The - begins - inquiresing of chess game in the future Pursue to solve the profound contradiction of the medical reform

The - begins - inquiresing of chess game in the future Pursue to solve the profound contradiction of the medical reform
The - begins - inquiresing of chess game in the future Pursue to solve the profound contradiction of the medical reform
The basic medicine system cleared away the great obstacle of financial compensation at the end of this year. (reporter Liu take the photograph noon) On December 24, the 18th session of the Standing Committee of the National People's Congress holds the joint group meeting, carry on the special topic on report on deepening the system reform working condition of the medical and health of the State Council to inquire. Entrusted by the State Council, committee of national development and reform, Ministry of Finance, department that protects people, Ministry of Public Health, national food medicines supervise administration bureau, State Administration of Traditional Chinese Medicine and the State Council deepening the persons in charge of the other member units of leading group of system reform of medical and health, attend the meeting to listen to opinions and answer inquiry. The system reform of the new round of medical and health is implemented since April of 2009, every key reform will move forward steadily, the effect appears progressively. But gradual to deepen with reform, some new situation, new problem emerge constantly. It is numerous to register to demand to propose the committee member who inquires, in order to save time, raise the efficiency, vice chairman of Standing Committee of the National People's Congress and concurrently general secretary Li Jianguo who presides over meeting makes " The rule " : The committee member questions for time to make a speech and controls within 3 minutes, the persons in charge of related departments answer the question to control within 10 minutes as inquired. Narrow by the first of disparity of the three basic medical insurance to propose what inquired is committee member Song FaTang, he has asked two questions: Is there any concrete plan in strengthening the basic medical treatment and ensuring the global design of the system, making management system in order in the State Council and relevant department? What concrete policies and measures are there to further improving medical insurance level? The division of labour of the leading group of the medical reform of the State Council is led by department that protects people responsible for the work advancing construction of basic medical security system. To this question, justice answers, will try hard at the treatment level of the medical insurance to notice that ensures the equilibrium of systems big three times the moustache dawn of Vice Minister of people's protecting department, " The treatment level that it is worker's medical insurance now is relatively high, the proportion paid is up to about 75% this year; Shut newly and agriculturally and resident's proportion with original medical insurance is relatively low, the proportion that will submit an expense account newly and agriculturally and of only shutting 38% in 2008, resident medical insurance 50% wipe out proportion is to wipe out proportion 50%- 55% by 2009 only; And medical insurance and what has been shut newly and agriculturally of urban residents submit an expense account the proportion can be up to 60% basically this year, one that is with worker's medical insurance submits an expense account proportion disparity is dwindling too. " The next step, the preliminary consideration with three respects of people's protecting department: First, continue encouraging and supporting all parts to probe boldly on ensuring the system reform in basic medical treatment, further summarize the experience, propose the basic medical treatment in urban and rural areas ensures improving management system on this basis, perfect the suggestion of operating mechanism. Second, here " Twelve five " Advance the systematic construction of informationization of the social medical insurance in a more cost-effective manner during this time, especially accelerate issuing the nationwide unified social security card, plan to be here tentatively " Twelve five " Increase circulation of the social security card to more than 800 million during this time. Have " The all-purpose card " Technological for foundation,it is last management, connecting and the peoples favourables convenient for peoples in urban and rural areas not to help by system to make. Third, continue improving the treatment level ensured in basic medical treatment in urban and rural areas in overall arrangement, and narrow the disparity between the systems, between town and country progressively. While stabilizing worker's medical insurance and raising money, improve the subsidy level of the medical insurance to urban and rural residents of the government progressively, on this basis, expand the payment range of urban and rural residents medical insurance progressively too. While improving worker's medical insurance personal account policy, advance the clinic pool of urban and rural residents synchronously, bring those common diseases, frequently-occurring diseases into the payment range of the medical insurance too, expand the masses' benefited one. Raise resident's medical insurance with sharing the proportion of serious disease expenses of the institute and the conducting the limit of the pool fund newly and agriculturally by a relatively large margin, and narrow and follow the disparity of levels of the urban worker's treatment progressively. A group of statistic expresses, government the intersection of hygiene and expenditure and social the intersection of hygiene and expenditure add up, account for the intersection of the whole society and the intersection of hygiene and proportion of all-inclusive cost from 59.6% 61.8% to rise to 2009 for 2008, have improved by 2.2 percentage points; Corresponding, the expenditure of personal hygiene accounted for to drop than from 40.4% in 2008 by 2.2 percentage points, have reflected masses' personal medical burden is lightened to some extent. Continue advancing the national basic medicine system of medicine system of the base to last one year, it is a new system in the medical reform, make some effects so far. But had some difficulties and the question. Among them, the mechanism that the outstanding problem is the financial compensation is imperfect, the method compensated is not complete, the fund is not put in place in time. The intersection of Wang Ningsheng and on have proposed two in promotion, implementation of the national basic medicine system committee member - -" The related departments, to advancing the national basic medicine system in an all-round way, does the expenditure needed to lighten masses' medical burden have concrete rough estimate, are there further supplementary measure and long-efficiency mechanism of solving these problems? " , " How to solve about problem not enough of 307 kinds of basic medicines? " Committee's Deputy Director Zhu Zhixin of national development and reform answers, the basic medicine system began to implement last August, the medical health organ of basic unit that over 50% of the governments in the whole country ran has implemented the basic medicine system till now, sell a difference rate in a greatest characteristic of it. " According to our preliminary statistics, the price of the basic medicine has probably dropped by 30%. " Zhu Zhixin says. But the implementation of the national basic medicine system is to mend and cure the mechanism to reform to the medical health organ in the basic unit completely with medicine, very great shortfall has appeared in revenue and expenditure of the medical health organ in the basic unit. " According to statistics in 2008 of Ministry of Public Health, the medical medicines addition income of health organ of national basic unit is 15,200 million, the addition rate is 40.5%. But according to actual conditions of all parts, very different, some places addition rate but also high a bit, the addition rate of some health clinics in towns and townships is up to 167%, with calculating the difference initially bigger. According to calculating newly, it is about 20 billion yuans to need newly-increased input on the whole, has not considered yet the debt of the medical organization at the basic level is dissolved and to situations such as the subsidy of medicine of village,etc. here, if add these two items, I think I may still have more. " Zhu Zhixin says. Zhu Zhixin says, the government compensates many kinds of factors of running etc. of involving mechanism of organizations, personnel system, personnel's treatment level and organization actually, it is obviously not all right to mend a difference rate simply, must run effectively according to ensuring the medical health organ in the basic unit, secondly should be according to ensuring the principle of the rational treatment of medical worker at the basic level to go on, compensate the fund reasonably. In practice, local because of " How much, how is mended to mend" Question reach an agreement,is it to make items of system on this whether implementation meet difficulty. To this question, the State Council has drafted <>And already announced. State revenue Israel " Take the place of mending in order to reward " Form,last all parts last and basic unit reforms comprehensive of health organs medical. Become the main channel that the government subsidizes to the medical health organ in the basic unit progressively, include in budget management, form the long-efficiency mechanism, ensure the normal running of the medical health organ in the basic unit better. On committee member Wang Ningsheng's question regarding basic medicine quantity, the variety selects, Zhu Zhixin answers, have already fully considered the habit that difference, the masses of the area used medicine on the basic medicine system design frame, allow rational and some supplementary medicines of all parts. By the end of September, have had 14 provinces (the district, city) already Having finished the augmenting of the medicines catalogue, augment minimum increasing by 31 kinds, increasing by 502 kinds at most, general about 200 kinds. But on the issue that the variety selects, Zhu Zhixin points out, it is to ensure the security that use medicine at the basic level to implement a very important purpose of basic medicine system, safeguard the people's health better. Here in the past " Raise medicine with medicine " Mechanism under,it is at the basic level for medical organization drug abuse is serious in situation. So, the basic medicine is selecting four principles, just must prevent and cure, clinical and first-selected, the dosage form is suitable, safe and effective. " Strengthen the intersection of training and efforts in medical worker next, lead masses form, used to it by a good administration progressively. If realize this goal, it may be bigger than the simple meaning of lowering person's administration burden. " Zhu Zhixin says. The public hospital reform insists on " Four are parted " The public hospital reform is the focal point of the medical reform and difficult point, although make sure progress, but still there is greater disparity in the expectation from the various circles of society. Committee member Ren Maodong has put forward a very sharp question, he thinks the new medical reform lasts more than one year, but the public hospital reforms " Still stay on the pilot aspect or fight only on paper in the aspect " . " Invite the intersection of the State Council and related departments in the course of promoting the medical reform next, how to public the intersection of hospital and thinking of reform and how about it will be concrete measure, will you please solve the present problem? " Ren Maodong says. As to this, Zhu Chen, minister of Ministry of Public Health, respond, say public hospital reform difficult, its interests roller chain involved is quite long, consume the side from medicines to square, medical treatment, will reach the vital interests of different colonies such as the production circulation of medicines, medical organization, medical worker, patient inevitably. Do, it cures subjects to be still a government at present, but the public hospital runs curing the subject to relatively disperse, hold and on the membership, not only involve the Ministry of Health, but also involve many departments such as the education, army, state-owned enterprise. Chen Zhu thinks, the public hospital is an important component in the public institution classifies and manages the reform, need and group the department of assuaring etc. into doing, people to cooperate too in this respect. " The public hospital reform must be both a positive one while and the safe course, impossible ' make it rigidly uniform ', can not accomplish in one move either, need pilot project to go ahead of the rest, through studying, exploring and summarizing constantly, form the effective policies and measures finally, popularize. " Chen Zhu says. Chen Zhu introduces, the next work will move forward from two respects: First, insist the government affairs will be separated, in charge of doing separating, medicine to separate, profit-generating and separate from that non-profit-making, strengthen in pilot city and area as the comprehensive reform, must make the break-through on great system mechanism. Second, according to the principle of linking from head to foot, increasing vigor inside, increasing thrust outside, use some effective measures, let the masses experience the medical reform, especially effect that the public hospital reform brings conscientiously. " These methods are not a gust of wind, but should work hard on the mechanism under construction, forms a long-efficiency mechanism. " Chen Zhu says. ( Reporter Zhong KeFen's round-up report)


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