關于職工患病期間工資(zi)待遇問題。
根據原(yuan)勞(lao)動(dong)部(bu)(bu)(bu)《關(guan)于(yu)(yu)發(fa)(fa)布<企(qi)業(ye)職工(gong)(gong)(gong)(gong)患(huan)病(bing)(bing)(bing)(bing)(bing)或(huo)(huo)(huo)(huo)非(fei)因(yin)工(gong)(gong)(gong)(gong)負(fu)傷(shang)(shang)醫(yi)療(liao)期(qi)(qi)規(gui)定(ding)(ding)>的(de)(de)(de)(de)(de)(de)(de)通(tong)知》（勞(lao)部(bu)(bu)(bu)發(fa)(fa)〔1994〕479號）和《關(guan)于(yu)(yu)貫(guan)徹<企(qi)業(ye)職工(gong)(gong)(gong)(gong)患(huan)病(bing)(bing)(bing)(bing)(bing)或(huo)(huo)(huo)(huo)非(fei)因(yin)工(gong)(gong)(gong)(gong)負(fu)傷(shang)(shang)醫(yi)療(liao)期(qi)(qi)規(gui)定(ding)(ding)>的(de)(de)(de)(de)(de)(de)(de)通(tong)知》（勞(lao)部(bu)(bu)(bu)發(fa)(fa)〔1995〕236號），職工(gong)(gong)(gong)(gong)患(huan)病(bing)(bing)(bing)(bing)(bing)或(huo)(huo)(huo)(huo)非(fei)因(yin)工(gong)(gong)(gong)(gong)負(fu)傷(shang)(shang)，根據本(ben)人(ren)實際參加工(gong)(gong)(gong)(gong)作年(nian)限(xian)和本(ben)企(qi)業(ye)工(gong)(gong)(gong)(gong)作年(nian)限(xian)長短，享(xiang)受3-24個月的(de)(de)(de)(de)(de)(de)(de)醫(yi)療(liao)期(qi)(qi)。對(dui)于(yu)(yu)某些患(huan)特殊疾病(bing)(bing)(bing)(bing)(bing)（如癌癥、精神病(bing)(bing)(bing)(bing)(bing)、癱瘓等）的(de)(de)(de)(de)(de)(de)(de)職工(gong)(gong)(gong)(gong)，在24個月內尚不(bu)(bu)能痊愈(yu)的(de)(de)(de)(de)(de)(de)(de)，經企(qi)業(ye)和當(dang)(dang)(dang)地勞(lao)動(dong)部(bu)(bu)(bu)門批準(zhun)(zhun)，可以(yi)適當(dang)(dang)(dang)延長醫(yi)療(liao)期(qi)(qi)。根據原(yuan)勞(lao)動(dong)部(bu)(bu)(bu)《關(guan)于(yu)(yu)貫(guan)徹執(zhi)行<中華人(ren)民(min)共和國勞(lao)動(dong)法(fa)(fa)>若干問題的(de)(de)(de)(de)(de)(de)(de)意見》（勞(lao)部(bu)(bu)(bu)發(fa)(fa)〔1995〕309號），職工(gong)(gong)(gong)(gong)患(huan)病(bing)(bing)(bing)(bing)(bing)或(huo)(huo)(huo)(huo)非(fei)因(yin)工(gong)(gong)(gong)(gong)負(fu)傷(shang)(shang)治(zhi)療(liao)期(qi)(qi)間(jian)，在規(gui)定(ding)(ding)的(de)(de)(de)(de)(de)(de)(de)醫(yi)療(liao)期(qi)(qi)間(jian)由(you)企(qi)業(ye)按(an)有關(guan)規(gui)定(ding)(ding)支(zhi)付(fu)其病(bing)(bing)(bing)(bing)(bing)假(jia)工(gong)(gong)(gong)(gong)資(zi)(zi)(zi)(zi)或(huo)(huo)(huo)(huo)疾病(bing)(bing)(bing)(bing)(bing)救濟費，病(bing)(bing)(bing)(bing)(bing)假(jia)工(gong)(gong)(gong)(gong)資(zi)(zi)(zi)(zi)或(huo)(huo)(huo)(huo)疾病(bing)(bing)(bing)(bing)(bing)救濟費可以(yi)低于(yu)(yu)當(dang)(dang)(dang)地最低工(gong)(gong)(gong)(gong)資(zi)(zi)(zi)(zi)標(biao)準(zhun)(zhun)支(zhi)付(fu)，但不(bu)(bu)能低于(yu)(yu)最低工(gong)(gong)(gong)(gong)資(zi)(zi)(zi)(zi)標(biao)準(zhun)(zhun)的(de)(de)(de)(de)(de)(de)(de)80%。目(mu)前，病(bing)(bing)(bing)(bing)(bing)假(jia)期(qi)(qi)間(jian)工(gong)(gong)(gong)(gong)資(zi)(zi)(zi)(zi)待遇(yu)的(de)(de)(de)(de)(de)(de)(de)具體標(biao)準(zhun)(zhun)，由(you)各地人(ren)民(min)政府(fu)結合當(dang)(dang)(dang)地實際制定(ding)(ding)，企(qi)業(ye)可根據自身的(de)(de)(de)(de)(de)(de)(de)經營情況(kuang)，在不(bu)(bu)低于(yu)(yu)當(dang)(dang)(dang)地法(fa)(fa)定(ding)(ding)標(biao)準(zhun)(zhun)的(de)(de)(de)(de)(de)(de)(de)情況(kuang)下(xia)，確(que)(que)定(ding)(ding)本(ben)企(qi)業(ye)的(de)(de)(de)(de)(de)(de)(de)標(biao)準(zhun)(zhun)，如廣東(dong)省(sheng)、江(jiang)蘇(su)省(sheng)、北京市(shi)等省(sheng)市(shi)規(gui)定(ding)(ding)，勞(lao)動(dong)者(zhe)(zhe)(zhe)在國家規(gui)定(ding)(ding)醫(yi)療(liao)期(qi)(qi)內的(de)(de)(de)(de)(de)(de)(de)，用(yong)(yong)人(ren)單(dan)位應當(dang)(dang)(dang)按(an)照勞(lao)動(dong)合同、集體合同的(de)(de)(de)(de)(de)(de)(de)約(yue)(yue)定(ding)(ding)或(huo)(huo)(huo)(huo)者(zhe)(zhe)(zhe)國家有關(guan)規(gui)定(ding)(ding)，向勞(lao)動(dong)者(zhe)(zhe)(zhe)支(zhi)付(fu)病(bing)(bing)(bing)(bing)(bing)假(jia)工(gong)(gong)(gong)(gong)資(zi)(zi)(zi)(zi)或(huo)(huo)(huo)(huo)者(zhe)(zhe)(zhe)疾病(bing)(bing)(bing)(bing)(bing)救濟費；陜西省(sheng)、深圳(zhen)市(shi)、青島市(shi)等省(sheng)市(shi)規(gui)定(ding)(ding)用(yong)(yong)人(ren)單(dan)位應當(dang)(dang)(dang)按(an)照不(bu)(bu)低于(yu)(yu)本(ben)人(ren)標(biao)準(zhun)(zhun)工(gong)(gong)(gong)(gong)資(zi)(zi)(zi)(zi)（或(huo)(huo)(huo)(huo)勞(lao)動(dong)合同約(yue)(yue)定(ding)(ding)工(gong)(gong)(gong)(gong)資(zi)(zi)(zi)(zi)標(biao)準(zhun)(zhun)）的(de)(de)(de)(de)(de)(de)(de)60%-70%支(zhi)付(fu)員工(gong)(gong)(gong)(gong)病(bing)(bing)(bing)(bing)(bing)傷(shang)(shang)假(jia)期(qi)(qi)工(gong)(gong)(gong)(gong)資(zi)(zi)(zi)(zi)。這些規(gui)定(ding)(ding)也適用(yong)(yong)于(yu)(yu)國有企(qi)業(ye)職工(gong)(gong)(gong)(gong)。您(nin)在建(jian)議中提(ti)出的(de)(de)(de)(de)(de)(de)(de)進一步出臺較為詳細的(de)(de)(de)(de)(de)(de)(de)實施細則和辦法(fa)(fa)等問題，我們將積(ji)極(ji)建(jian)議業(ye)務主管部(bu)(bu)(bu)門進行研(yan)究，在國家政策范圍內，指導(dao)國有企(qi)業(ye)合理確(que)(que)定(ding)(ding)職工(gong)(gong)(gong)(gong)患(huan)病(bing)(bing)(bing)(bing)(bing)期(qi)(qi)間(jian)工(gong)(gong)(gong)(gong)資(zi)(zi)(zi)(zi)待遇(yu)。同時，鼓勵企(qi)業(ye)將職工(gong)(gong)(gong)(gong)患(huan)病(bing)(bing)(bing)(bing)(bing)期(qi)(qi)間(jian)工(gong)(gong)(gong)(gong)資(zi)(zi)(zi)(zi)標(biao)準(zhun)(zhun)作為集體協商的(de)(de)(de)(de)(de)(de)(de)內容。
（二）關于加(jia)強國有企業(ye)患病職工醫(yi)療保險保障力度(du)問(wen)題。
按照目(mu)前(qian)政(zheng)策，國(guo)有(you)企(qi)業(ye)(ye)(ye)職(zhi)(zhi)工(gong)通(tong)過(guo)參(can)加職(zhi)(zhi)工(gong)醫(yi)(yi)(yi)保(bao)(bao)(bao)獲得(de)基(ji)本(ben)醫(yi)(yi)(yi)療(liao)保(bao)(bao)(bao)障。對于(yu)(yu)職(zhi)(zhi)工(gong)醫(yi)(yi)(yi)保(bao)(bao)(bao)報(bao)銷(xiao)外的(de)(de)費(fei)用(yong)(yong)(yong)(yong)，其所在單位還(huan)可通(tong)過(guo)為其購買(mai)商業(ye)(ye)(ye)醫(yi)(yi)(yi)療(liao)保(bao)(bao)(bao)險或(huo)建(jian)立補(bu)充(chong)醫(yi)(yi)(yi)療(liao)保(bao)(bao)(bao)險等(deng)方式給(gei)予補(bu)充(chong)保(bao)(bao)(bao)障。企(qi)業(ye)(ye)(ye)根據(ju)國(guo)家(jia)有(you)關政(zheng)策規(gui)(gui)定，為在本(ben)企(qi)業(ye)(ye)(ye)任職(zhi)(zhi)或(huo)者受雇的(de)(de)全體(ti)員工(gong)支付(fu)的(de)(de)補(bu)充(chong)醫(yi)(yi)(yi)療(liao)保(bao)(bao)(bao)險費(fei)，在不超過(guo)職(zhi)(zhi)工(gong)工(gong)資(zi)總額(e)5%標準(zhun)內(nei)的(de)(de)部分，在計算應納稅(shui)所得(de)額(e)時準(zhun)予扣除。同時根據(ju)《國(guo)務院辦公(gong)廳轉發(fa)(fa)民政(zheng)部等(deng)部門關于(yu)(yu)進一步(bu)完善(shan)醫(yi)(yi)(yi)療(liao)救助(zhu)制度全面開(kai)展(zhan)重特大(da)疾病醫(yi)(yi)(yi)療(liao)救助(zhu)工(gong)作意見的(de)(de)通(tong)知(zhi)》（國(guo)辦發(fa)(fa)〔2015〕30號），可對發(fa)(fa)生(sheng)高額(e)醫(yi)(yi)(yi)療(liao)費(fei)用(yong)(yong)(yong)(yong)、超過(guo)家(jia)庭(ting)承受能力(li)、基(ji)本(ben)生(sheng)活出現(xian)嚴重困難(nan)家(jia)庭(ting)中的(de)(de)重病患者實施救助(zhu)，對重點(dian)救助(zhu)對象(xiang)和低(di)收入救助(zhu)對象(xiang)經(jing)基(ji)本(ben)醫(yi)(yi)(yi)療(liao)保(bao)(bao)(bao)險、城鄉居民大(da)病保(bao)(bao)(bao)險及各類補(bu)充(chong)醫(yi)(yi)(yi)療(liao)保(bao)(bao)(bao)險、商業(ye)(ye)(ye)保(bao)(bao)(bao)險等(deng)報(bao)銷(xiao)后個人負擔的(de)(de)合規(gui)(gui)醫(yi)(yi)(yi)療(liao)費(fei)用(yong)(yong)(yong)(yong)，直(zhi)接予以救助(zhu)，多數(shu)省（區、市(shi)）也(ye)相應出臺了(le)因病致(zhi)貧家(jia)庭(ting)醫(yi)(yi)(yi)療(liao)救助(zhu)辦法。此(ci)外，對于(yu)(yu)符合條件的(de)(de)特殊困難(nan)職(zhi)(zhi)工(gong)，還(huan)可申請全國(guo)總工(gong)會等(deng)開(kai)展(zhan)的(de)(de)職(zhi)(zhi)工(gong)醫(yi)(yi)(yi)療(liao)互助(zhu)幫扶(fu)。總體(ti)上看(kan)，伴隨(sui)著醫(yi)(yi)(yi)療(liao)衛生(sheng)事業(ye)(ye)(ye)的(de)(de)發(fa)(fa)展(zhan)和醫(yi)(yi)(yi)療(liao)改革的(de)(de)深(shen)化，我國(guo)醫(yi)(yi)(yi)療(liao)保(bao)(bao)(bao)障體(ti)系不斷完善(shan)，現(xian)行制度已經(jing)為國(guo)有(you)企(qi)業(ye)(ye)(ye)患病職(zhi)(zhi)工(gong)醫(yi)(yi)(yi)療(liao)費(fei)用(yong)(yong)(yong)(yong)提(ti)供了(le)解決渠道(dao)，對保(bao)(bao)(bao)障國(guo)有(you)企(qi)業(ye)(ye)(ye)職(zhi)(zhi)工(gong)的(de)(de)身體(ti)健(jian)康起到了(le)重要作用(yong)(yong)(yong)(yong)。您提(ti)出的(de)(de)建(jian)立大(da)病醫(yi)(yi)(yi)療(liao)救助(zhu)基(ji)金等(deng)建(jian)議，我們將積極配(pei)合業(ye)(ye)(ye)務主管部門，通(tong)過(guo)完善(shan)現(xian)有(you)制度，提(ti)升包括國(guo)有(you)企(qi)業(ye)(ye)(ye)患病職(zhi)(zhi)工(gong)在內(nei)的(de)(de)參(can)保(bao)(bao)(bao)職(zhi)(zhi)工(gong)基(ji)本(ben)醫(yi)(yi)(yi)療(liao)保(bao)(bao)(bao)障水平，將其個人負擔控制在家(jia)庭(ting)可承受范圍內(nei)。
（三）關于完善國(guo)有企業職(zhi)工(gong)退(tui)休政策問題(ti)。
社會(hui)保(bao)(bao)險(xian)遵循權利義務(wu)相(xiang)對應的(de)(de)(de)(de)原則，單位(wei)和(he)(he)個人應依法繳納(na)社會(hui)保(bao)(bao)險(xian)費(fei)，才能(neng)享受相(xiang)應的(de)(de)(de)(de)社會(hui)保(bao)(bao)險(xian)待(dai)遇。《中華人民共和(he)(he)國(guo)(guo)(guo)社會(hui)保(bao)(bao)險(xian)法》規定，參加基本(ben)養(yang)(yang)老(lao)保(bao)(bao)險(xian)的(de)(de)(de)(de)個人，達(da)到法定退休(xiu)(xiu)年(nian)齡時(shi)(shi)累計繳費(fei)滿十五年(nian)的(de)(de)(de)(de)，按月(yue)領(ling)取基本(ben)養(yang)(yang)老(lao)金。根據1953年(nian)修訂的(de)(de)(de)(de)《中華人民共和(he)(he)國(guo)(guo)(guo)勞(lao)(lao)(lao)動(dong)(dong)保(bao)(bao)險(xian)條例(li)》和(he)(he)《國(guo)(guo)(guo)務(wu)院(yuan)關于(yu)(yu)(yu)頒發(fa)<國(guo)(guo)(guo)務(wu)院(yuan)關于(yu)(yu)(yu)安置(zhi)老(lao)弱病(bing)(bing)(bing)殘干(gan)部暫行辦法>和(he)(he)<國(guo)(guo)(guo)務(wu)院(yuan)關于(yu)(yu)(yu)工(gong)人退休(xiu)(xiu)、退職(zhi)的(de)(de)(de)(de)暫行辦法>的(de)(de)(de)(de)通知》（國(guo)(guo)(guo)發(fa)〔1978〕104號），企業職(zhi)工(gong)男(nan)60周(zhou)歲(sui)(sui)(sui)、女干(gan)部55周(zhou)歲(sui)(sui)(sui)、女工(gong)人50周(zhou)歲(sui)(sui)(sui)應當(dang)退休(xiu)(xiu)；同時(shi)(shi)，因(yin)病(bing)(bing)(bing)或非(fei)因(yin)工(gong)致殘、由醫院(yuan)證(zheng)明并經勞(lao)(lao)(lao)動(dong)(dong)鑒(jian)(jian)定委員會(hui)確(que)認(ren)完全(quan)喪(sang)失(shi)勞(lao)(lao)(lao)動(dong)(dong)能(neng)力(li)的(de)(de)(de)(de)，退休(xiu)(xiu)年(nian)齡為(wei)男(nan)滿50周(zhou)歲(sui)(sui)(sui)、女滿45周(zhou)歲(sui)(sui)(sui)。參加企業職(zhi)工(gong)基本(ben)養(yang)(yang)老(lao)保(bao)(bao)險(xian)的(de)(de)(de)(de)國(guo)(guo)(guo)有企業職(zhi)工(gong)，符合條件(jian)的(de)(de)(de)(de)可(ke)以辦理病(bing)(bing)(bing)退，按月(yue)領(ling)取基本(ben)養(yang)(yang)老(lao)金。關于(yu)(yu)(yu)病(bing)(bing)(bing)退鑒(jian)(jian)定問題，根據原勞(lao)(lao)(lao)動(dong)(dong)部《關于(yu)(yu)(yu)印發(fa)<職(zhi)工(gong)非(fei)因(yin)工(gong)傷殘或因(yin)病(bing)(bing)(bing)喪(sang)失(shi)勞(lao)(lao)(lao)動(dong)(dong)能(neng)力(li)程度(du)鑒(jian)(jian)定標準(zhun)（試行）>的(de)(de)(de)(de)通知》（勞(lao)(lao)(lao)社部發(fa)〔2002〕8號），勞(lao)(lao)(lao)動(dong)(dong)者由于(yu)(yu)(yu)非(fei)因(yin)工(gong)傷殘或因(yin)病(bing)(bing)(bing)后，于(yu)(yu)(yu)醫療期滿或醫療終結(jie)時(shi)(shi)對傷殘失(shi)能(neng)程度(du)做出判定結(jie)論的(de)(de)(de)(de)準(zhun)則和(he)(he)依據，統(tong)一了分類標準(zhun)，明確(que)了病(bing)(bing)(bing)退條件(jian)，規范了病(bing)(bing)(bing)退鑒(jian)(jian)定工(gong)作。您提出的(de)(de)(de)(de)建(jian)(jian)立養(yang)(yang)老(lao)保(bao)(bao)險(xian)基金補償機制、改革病(bing)(bing)(bing)退工(gong)作管理模(mo)式等建(jian)(jian)議，我(wo)們將積極配合業務(wu)主管部門，進一步研究完善相(xiang)關政策。
國 資 委
2019年7月15日