China's primary health care reform in 2011 to promote the highlights of frequency

Basic medical insurance for all covers 1.295 billion people. Nearly 8 million retirees from bankruptcy enterprises and employees from difficult enterprises are all included in basic medical insurance. The ratio of individual health expenditure to total health expenditure is reduced by 4.8%, the price of grass-roots medicines is reduced by about 30%, and 41 items are classified into 10 categories. Basic public health services are provided free or on a grant basis...

These eye-catching figures show the remarkable results of medical reform. In the past three years, especially the breakthrough in the reform of primary health care in 2011, the appearance of the primary health care industry has undergone tremendous changes. The grass-roots medical reform has made continuous breakthroughs and achievements and accumulated important experience for the next step of medical reform.

Breakthrough benefits from exploration

The breakthrough in medical reform at the basic level has benefited from pioneering exploration in many places. In order to alleviate the problem of “expensive medical treatment”, in November 2009, the comprehensive reform of the grass-roots medical and health system in Anhui Province was officially launched. The “basket” reformed the management system, personnel, distribution, essential medicines, and security systems at the primary level of medical institutions to make them return to public welfare. .

Anhui Province puts the starting point of medical reform on the sale of zero sales of essential drugs. All the 32 pilot counties (cities, districts) in the province have all basic medical and health institutions run by the government. They have used basic drugs, and 593 kinds of zero-difference medicines have been sold, including 307 kinds of basic medicines for the country, and basic medicines determined in Anhui Province. There are 172 kinds of medicines and 114 kinds of supplemental medicines in urban communities.

These basic medicines and supplemental medicines were purchased by Anhui Province on a centralized and centralized bidding and procurement system at the provincial level, unified prices, and unified distribution. The distribution companies unified basic medicines and supplementary medicines to the primary health care institutions. The basic medicines and supplementary medicines sold by pilot county and district government-run township and township hospitals, community health service agencies, and integrated administrative village clinics are all subject to zero-rate sales and must not be increased in price.

Beijing and Shanghai started earlier in the development of community health services. In 1997, Shanghai launched the standardization of the community health service system. In 2006, it initiated the comprehensive reform of community health. In 2006, Beijing government-run community health agencies implemented zero-dip sales of commonly used drugs. The government centralized bidding and unified distribution. These explorations have created conditions for the comprehensive development of basic medical reform.

Changes benefit from breakthroughs

In medical reform, the old mechanism of “remedying medicine” was broken. In this reform, all basic medical and health institutions are equipped to use basic medicines, sell at a zero margin, and implement centralized drug procurement mechanisms characterized by quantity-price linkage and recruitment. After the “remedy of medicines” was cancelled, the construction and development costs of basic medical and health institutions were financed, and the balance of daily receipts and payments was subsidized by the government. In some places, the pace of implementing income and expenses was accelerated.

With limited financial resources, Jilin has implemented a two-line management model for revenue and expenditure across the province's primary health care facilities since July 1, 2011. It has completely solved the indiscriminate charging and chaos of grassroots medical and health institutions from the operating mechanism. Question of increase.

Shanghai districts and counties have established community health service management agencies, set up special accounts for revenue and expenditure management, and strengthened management of income and expenses in community health service centers. The Xinjiang Uygur Autonomous Region’s finances provide full protection for the personnel and public funds of the township hospitals. Shihezi City, the 8th Agricultural Division of the Xinjiang Production and Construction Corps, implemented all zero-difference sales of medicines in the medical insurance catalog, benefiting 1.85 million people in the agricultural and animal husbandry group, accounting for 72% of the total population of the XPCC.

Achievements benefit from change

After the medical reform, the most intuitive change for people is that the service capacity of grass-roots medical and health institutions has obviously increased. Many hospitals and clinics are bright and spacious, warm and comfortable.

Before the reform, the primary medical and health institutions mainly depended on self-income, and many institutions were in debt and even directly affected the provision of basic medical and health services.

In this medical reform, the central government has invested more than 60 billion yuan to strengthen the standardization of grass-roots medical and health service systems. This is the period with the largest investment, the largest construction scale, and the most obvious improvement of conditions. In Inner Mongolia, starting from the characteristics of population sparsely populated, the project “Family Medicine Boxes Entering Pastoral Households” was implemented to solve the problem of “difficulties in seeing a doctor and getting medical treatment” in herdsmen living in pastoral areas far away from towns; in Jiangxi, the long-term implementation mechanism of “bright smile” project was implemented. For the patients, they brought hope for life; in Hubei, the residents have healthy cards and achieved the participation of farmers in the fixed-point medical institutions to get medical treatment and instant settlement.

One item of innovation system, one by one, was a practical measure, in exchange for a smile, and a group of groups included the figures of the achievements of the medical reform.

The government subsidy standard for new rural cooperative medical insurance and urban residents' medical insurance increased from 80 yuan per person in 2009 to 200 yuan in 2011. The proportion of inpatient reimbursement within the policy range has increased from 40%-50% in 2008 to 70% in 2011...

The effectiveness of medical reform is ultimately reflected in reducing the burden on the people, improving service quality, and improving health.

People have reason to believe that with the gradual advancement of medical reform, every exploration will break through a bottleneck. Each breakthrough will show a change, and every change will benefit more people. (Reporter Wang Hao)