Two weeks of intensive medical and health reforms

In just two weeks, three supporting documents to deepen the reform of the medical and health system were issued intensively.

On December 14, the "Opinions of the General Office of the State Council on Establishing and Perfecting the Compensation Mechanism for Basic Medical and Health Institutions" (hereinafter referred to as the "Opinions") was officially announced. Since the beginning of this month, there have been documents such as encouraging social capital to set up medical and health institutions and establishing and regulating basic drug procurement mechanisms.

The recently held Central Economic Work Conference emphasized that five key reforms in the medical and health system must be solidly promoted, and that the basic drug system must be properly established and the public hospital reform pilot should be accelerated to ensure that the people's medications are safe, effective, reasonably priced, and accessible, and adhere to the public. The public welfare nature of health care provides the people with basic medical and health services.

From the above three documents, we have involved five key tasks: accelerating the development of the basic medical security system, establishing a preliminary national drug system, improving the primary medical and health service system, and promoting the gradual equalization and promotion of basic public health services. Public hospital reform pilot.

The “Opinions on Further Encouraging and Guiding Social Capital to Organize Medical Institutions” focuses on eliminating policy barriers that hinder the development of non-public medical institutions.

The Standing Conference of the State Council held on December 6 deployed measures to establish and improve the compensation mechanism for primary health care institutions.

At present, 50% of grass-roots medical and health institutions in the country have implemented a basic drug system and implemented zero-salty drug sales, completely changing the mechanism of “taking drugs to support medical care” at grass-roots medical and health institutions, which has significantly eased the burden of drug use by the masses, but at the same time Grass-roots medical and health institutions have seen a large gap in revenue and expenditure.

“The government only paid for the salaries of employees, and other operations of the community health service centers needed to be supported on their own,” said Han Xin, director of the Dewai Community Health Service Center in Xicheng District, Beijing, in an interview with the reporter.

The “Opinions” clearly stated that after the implementation of the basic drug system, the operating costs of personnel expenditures and business expenses of the township hospitals and urban community health service institutions held by the government were compensated through service fees and government subsidies. At the same time, funds for basic public health services are implemented. In 2010, governments at all levels must implement basic public health service funding at a rate of no less than 15 yuan per capita. From 2011 onwards, they will further increase the per capita funding standard and establish a stable basic public health service funding guarantee mechanism.

However, the current situation in some localities is that after the implementation of the essential medicine system, due to inadequate supporting measures, difficulties have arisen in the operation of basic medical institutions.

Far away from the Fengjie Community Health Service Station in Xiajian Town, Baoying County, Jiangsu, a staff member stated that their drug income accounted for 50% to 60% of the total income, but the government subsidy was only 30%. In addition, they are still faced with the flaw of 15 yuan per capita basic public health service funding.

In the view of some people in the industry, in the process of deepening medical reform, if the supporting measures are not perfect, it will affect the effectiveness of the basic drug system.

The "Guidelines for Establishing and Regulating the Basic Drug Purchase Mechanism for Basic Medical and Health Institutions by the Government" (hereinafter referred to as the "Procurement Mechanism") is another measure.

Previously, there was no harmonization across the country regarding the way medicines were tendered for procurement. A staff member in charge of drug procurement in a certain place told reporters that there are currently two methods for the procurement of medicines, one for the primary medical institutions to purchase on their own, and the other for the centralized procurement by the county government.

Therefore, high-priced drugs still have room for survival.

The "Procurement Mechanism" stipulates that centralized procurement and unified distribution shall be implemented in provinces (autonomous regions and municipalities) as a unit; government-led and market-based mechanisms shall be adhered to, and the advantages of centralized bulk procurement shall be brought into play, tendering and procurement shall be combined, and quantity and price shall be linked and contracts signed. Complete the entire procurement process at one time, minimize procurement costs, achieve basic safe and effective drugs, good quality, reasonable prices, and timely supply.

"The introduction of this policy is a good thing. In the end it can play a big role, but also need to see how to land." Wang Bo, vice president of the China Pharmaceutical Enterprise Management Association, said in an interview with reporters.