On May 12, the national health and family planning commission held a special press conference on the task of deepening health reform in 2017. Health under the state council for full-time, deputy director of the national health and family planning commission TiGaiSi chief priests Liang Wannian and deputy director general of the Treasury Department of social security Song Jichao answer questions from the media at the scene, on health care reform fiscal budget, shortage of drugs on safeguard measures, urban public hospital reform implemented some quantitative rigid requirements, and how to ensure to be fully effective implementation of the key tasks such as problem to solve. Liang wannian, deepen the reform of medical health system in 2017 as a work to carry out the years, compaction is emphasis on how to take responsibility, the mission real ground, effective.
According to Song Jichao, national fiscal health care expenditures budget arranged 1.4044 trillion yuan this year, 4.4 times that of medical reform before the start of 2008, 5.1% with diameter growth than in 2016, 1.9% higher than national fiscal expenditure budget increase over the same period, medical and health care spending accounts for the proportion of national fiscal expenditure increased to 7.2%.
The central government continues to subsidies of 3 million yuan, according to each county each new pilot cities subsidies of 20 million yuan, every city municipal district subsidy of 1 million yuan standard to arrange subsidy funds, support implemented nationwide public hospital reform. At the same time, with the financial department under the state council reform office and other departments to carry out the public hospital performance evaluation work, establish the assessment results and the central fiscal subsidy funds tied mechanism.
For drug shortage, Liang Wannian said, shortly before the state health and family planning commission jointly with the relevant departments to specifically study the problem of shortage of medicine supply security, the central deep restructuring also has carried on the review meeting dedicated to the document, this file will be printed and distributed in the near future.
So let's see, let's see, let's see, let's say that this is >, >, >
Host:
Friends of the media, welcome to today's special event. On May 5, 2017, Chinese government published online in the deepening medical and health system reform in 2017 key task ", caused the widespread media attention, do a lot of news reports. In order to help people further understand the key tasks this year, we today and reform of the state council to handle the project, we invite to the guest is: reform of the state council for full-time, deputy director of the national health and family planning commission TiGaiSi Liang Wannian secretary, deputy director general of the social security department Song Jichao, both of them is also introduced to you here last year in 2016, the focus of the work task. Two material, we give you prepared a works in 2016, we will deepen reform of the medical and health system, and a task is the key of the reform in 2017, the content of these two material are detailed.
I particularly want to emphasise that in 2016, and the vast majority of other media is very concerned about the present work pay attention to our health, they publish or broadcast the important policy information in time, and the grass-roots level, to write a lot of high quality, to promote the reform to build a good public opinion atmosphere, in this also thank you, hope in the future continue to work on healthcare reform increase support, and strengthen the propaganda. Below, we will first ask the director general liang to brief you on the priorities of 2017.
Liang:
Good morning, everyone in the media.
2017 is the implementation of the national health and health conference spirit and the implementation of "much starker choices-and graver consequences-in" deepening the reform of medical health system planning is important for a year, is to form a system of basic medical and health care system framework, the key to the reform progress goal task for a year. Recently, the general office of the state council issued the deepening medical and health system reform in 2017 key task "(countries do hair [2017] no. 37), has been clear about the need to pay special attention to the year of 70 priority task.
In 2017 the reform the key work mainly revolves around the basic establishment of grading diagnosis and treatment, the modern hospital management, universal health care, drug supply security, comprehensive regulation of the five basic medical and health care system framework. Is focused on the 2017 as "the work carries out years," the responsibility compaction, it for real, evaluation emphasizing, pays special attention to have introduced the major reform measures implementation and supervision of assessment. This year, the task is divided into the documents that need to be researched and the key work that drives implementation.
One is the need to study the documented documents. Lists 2017 should formulate the policy of reform of the important documents, including promoting the construction of medical association and development, to set up the modern hospital management system, strengthen the health care industry comprehensive regulation 14 policy documents, and clear the lead responsibility department. At the same time, to ensure the working progress, the deadline for each policy document is put forward.
Second, we need to promote the implementation of key tasks. This paper mainly focuses on five basic systems and proposes 56 specific tasks.
In terms of hierarchical diagnosis system construction, the main tasks include: further expanding the scope of the pilot, grading treatment pilot sign with the family doctor service expanded to more than 85% of the cities; We will energetically promote the signing of family doctors, with more than 60% of the coverage of key people signing up. Comprehensive start construction experimental unit of various kinds of medical association, all tertiary public hospital to participate in and play a leading role, longitudinal cooperative medical association collaboration mode total medicare payment, etc.
In the construction of modern hospital management system, mainly including: expanding the scope of the reform of public hospitals at the county level comprehensive demonstration, start the demonstration city public hospital reform work; We will comprehensively push through comprehensive reform of public hospitals, and all public hospitals will eliminate the addition of medicines altogether. To implement the policy on price reform of medical services; We will carry out the construction of modern hospital management systems and carry out trials in the formulation of the charter of public hospitals. We will carry out reform of the compensation system for public hospitals.
In the construction of universal health care system, mainly including: the complete integration of urban and rural residents basic health care system, adopted a policy of "six reunification", straighten out the management system; We will promote the establishment of a multiplex payment system based on the priority of the disease, and select some areas to carry out the trial of payment by disease diagnosis related group (DRGs). The nationwide push for the Internet of health insurance information, and the implementation of the direct settlement of the hospitalization fee for the transfer of medical care in different places where the referral is required; We will support the participation of social forces such as commercial insurance institutions in the handling of health insurance.
In drug supply security system construction aspect, mainly includes: the implementation of the "on further reform and improve the use policy for producing and distributing medicines of several opinions, guide the provinces (autonomous regions and municipalities) to develop detailed policies and measures; Further expanding the range of targeted areas of the shortage; Cultivate centralized purchasing bodies and encourage joint procurement across regions; We will promote the unification of high-value medical consumables purchasing and coding, and carry out a pilot program to purchase high-value medical consumables. In the pilot cities of comprehensive health reform and the reform of public hospitals, the "two-ticket system" was first implemented; We will increase the number of varieties of national drug price negotiations, and do a good job of linking price negotiations with policies such as health insurance.
In the construction of comprehensive supervision system, the main factors include: promoting the application of the intelligent monitoring system of health insurance; We will implement the policy of prescribing reviews and other regulations, and guide local governments to list detailed lists of high-priced medicines such as supplementary and nutritional supplements, and carry out key monitoring. We will strengthen supervision and control over the ownership, financial operation and surplus use of medical institutions in the non-profit community.
In the related fields of push forward reform, mainly including: press for detailed measures to allow to break through the current health services level salary adjustment and allow the medical service revenue after deducting costs and in accordance with the provisions, extraction of various funds is mainly used for personnel incentives; Continue to carry out general practitioner training, training general practitioners more than 25000 people, continue to organize the implementation of general practitioners, work plan, about 70000 new resident standardization training for physicians, propulsion specialist standardization pilot training system; The financial subsidy for basic public health services per person increased to 50 yuan. To improve the health information platform for population health in provinces, cities and counties; We will continue to organize efforts to improve the action plan for medical services.
I'll just do that. Thank you all!
Host:
Thank beam chief priests, the following two guests sitting on the stage is willing to have topics to communicate with you today, please hands up to ask questions and reported questions before your represented by the media. Let's start with the question.
People's Daily reporter: my question is to the Treasury, director of the song dynasty, when we reform requires a lot of money, I want to ask, in 2017 we budget arranged in health have? How does the Treasury support healthcare reform in this regard?
Song qichao:
Good morning, everyone in the media. Beam director has introduced just now, in 2017 we reform task is very heavy, governments at various levels will be in accordance with the spirit of the national health and health conference last year and this year the work plan for the overall health under the state council, continue to health as a key area of fiscal support, increasing investment, support the reform the key work.
The national fiscal health expenditure budget, we arranged this year is 1.4044 trillion yuan, 4.4 times that of medical reform before the start of 2008, 5.1% with diameter growth than in 2016, 1.9% higher than national fiscal expenditure budget increase over the same period, medical and health care spending accounts for the proportion of national fiscal expenditure increased to 7.2%. This 7.2%, I'll give you a comparison, the figure was 5 percent in 2008 before health reform started, and in 2017 it increased to 7.2 percent, an increase of 2.2 percent. You may think that 2.2% is not high, but you think about it, from 2008 to 2017, the nine years, the national financial revenue and expenditure scale is increased significantly, in proportion to the relative may not be very high, but buy-backs growth is high. Among them, the central government health expenditure budget of 398.2 billion yuan, 4.7 times that of medical reform before the start of 2008, more than 2016 years with caliber spending growth of 7.7%, 1.6% higher than that of the central fiscal expenditure budget increase over the same period. This is the general arrangement of the budget this year.
This year, we will focus on the following areas to support the push for healthcare reform.
First, we will support the improvement of basic health care. New farmers and urban residents health insurance subsidies standards increase 420 yuan per person per year from 2016 to 450 yuan this year, the per capita increase 30 yuan, it was the eighth straight year increased the fiscal subsidy standards. Remember, new farming system started in 2003, when financing standard is "three-thirds system", the central government subsidies for $10 a year, each local fiscal subsidies for $10 a year, each individual own pay cost 10 yuan per person per year, is 30 dollars in financial aid 20 pieces, individual pay cost 10 yuan. After 14 years, the total amount raised in 2017 has reached 630 yuan, 21 times that of 2003. The financial aid standards were raised from 20 yuan in 2003 to 450 yuan, 22.5 times. The personal contribution has increased from 10 yuan in 2003 to 180 yuan this year, 18 times. We will also vigorously promote the reform of the health care payment system, and give full play to the role of the health care fund in guiding medical care and controlling the unreasonable growth of health care costs. We will support efforts to promote the settlement of medical care in different areas of the country and facilitate the treatment of people.
Second, we will support comprehensive reform of public hospitals. Just introduced, director of the beam, we implemented the reform of public hospitals across the country this year, the central government continues to subsidies of 3 million yuan, according to each county each new pilot cities subsidies of 20 million yuan, every city municipal district subsidy 1 million yuan RMB to arrange such a subsidy funds, support implemented nationwide public hospital reform. At the same time, we will also be in conjunction with the reform of the state council office and other departments to carry out the public hospital performance evaluation work, establish the assessment results and the central fiscal subsidy funds tied mechanism. Marked achievements were scored in the implementation of the general office of the state council about our place to increase support incentive notice requirements, of the public hospital reform obvious effectiveness of cities and counties shall be rewarded. In addition, this year, the central government will also participate in the reform of the local public hospitals, and the central government will support the work and grant subsidies.
Third, we need to support improving the quality of public health services. The per capita basic public health service in 2017 increased from 45 yuan last year to 50 yuan. Further adjusting and optimizing the basic public health and major public health services, increase the intensity of performance appraisal, improve the effect of the implementation of the public health service, enhancing the acquisition of the masses.
Fourth, we should support the establishment of a tiered treatment system. We will arrange subsidy funds, continue to support the implementation of "rural order directional training medical students for free", "famous physician support rural" and standardized training for general practitioners and other kinds of grass-roots staff training project, to speed up the improve grassroots service ability. Support demand oriented do real signing the family doctor service, carry out various kinds of medical pilot couplet body construction, for the masses to provide continuous integration of the basic medical and health management service.
Fifth, we will support efforts to deepen reform in the distribution of pharmaceutical products. Support the implementation of the "on further reform and improve the pharmaceutical production circulation use policy several opinions, in comprehensive reform pilot provinces and public hospital reform pilot city vigorously implement the" two votes ", promote the quality of generic drugs and curative effect evaluation, consistency and solve the problem of drug prices artificially high, alleviate the burden of drug costs.
At the same time, health care reform is the "guarantee money" of the masses. The financial sector attaches great importance to the regulatory issue of health care reform and will step up efforts to ensure the safety, standards and effective use of funds. One is to strengthen regulation of health care funds. Press for the implementation of the "on strengthening the basic medical insurance fund budget management give play to the role of medical insurance fund control of the opinions, attaches great importance to the sustainability of medical insurance fund, strengthening the analysis of the balance of the medical insurance fund, on the basis of actuarial science, guard against and dissolve the fund operation risk early. Second, we will strengthen the management of financial budgets in public hospitals. Press for the implementation of the "on strengthening the management of the public hospital financial and budget guidelines", establish and improve the public hospital comprehensive budget management, cost control, financial report and information disclosure, the chief accountant and the third party audit system, standardize the hospital economic operation. Third, we will improve the use of public health funds. We will further integrate public health services and promote the overall use of funds. Increase the intensity of performance appraisal, in conjunction with the state health and family planning commission will performance evaluation of basic public health services expanded to all provinces across the country, improve the efficient use of funds of public health.
Epicenter wide net reporter: after the cancellation of drug addition, we will take what measures, reduce the burden of patients and can be ensured and can guarantee the normal operation of the hospital? What measures can be taken to motivate hospitals to participate in public hospital reform? thank you
Liang:
As you know, the reform of our public hospitals began in 2010. In 2010, we selected 17 cities for the trial of public hospital reform. Starting in 2012, we introduced the state of the state in 2012, which was a pilot program for reform at county level public hospitals. In 2015, the reform of county-level public hospitals was comprehensively pushed aside. At the end of the year, all public hospitals will be required to push through reforms. By the end of 2016, we had 200 pilot cities to do public hospital reform. We speak the comprehensive reform of public hospitals reform, emphasize "3 d linkage", health care, medicine and health care to linkage, it is the core of a reform task, is to break with medicine medical mechanism, set up new operation mechanism of public hospitals. We call this new operating mechanism the maintenance of public welfare, the mobilization of the initiative and the guarantee of sustainable development.
One of the most critical points in eliminating medicine is to eliminate the addition of drugs. The main sources of compensation for our current public hospitals are three channels, one for the government and the other for medical services, and the third is the addition of the drug to the income of the drug. The reform is to remove the third compensation channel from three channels, which is the service charge plus government subsidies. Up without a comprehensive reform, the hospital bonus to cancel, is bound to affect the normal operation of the hospital, will also affect the development of the hospital and mobilize the initiative of medical workers. So very important key point of this reform, is how to in addition to cancel, is that the hospital can benign operation, and to effectively mobilize the enthusiasm of the medical staff, and let the people of the whole medical burden is not increased, and can make the medical insurance fund to withstand and sustainable, it is a very important to solve the problem. For this reason, many parts of the country, especially the pilot cities and pilot areas have made the positive exploration, as everybody knows, sanming city, fujian province, in the reform of public hospitals in the city to create a good experience, we referred to as "called" vacate basket change a bird ", later in our reform of public hospitals in the city have been pushing is the reform of the system.
The so-called "vacate basket change a bird" is a trilogy, the first step is public hospital reform after the bonus to be cancelled, how to through the price mechanism, increase the medical services charges. If there is no room for more services, there will be a burden on the common people. So the first step is to make room to adjust the price of health care. The main source of space is the regulation and regulation of circulation and medical practice. Circulation mainly comes from the drugs, so the implementation of the "two votes", implement way of centralized bid procurement, with quantity in price, compressed recycled space, squeeze out water. The second is high-value consumables in the circulation area, especially in the area, which also has done a lot of trial, and also the inflated water pressure. Third, some irrational practices. Such as excessive, big check, how to effectively monitor, especially for the unreasonable inspection, doctors use to strict monitoring and management, so that can avoid some drug prices artificially high, high value material artificially high and unreasonable behavior, saving space is mainly for health care saves money.
The cost of the health care, the second step, the structure, the room, I saved how much money I saved and how much labor technology prices were raised. As we all know, now the doctor a lot of unreasonable medical behavior, one important reason is that our price system is not smooth, to a certain extent is distorted. That is to say, the current system of the system of medical services does not adequately reflect the knowledge and technology of the medical staff. Price and value are diverging. May we have a big operation to three or four doctors, and nurses, plus an anesthesiologist, for three or four hours, down to the operation of the overall cost is likely to be one thousand yuan to two thousand yuan. It must be a loss in terms of cost. So hospital to run, it may take physical and chemical ways to make up for a lack of their own, so be sure to get this straighten out the price mechanism, the unreasonable situation reversed. So the key is to improve these price programs that reflect the labor, knowledge and technology of health workers.
This part of the increase, and then into the third step, is all the room space is saved a space to the medical insurance fund, raise the price of labor technology, health care to join up, cohesion are two: one is to include health care reimbursement range, 2 it is to improve the part of the overall health care as far as possible to submit an expense account, make people overall cost burden do not rise.
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