Jiangsu tries water basic medicine and makes compensation mechanism The financial inability becomes the greatest obstacle

Jiangsu tries water basic medicine and makes compensation mechanism The financial inability becomes the greatest obstacle
Jiangsu tries water basic medicine and makes compensation mechanism The financial inability becomes the greatest obstacle
The first workday in New Year, Jiangsu Province issued the financial compensation method that the basic medicine system implements. This to continue, confirm first the intersection of catalogue and medicine enter variety and 68 selected delivery after the enterprise successively will it be will it be the last ten days December 2009, Jiangsu Province takes the lead in another new movement that is put out in the whole country. The principle of this method stipulates, try the medical health organ of basic unit of the basic medicine system, its income of medicines is compensated and fulfilled by the local finance, release personnel's funds and salary according to the average level of local public institution. However, it is a question mark whether the policy could be implemented. "Regional financial resources different, to compensate either hard to restrain from intensity. " The department of public health of Jiangsu Province counts the personage in the wealth place to state outright to the reporter. Take the lead in the intersection of Wuxi and city that respond to for advance basic the intersection of medicine and system, send the documents the community health Center all manage two lines of revenue and expenditure this year within the regulation. At present, the hygiene circle remains the dispute to this system, the method of Wuxi causes the pilot district (county) Worry to the service efficiency of hygiene at the basic level. At the national hygiene working conference that is held on January 5, Chen Zhu, minister of Ministry of Public Health, says, popularize the basic medicine system in 60% of the hospitals at the basic level and public hospital of the reform pilot project in the whole country this year. Obviously, the realization of this goal awaits the strong push of financial compensation mechanism. Can financial compensation be put in place? On December 30 of 2009, department of public health, the General Office of Finance, people in Jiangsu Province will assuare the three sides of drawing room countersign the financial compensation method that the basic medicine system will be implemented, have made the regulation to range, standard, subject of financial compensation,etc., and on medical health organ and the personnel's determination of basic unit which the government hold, basic unit medical task of health organ quantize, the intersection of revenue and expenditure and the intersection of person who check and ratify and a series of specification issue while implementing, provide the more concrete operation manual. The method is clear, the medical original medicines income of health organ of the basic unit is compensated, fulfilled by the local finance, stipulate relevant personnel's salary at the same time, keep an equal pace with average level of the local public institution in principle. This method still reserves the space for the implementation of the wage system of the performance in future, in order to connect with the systematic performance salary implementing method of the national hygiene that will issued. This lets Wang Cheng in Huaihai Road community health Center, Nanjing feel and inspire very much. He is a professional undergraduate course graduate of medical science in 2003, the present monthly salary was more than 2000 yuan. "It is a blessing I am a native, can save the rent, otherwise I will transfer to and become medical representatives like a lot of classmates. " He says. And consult the standard of the public institution of Nanjing, Wang Cheng's income can be expected to nearly double, this will make him settle down to be engaged in the work of speciality. But the health organ of this community which he belongs to for the moment, even public health funds have not been paid in full amount yet, medicine accounts for than 60% of Damien. The medicines income after the basic medicine system is implemented is compensated, it is a realistic difficult problem. "Even such a developed city of southern Jiangsu of Wuxi, feel more thorny. " Community hygiene service expert, public health Bao Yong, professor of institute of Shanghai Communications University of Ministry of Public Health reveal, he has just taken over the relevant subject of Wuxi, has needed surveying and studying thoroughly. In the morning of January 6, the system relevant person of the hygiene of Shanghai will have consultations with departments such as the development and reform committee,etc. on this question too. "Compensate 9 hundred million in one year. " The personage participating in the conference tells reporters. And the compensation to this one of fund of medical insurance of Shanghai of 2009 will be only 165 million yuan, public and financial corresponding input is more insignificant. There is mismatch of the duties and responsibilities and ownership of property in administrative systems now, make the compensation question of the medical organization at the basic level more thorny. What accepted with the duties and responsibilities was transferred ring upon ring, made even if it is finance at the basic level of the developed area it very pressing on each of the ownership of property. Take Shanghai as examples, in the input of the community health Center, the financial proportion at city level is only 0.95%. And this basic medicine system is to begin the pilot project from the medical organization at the basic level, this means county's finance and is one heavy load more to take on. The people of river of Deputy Director of administrative center of Shanghai Pudong hospital studying the performance problem of medical organization at the basic level for a long time point out, the government adopts the hygiene industry at present " Bale and compensate " Method,have clear each account,be be be be led to the fact whether there are getting smoother on that compensation mechanism too thiseddedded. For example to the compensation of the community health Center, except that the medical insurance fund accounts for 90%, 10% that finance put into, including organization run funds, the intersection of personnel and funds, the intersection of public health and funds, the intersection of revenue and expenditure and the intersection of difference and the intersection of person who compensate and a plurality of items. But the money bale, charge interconnected system account together in financial budget, " have some projects mend distinguishing one from the other or not " . Return to two lines of revenue and expenditure? In order to advance the implementation of the basic medicine system, Wuxi rushes to issue the relevant document at the end of the year of 2009, announce that manages two lines of revenue and expenditure to the community health Center of the whole city within this year. This file has defined 4 methods, namely implement budget management, the income is turned over fully, the expenditure is classified and checked and ratified, the overall management of the balance. The personage of Wuxi Municipal Health Bureau says, this measure of Wuxi is to want to further standardize management; And, the management expectancy community health Center of two lines of revenue and expenditure works out the annual budget every year, the funds include in this grade of financial budget, this can stress too it is public beneficial. Two lines of revenue and expenditure is a new kind of financial management modes that Ministry of Public Health puts out, manage through the centralized power and unity of budget internal and external fund, block trending towards the favourable behavior of the medical organization from source. The pilot project of already of this reform going ahead of the rest in some areas, but there are persons who query to its management style of returning to the planning system, and therefore the service efficiency that may bring is low and checks and rates the loophole and worries in the administration. It is reported, go straight in health care reform in Jiangsu Province ahead, management of two lines of revenue and expenditure has not been adopted extensively. Inside the province only the intersection of hygiene and the intersection of system reform and pilot the intersection of city and the intersection of Zhenjiang and city all, take keep attitude to this too. "Can finance it fills out incomes to be in debt no doubt fine, but efficiency influence what is to be done? " Zhenjiang the intersection of Municipal Health Bureau and personage in, woman of base, say, are calculating, make decision after the systematic performance wage system of hygiene of the country comes out. Bao Yong thinks, two lines of revenue and expenditure may influence enthusiasm while managing, but good system design can be corrected. Introduce he,Ministry of Public Health the pilot projects of two lines of revenue and expenditures the first Shanghai mayor would rather district, find out some experiences. For example presume the basic service is chartered, stipulate the service content that the medical health organ in the basic unit must finish, the expert calculates the value of each individual event among them, and establish a basic coefficient, the serving amount takes advantage of having this coefficient, it is compensation with deserved this service. The department of public health of Jiangsu Province counts the personage in the wealth place to say, have not required reform of two lines of revenue and expenditure in unison in Jiangsu Province, the more important thing is the question of the financial resources, Some local financial resources are not enough " Reveal all the details " ,This is a great obstacle of pursuing the basic medicine system.


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