Health Commission at the helm: the establishment of the listing for one and a half years, the introduction of 328 major policy innovations in 7 areas

The sea depends on the helmsman For the hard road of China's medical reform, every step forward largely depends on breaking the ice of policy The national health and Health Commission has been established for one and a half years In the past year and a half, what has the health care Commission done, in what areas has the reform been promoted, and what is the general direction of the health care Commission at the helm? We combed 328 policy documents issued by the health care commission after its establishment, trying to find the focus of the work of the Commission According to the data on the official website of the national health and Health Commission, since its establishment, the national health and Health Commission has released 328 policy documents, focusing on seven major fields, including information construction, drug management, and Internet medicine (Note: the research sample of this paper comes from the column of "Home Page > information > information disclosure" on the official website of the national health and Health Commission, with the time period from March 27, 2018 to October 9, 2019) In March 2018, the State Council launched the institutional reform The health and Health Commission, like other 24 institutions, is a newly established institution in the reform plan of the State Council On March 27, in the courtyard of the former national health and Family Planning Commission, the national health and Health Commission was listed for office, and people scrambled for photos in front of the new doorplate In addition to recording people's smiles, the camera also recorded such a moment: China's medical reform, set sail again Mission in 2018, great changes have taken place in the medical industry On February 28, the Third Plenary Session of the 19th CPC Central Committee adopted the plan for deepening the reform of Party and state institutions In the field of medical treatment, the National Health Care Commission and the National Health Insurance Bureau have been newly established The main responsibilities of the state health insurance bureau are medical insurance fee control, fund supervision, information construction, etc., while the responsibilities of the state health care Commission almost cover the whole industry, which is the real helmsman of China's medical reform It is responsible for formulating national health policies, coordinating and deepening the reform of the medical and health system, organizing the formulation of the national basic drug system, supervising and managing public health, medical services and health emergencies, family planning management and services, and formulating policies and measures to cope with the aging of the population and the combination of medical and health care The establishment of the National Health Insurance Bureau and the national health and Health Commission bears the public's expectation for the linkage of "medical insurance, medical treatment and medicine" This round of institutional reform plan of the State Council redefines the relationship between the government, society and market, redefines the authority boundary of the government, and is an active exploration to promote the modernization of national governance system and governance capacity There are two specific operational principles: the first is clearly put forward in the decision of the Third Plenary Session of the CPC Central Committee that "one department shall be responsible for one kind of matters in principle, and one department shall be responsible for one thing in principle, so as to avoid multiple political outlets, unclear responsibilities and prevarication" The second principle does not give a special written expression, but in the responsibilities of each institution clearly defined in the plan, none of them endows ministries with the responsibility of formulating reform plans and leading reform For the reform of the industry, if there is a statement, it is "coordinated promotion" or "coordinated promotion" This means that this institutional reform plan is committed to changing the shortcomings of the previous reform plan designed by the Department itself and led by the Department, but let the authoritative institutions beyond the interests of the Department design the reform plan and lead to promote the reform On March 19, at the seventh plenary session of the first session of the 13th National People's Congress, it was decided that Ma Xiaowei was elected director of the national health and health commission after voting Ma Xiaowei once studied in China Medical University, served as vice president of China Medical University, director of Liaoning Provincial Department of health, Vice Minister of the Ministry of health, deputy director of the national health and Family Planning Commission, etc his resume is extraordinary On March 27, the national health and Health Commission was officially listed for office at the level of ministry, with 23 departments including the medical administration and medical administration bureau, the system reform department, and the grass-roots health and health department At that time, when the photos of the national health and Health Commission were once swiped on the screen, people seemed to have a hunch that the industry would change From the point of view of the policy interests, the National Health Care Commission is much more gentle than the State Health Insurance Bureau in the field of health insurance If the treatment plan given by the state health insurance bureau to the medical industry is knife operation, then the treatment plan given by the state health care Commission is chronic disease conditioning One and a half years after its establishment, the national health and Health Commission issued 328 policy documents These policies are not all policies that bring direct innovation to the industry Most of them seem to be inadvertent ones, but they are really necessary for medical reform To some extent, the national health and Health Commission is more like an experienced chess player, strategizing and winning in ten years From the perspective of industry, this paper will take half a year as a stage to sort out the key measures of the National Health Commission The first stage (March 2018 to September 2018): establishing industry standards, specifications and informatization is the general direction (important policies issued by the national health and Health Commission in this period of time) On the second day of listing for office, the health care Commission issued four notices on health industry standards, such as "notice on seven health industry standards including hepatitis C diagnosis" and "notice on two recommended health industry standards including overweight and obesity screening for school-age children and adolescents" The compulsory industry standards and recommended industry standards mentioned in the notice Will take effect on August 1, 2018 In early April, the national health and Health Commission set fire to the allocation and management of large medical equipment A notice of "Management Catalogue of large medical equipment configuration license (2018)" caused a huge shock in the industry This document officially publishes the latest management catalogue of class A and class B large medical equipment (2018 edition catalogue), and standardizes the class A and class B large medical equipment to be configured with permission The number of category a management catalogues in the catalogue has been reduced from 12 to 5, and the price limit for the first allocation of large medical devices to be included in the category a management catalogue has been adjusted from 5 million yuan to more than 30 million yuan; the number of category B management catalogues has been adjusted from 5 to 7, and the large medical devices of 10-30 million yuan allocated for the first time have been included in the category B Management Catalogue The notice on further promoting the informatization construction of medical institutions with electronic medical records as the core issued in September has had a significant impact on the industry The document involves the core issues such as hospital rating, standard and so on, which attracts the attention of hospitals at all levels In this half year, the national health and Health Commission issued a total of 152 policy documents, which mainly focused on the formulation of industry norms and standards, and released heavyweight documents in the fields of family doctors, Internet health care, health care, electronic medical records, etc The second stage (October 2018 to March 2019): medical resource sinking and intelligent service are the key points (important policies issued by the national health and Health Commission in this period) On the last day of October 2018, the national health and Health Commission issued the assessment indicators of action plan for further improvement of medical services (2018-2020), which is divided into two versions according to medical institutions and health administration departments In each version, there are requirements for informatization In the medical institution version, there are 12 first level indicators and 39 second level indicators, with a total score of 100 points In the version of health administration department, there are 6 first level indicators and 15 second level indicators, with a total score of 50 points With the introduction of this policy, the informatization construction of medical reform has been quantified for the first time In 2019, the national health and Health Commission still played some "idle chess" Several policies issued in the new year include praise for the blood collection team and suggestions for the establishment of national food safety standards In March this year, the national health and Health Commission issued the notice of the general office of the national health and Health Commission on the pilot work of community hospital construction, which listed 20 provinces and cities including Hainan Province, Chongqing City, Sichuan Province, Yunnan Province, Shaanxi Province and Gansu Province as the pilot areas Carrying out the pilot work of community hospital construction is a powerful starting point to improve the ability of medical and health services at the grass-roots level, a major measure to promote the construction of hierarchical diagnosis and treatment system, and an excellent path to promote the construction of high-quality and efficient medical and health service system Subsequently, the national health and Health Commission also set the direction for the construction of smart hospitals On March 18, the national health and Health Commission issued the notice on printing and distributing the standard system for grading evaluation of hospital intelligent services (Trial) According to the basic service content that patients should cover before, during and after diagnosis, combined with hospital information construction and Internet environment, the health committee has determined 5 categories and 17 evaluation projects in total In the past six months, the national health and Health Commission issued 116 policies, and issued important documents in the fields of drug management, diagnosis and treatment standards, intelligent medical treatment, etc Phase III (April 2019 September 2019): highlight the blueprint of "healthy China" (important policies issued by the national health and Health Commission in this period) On July 15, the Information Office of the State Council held a regular policy briefing for the State Council, introducing the relevant information of the opinions on the implementation of the health China action and the notice on the issuance of the implementation and assessment plan for the organization of the health China action The two heavyweight documents were developed under the leadership of the national health and Health Commission Yu Xuejun, deputy director of the national health and Health Commission, attended the conference and interpreted the policies He believed that the implementation of healthy China should focus on four aspects: in terms of positioning, from disease-centered to health-centered; in terms of strategy, from focusing on "treating already sick" to focusing on "treating not sick"; in terms of subject, from relying on the health system to the overall linkage of society; in terms of action On the one hand, efforts should be made to shift from advocacy to participation by the whole people and individual action In the last ten days of the month, the national health and Health Commission also issued the "notice on printing and distributing the standard system for grading evaluation of hospital intelligent services (Trial)", which decided to carry out the grading evaluation of hospital intelligent services in 2019 in the secondary and above hospitals applying the information system, and made clear requirements for the grading evaluation standards and methods of intelligent hospitals At that time, the "wisdom" of the hospital will become a part of the hospital assessment On September 3, the national health and Health Commission issued the notice on printing and distributing the work measures of national health informatization to reduce the burden at the grassroots level According to the document, more than 200 original information systems of the national health and Health Commission were cleaned up and integrated, and a list of information system directories was issued For those not included in the list, the grass-roots level could refuse to submit data For the statements required to be submitted by the grass-roots level by the direct or entrusted third-party organizations that are not included in the health statistics and investigation system, in principle, the grass-roots level is no longer required to submit, so as to ensure that the number of statements is reduced by more than 30% In this half year, the national health and Health Commission issued 59 policies, and published important documents in the fields of social medicine, medical association construction, public hospital performance evaluation, etc Up to now, the latest policy issued by the national health and Health Commission is the notice on printing and distributing the first batch of catalogue of drugs encouraging imitation, which involves 33 drugs, most of which are concentrated in the fields of tumor and genetic rare diseases In the past year and a half of innovation, great changes have taken place in the medical industry Through sorting out 328 policy documents issued in the past year and a half, we found that the policies of the national health and health commission are mainly to guide disease prevention and health promotion of the whole society in the next decade at the national level, and the healthy China in 2030 is the place it must reach In addition to the immediate short-term effect, we combed out seven areas of policy impact of the health care commission from the perspective of industry In the medium and long term, these seven areas are either