After reading the part of the government work report related to medical care this year (see the end of the article), I deeply feel that China's medical reform is still playing in deep water. The key points involved in these 365 words are so familiar: three medical linkages, medical insurance payment reform, medical service price reform, personnel compensation system reform and social medical treatment.
This is the oldest medical reform since the Third Plenary Session of the 18th CPC Central Committee. Repeated emphasis also means that these reforms are more difficult, the chain of interest is deeper, and the process of advancement is longer.
First of all, the burden on medical insurance is even heavier. Direct pressure is how to ensure the safety of funds. After the reform of medical service prices and the reform of the drug circulation field, more detailed and more standard medical insurance payment schemes are needed. The more neutral and broad integration of urban and rural residents' basic medical insurance integration plan has been announced. How to rationalize the management system in various places may increase the difficulty of solving the problems jointly by the three central departments.
In terms of medical price reform, the national reform plan has not been delayed. At present, the ideas of Jiangsu, Shandong and other places are: the government manages the price of basic medical services, the government will set a medical insurance payment reference line, the basic medical services will float around the reference line, and the qualified private hospitals are also within the scope of payment. The prices of medical services in the remaining competitive areas are self-priced, and public hospitals can also provide these services. At present, the price of medical services in many areas has only been fine-tuned. What is the difference between the past and the past, and how to affect hospital patients, there are no more reports.
In terms of drug circulation reform, it is still turning around in bidding and procurement. The benefits of the next touch are more, for example, when a region wants to replace imported drugs with generic drugs, how to solve the problem of the quality of generic drugs. For example, how do some small scattered pharmaceutical companies withdraw from the local market, and many enterprises are still local taxpayers.
The most weighty is the reform of the personnel and compensation system. Although there is no more explanation in the government work report, combined with the reform direction in 2013 and 2014, it is the overall idea of ​​the country not to raise one person. It is already a matter of course to cancel the establishment of public hospitals.
On January 15, 2016, at the “News Forum on the Latest Developments and Hot Issues of Personnel System Reform in Institutions†held in Beijing, officials of relevant ministries and commissions stated that universities and public hospitals are not included in the management of the establishment, and this year we will focus on the preparation of innovative reforms. In particular, public hospitals in universities are not included in the management of the relevant reforms. In addition, the pension plan of the public institution has been adjusted first, paving the way for the cancellation of the reform. Individuals and units of public institutions pay pensions in proportion, and the payment methods are consistent with those of the enterprise.
The reform of the compensation system is also a very complicated matter. At present, the salary system of the “annual salary system†is highly respected, and it is advocated that the assessment of doctors and departments is not linked to the business volume. However, this is a big-package practice, and it is also a kind of salary payment for the top management of the enterprise unit. Only by changing the incentive system of doctors and hospitals, the role of the annual salary system can be truly exerted.
Puyang Linshi Medical Supplies Co., Ltd. , https://www.linshihealths.com