The head of Medical Reform Office of the State Council explains how to tackle the new medical reform in the past eight years

Source: on November 9, 2016, medical network established the national medical insurance system, deepened the comprehensive reform of public hospitals, and improved the basic medical and health service system China's new round of medical reform has made great progress and obvious results, but some institutional obstacles still restrict the pace of medical reform The central office and the State Office recently forwarded the opinions of the leading group of the State Council on deepening the reform of the medical and health system on further promoting the experience of deepening the reform of the medical and health system What are the highlights of the implementation of medical reform programs in different regions? How to promote medical reform to a higher level with practical experience? Liang Wannian, the full-time deputy director of the medical reform office of the State Council and the director of the Department of system reform of the national health and Family Planning Commission, interpreted the opinions a few days ago Carrying out the pilot and strengthening the basic medical insurance of "three medical" linkage plays an important basic role in deepening medical reform, promoting the linkage of medical, medical and medical "three medical" [comments] the pilot project of establishing medical insurance fund management center can be carried out to undertake the functions of fund payment and management, drug purchase and expense settlement, medical insurance payment standard negotiation, agreement management and settlement of designated institutions, etc Liang Wannian: integrating the responsibilities of supervision and management of medical insurance fund, price negotiation of medical service, joint purchase and settlement of drug consumables, supervision of medical service behavior, construction of medical insurance information system, etc., and exercising them by one organization, which is conducive to the overall management of basic medical insurance fund, the centralized payment function of medical insurance for purchasing drugs, and the reduction of drugs by linking quantity and price The price of products is also conducive to strengthening the supervision and restriction of hospitals and doctors, and standardizing service behavior In particular, it is conducive to promoting the formation of medical insurance and medical reform policy coordination, and accelerating the construction of a healthy pattern It is the key to rationalize the price of drugs In the rising voice of "expensive medical treatment", we must straighten out the high prices of drugs We must not only ensure that patients can afford to see the doctor, but also not frustrate the enthusiasm of drug manufacturers [opinions] actively and steadily promote the reform of medical service price On the premise of ensuring the healthy operation of public hospitals, affordability of medical insurance funds, and no increase in the burden of the masses as a whole, according to the requirements of total amount control, structural adjustment, rise and fall, and gradually in place, guide and straighten out the price comparison relationship between different levels of medical institutions and medical service projects Liang Wannian: all public hospitals have cancelled the drug mark up, considered the compensation policies determined by the local government as a whole, accurately calculated the price adjustment level, and simultaneously adjusted the price of medical services By standardizing the behavior of diagnosis and treatment, reducing the cost of drugs and consumables to make room, and dynamically adjusting the price of medical services Resources are uneven, family doctors and hierarchical diagnosis and treatment are the key On the premise of uneven distribution of high-quality medical resources, we must promote hierarchical diagnosis and treatment and family doctors' signing services as a whole, not only to ensure patients to see well, but also to solve the dilemma of "large hospitals are overcrowded, small hospitals can be spared" [comments] promote the signing service of family doctors Set up a contracted service team with family doctors as the core and specialized doctors providing technical support to provide residents with long-term and continuous basic medical, public health and health management services Liang Wannian: it can guide the residents or families to choose a secondary hospital and a tertiary hospital voluntarily while signing a contract with the family doctor team, and establish a "1 + 1 + 1" combined contract service mode The contracted residents can choose any medical institution within the contract combination for medical treatment If they want to see a doctor outside the combination, they must be referred by the family doctor "Internet + health care" to improve people's medical experience at present, the Internet and medical care are deeply integrated, and the sharing economy has been extended and expanded in the medical field The experience of Hangzhou city and other places in improving medical services with the help of information technology proves that the concept of "Internet + health care" is the technical guarantee to promote the successful implementation of hierarchical diagnosis and treatment, and also an effective way to improve the medical experience of the masses Liang Wannian: Internet thinking can help strengthen the construction of health information infrastructure and play a role of technical support in the reform of medical and health service system We will build a population health information platform at the national, provincial, municipal and county levels with mutual sharing and business collaboration, improve the basic database with residents' electronic health files, electronic medical records, electronic prescriptions, etc as the core, and open data resource sharing channels for all kinds of medical and health institutions A series of "Internet + health care" experience should be further promoted and applied In order to arouse the enthusiasm, we should not only insist on making the common people "able to cure and buy medicine", but also strengthen the vitality of the hospital in the market, promote the reform of the salary system and mobilize the enthusiasm of the medical staff Jiangsu Province and Youxi County in Fujian Province have provided successful experience in this regard [opinions] promote the reform of salary system We will establish a performance appraisal mechanism guided by public welfare, and achieve a moderate increase in remuneration on the basis of maintaining the current level Liang Wannian: the local government can reasonably determine the salary level of public hospitals according to relevant regulations based on the actual situation, and gradually increase the proportion of personnel expenditure in business expenditure Promotion and implementation, comparative learning and re innovation opinions summed up 24 experiences in 8 aspects from Sanming City, Fujian Province, Jiangsu Province, Anhui Province, Fujian Province and Qinghai Province Only by combining the advanced experience with the local practice and enhancing the initiative and creativity of deepening the medical reform, can we innovate in the comparative study and make new progress in deepening the medical reform Liang Wannian: all localities should deeply understand the significance of promoting medical reform experience, and ensure that reform experience takes root and produces actual results Around key links and key areas, explore effective implementation paths of reform and encourage regional linkage In the future, it is necessary to strengthen supervision and inspection, further summarize the mature experience created by all regions, and timely upgrade it to a policy.