New medical reform point "bright" keywords
On April 7, the State Council's "Key Implementation Plan for the Reform of the Medical and Health System (2009-2011)" was promulgated. This program proposes to promote five key reforms, and strives to solve the problem of “difficult to see a doctor and expensive to see a doctor”, which is reflected by the masses, and promotes a comprehensive reform of the medical and health system.
Medical reform is a social system project. It requires not only multi-sectoral efforts, but also five key points. The five key points are like the five fingers of a person. They are indispensable. Which finger is slightly uncomfortable, and other fingers will be affected. Five fingers into a fist, the new medical reform to form a joint force, in order to benefit the people.
Medical insurance coverage
Zheng Bingwen (Director and Professor of the Latin American Institute of the Chinese Academy of Social Sciences): The key to cracking the problem of “expensive medical treatment” is not only to control the price of medicines, but to increase the level of reimbursement and reduce the proportion of personal payments after establishing a medical insurance system. A society without a perfect social security system is certainly not a harmonious society. The coverage of the social security system is small, or the urban and rural areas are fragmented, and a fragmentation system with a large gap in the level of treatment will be formed. Improve the basic medical security system, the purpose is to reduce the proportion of personal medical expenses. This is a sign of the progress of social civilization.
Off-site medical insurance
Han Keqing (Associate Professor, Renmin University of China): The medical insurance in different places not only involves the problem of retiring old people in different places, but also the problem of migrant workers. Resolving medical insurance in different places is not only a problem at the technical level, but also a problem at the institutional level. Establish a basic medical security system covering urban and rural residents, and integrate urban and rural residents, towns and villages together, and narrow the gap between urban and rural areas. This is the direction of the construction of the medical insurance system.
Essential drug reimbursement
Wu Yongpei (Professor, Hospital Management Research Institute, Ministry of Health): The basic drug system is a relatively common form in the world and plays an important role in lowering drug prices and ensuring the supply of essential drugs. The national essential medicines system is at the heart of the national drug policy. Its selected national essential medicines list was developed for the medical needs of major diseases. Essential medicines are the most basic and essential medicines needed for primary health care. In order to implement the national essential medicine system, it is necessary to formulate a national drug formulary, a national essential medicine list and a clinical diagnosis and treatment guide. It is reported that the Ministry of Health has organized relevant experts in medicine to formulate these policies and technical specifications one by one. A new version of the National Essential Drugs List will be announced soon; the national drug formulary has been initiated. The clinical diagnosis and treatment guidelines should first establish the “Guidelines for the Standard Treatment of Antibiotics”, and on this basis, gradually expand to the diagnosis and treatment guidelines for other clinical special diseases, and push them to medical institutions for implementation.
Essential drug supply guarantee
Xu Jiaqi (Deputy Director of the State Food and Drug Administration): Bidding and procurement of essential drugs is not only for competing on drug prices. From the perspective of realizing the safety and effectiveness of essential drugs, it is more important to implement open tendering and procurement and unified distribution. The purpose is to ensure the quality of essential drugs. There are many pharmaceutical production and management companies in China. There are differences in the quality control capabilities and the level of risk control between pharmaceutical production and operation enterprises. The implementation of tender procurement is also a tender for the quality and capacity of pharmaceutical production and operation. It is necessary to bid for enterprises with high social integrity, good quality management, and strong product risk control to produce and distribute basic drugs, and to ensure the safety and effectiveness of essential drugs in production and distribution.
Primary medical staff treatment
Liu Xinming (Director, Policy and Regulation Department of the Ministry of Health): It is difficult to see the doctor at the "two ends", that is, remote rural areas and large city hospitals. The root cause lies in the uneven distribution of medical resources. To solve this problem, it is necessary to “soft and hard” from the aspects of equipment and talents, and to allocate medical resources in a balanced manner. Through the pilot promotion of the “resident physician training system”, rural doctors and grassroots doctors will enter the large hospital for training, and then walk out of the hospital to the grassroots level to effectively alleviate the difficulty of seeing a doctor in rural areas and communities.
Basic public health services
Bai Chongen (Professor, School of Economics and Management, Tsinghua University): Achieving equalization of public health services is not only the starting point for medical reform, but also the end point for everyone to enjoy basic medical and health services. It is an international practice to establish a public health service system to provide public health protection for residents. In the process of promoting equalization, we must focus on solving the gap in service quality. It is necessary to fundamentally establish a new mode of co-ordinating urban and rural health financing and input, to achieve balanced urban and rural health development, and to ensure that urban and rural medical and health institutions provide equal services and receive equal compensation.
Major public health services
Ren Wenjie (Dean of Henan Pingmei Medical Group General Hospital): The cost of public health services is low and the effect is good, but it is also a service with a relatively long return period of social benefits. The establishment of a national major public health service project, public health investment is no longer a single project, nor is it set up to deal with public health emergencies or certain public diseases. This is an important step in the construction of a long-term public health mechanism.
"Remedy with medicine"
Xu Shuqiang (President of the China-Japan Friendship Hospital of the Ministry of Health): Reforming the compensation mechanism of public hospitals, the purpose is to gradually solve the "medical supplementation" mechanism and cut off the interest relationship between hospitals, doctors and drug purchases and sales. As a carrier of government functions, public hospitals should pursue the government's social public welfare goals, but perfecting the compensation mechanism is the fundamental guarantee for realizing public welfare. To fundamentally reverse the mechanism of "medical supplementation with medicine", it is necessary to implement various measures such as the establishment of medical service fees, appropriate adjustment of the price of some medical technology services, increase of financial input, and reform of payment methods for social medical insurance. Make medical services reasonablely compensated. If there is no reasonable compensation mechanism, it is only for public hospitals to subsidize the patient's medical expenses by using the drug-added income and inspection income. The realization of public welfare in public hospitals is an empty talk.