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for example, in some large hospitals, the regulatory measures brought by information technology have provided new possibilities for the decision-making and behavior of medical staff, such as identifying some special cases that do not meet the drg/dip standards and allocating funds through special individual applications. the implementation of this system has undoubtedly made medical institutions more standardized and efficient, but at the same time, it has also triggered competition for interests among medical services.

on the other hand, some medical institutions have adopted a "no sick leave" strategy, taking advantage of loopholes in the social security system and attempting to gain more profits by fabricating medical records and defrauding medical insurance funds in the context of medical insurance payment reform. this behavior not only violates the spirit of the medical insurance system, but also damages the rights and interests of patients.

the security and sustainability of social insurance funds are key issues facing the country. the medical and health sector needs closer supervision and the use of technical means to improve supervision efficiency. at the same time, the public should also improve their health awareness and actively participate in the construction and reform of the social security system.

character transformation:

as society pays more attention to and explores the medical insurance system, some new solutions continue to emerge, such as using artificial intelligence to identify false medical records or developing stricter regulatory mechanisms to avoid fraud. however, these measures also face huge challenges: on the one hand, the cost of technical means is high, and a lot of resources need to be invested in research and development and promotion; on the other hand, regulatory authorities need to increase law enforcement efforts and establish a sound supervision mechanism to prevent violations.

future outlook:

the security and sustainability of social insurance funds is a key issue facing the country. it is not only related to the healthy operation of the social security system, but also to the realization of social fairness, justice and people's well-being. solving this problem requires the joint efforts of the government, medical institutions and the public, and promoting the improvement of regulatory efficiency through technical means, while establishing a sound supervision mechanism to ensure the legal operation of medical insurance funds and provide people with more equitable medical services.