Ministry of Agriculture, State Food and Drug Administration, state administration of traditional chinese medicine
Notice on Accelerating the Pilot Work of New Rural Cooperative Medical System
(Wei Nong Wei Fa [2006] 13No.)
Provinces, autonomous regions and municipalities directly under the central government, health departments, development and Reform Commission, Civil Affairs Bureau, Finance Bureau, Agriculture (Forestry) Bureau (bureau, committee), Food and Drug Administration, Chinese Medicine Bureau, Health Bureau of Xinjiang Production and Construction Corps, Development and Reform Commission, Ethnic Affairs Commission, Finance Bureau, Agriculture Bureau, and Food and Drug Administration Branch:
Since the pilot work of the new rural cooperative medical system was carried out, all localities have made clear understanding, strong organization, solid work and steady progress, and achieved remarkable results, which have been welcomed by farmers, and accumulated experience for exploring the medical security work of farmers under the new situation and gradually improving the new rural cooperative medical system. According to the spirit of the State Council 10 1 executive meeting and the 2005 national conference on pilot work of new rural cooperative medical system, from 2006, relevant policies will be adjusted, efforts will be intensified, and the pilot work of new rural cooperative medical system will be actively promoted. The relevant issues are hereby notified as follows:
First, attach great importance to the pilot work of the new rural cooperative medical system
Establishing a new rural cooperative medical system is an important measure to solve the problem of farmers' difficulty in seeing a doctor based on China's basic national conditions, which plays an important role in improving farmers' health level, alleviating farmers' poverty caused by illness, coordinating urban and rural development and realizing the goal of building a well-off society in an all-round way. All relevant departments should fully understand the great significance of carrying out the pilot work of the new rural cooperative medical system from the height of governing for the people, putting people first and building a harmonious society. In accordance with the State Council's deployment and requirements, they should unify their thinking, make clear their objectives, carefully organize and do solid work, and grasp, grasp and do a good job in this great event that benefits the broad masses of farmers. Relevant departments of all provinces (autonomous regions and municipalities) should seriously organize and carry out investigation and study, improve the pilot scheme, standardize the operation mechanism, and form 2 ~ 3 mature pilot modes for reference in future promotion.
Two, clearly expand the pilot objectives and requirements.
All provinces (autonomous regions and municipalities) should, on the basis of earnestly summing up the pilot experience, intensify their work, improve relevant policies, and expand the pilot of the new rural cooperative medical system. In 2006, the number of pilot counties (cities, districts) in China will reach about 40% of the total number of counties (cities, districts) in China; In 2007, it expanded to about 60%; In 2008, it was basically implemented nationwide; In 20 10, the new rural cooperative medical system will basically cover rural residents. The eastern region can speed up the promotion on the basis of standardized management, and areas with conditions can explore various forms of rural medical security. In promoting the pilot work, all regions should implement the principles of voluntariness, mutual assistance, openness and service, adhere to the voluntary participation of farmers as a unit, and do not engage in compulsory orders; Adhere to the mutual assistance and economy of cooperative medical care and mobilize farmers to resist the risk of disease; Adhere to openness, justice and fairness, standardize operations and strengthen supervision; Adhere to the convenience of the people and benefit the people, and truly benefit farmers.
Third, increase financial support from the central and local governments.
In order to show the concern of the Party and the government for farmers' health, improve farmers' benefit level and guide farmers to actively participate, from 2006, the central government will increase the annual subsidy for farmers in the central and western regions except towns 10 yuan to 20 yuan, and the local finance will increase accordingly 10 yuan. Provinces (autonomous regions and municipalities) with financial difficulties can increase 5 yuan in 2006 and 2007 respectively, and put it in place within two years. The cooperative medical subsidy funds increased by local finance should be mainly borne by provincial finance. In principle, it should not be shared equally by provinces, cities and counties in proportion, and the financial burden of difficult counties cannot be increased. Farmers' individual payment standards will not be raised for the time being. At the same time, the municipal districts and pilot counties (cities, districts) of Liaoning, Jiangsu, Zhejiang, Fujian, Shandong and Guangdong provinces in the central and western regions will be included in the scope of central financial subsidies. The central government allocates subsidy funds to Liaoning, Jiangsu, Zhejiang, Fujian, Shandong and Guangdong provinces according to a certain proportion of the subsidy standards in the central and western regions. Financial departments at all levels should conscientiously implement the new rural cooperative medical subsidy funds, arrange them in full in the budget at the beginning of the year, and allocate them in time to provide the necessary financial guarantee for the smooth development of the new rural cooperative medical system.
Four, constantly improve the cooperative medical fund raising and supervision mechanism.
All localities should conscientiously sum up the good practices of the pilot units, actively explore individual payment methods for farmers, give full play to the role of grassroots organizations, and establish a stable financing mechanism. If the individual farmers wish, with the consent of the villagers' congress, the villagers' autonomous organizations can collect individual contributions from the farmers on their behalf. To strengthen the management of funds, special storage, earmarking, strictly implement the closed operation of funds, to ensure that the cooperative medical fund and interest are all used for participating farmers' Medicaid. It is necessary to establish and improve the audit reimbursement method of cooperative medical care that is convenient for farmers and easy to supervise, implement the publicity system of fund use management in counties, townships and villages, regard the reimbursement of cooperative medical care as an important content of village affairs disclosure, explore the long-term mechanism of farmers' participation in supervision and democratic management, and protect farmers' right to know and supervise. It is necessary to strengthen the special audit of the management and use of the cooperative medical fund, find problems and correct them in time.
Five, scientifically and reasonably formulate and adjust the compensation scheme for farmers' medical expenses.
With the increase of the number of pilots and the improvement of the level of government subsidies, all localities should carefully calculate and scientifically formulate and adjust the compensation scheme for farmers' medical expenses on the basis of analyzing and summarizing the cooperative medical system and fund operation. The following principles should be grasped in the formulation and adjustment of the scheme: first, on the basis of establishing the risk fund, the cooperative medical fund is balanced in income and expenditure, with a slight balance; Second, the new central and local financial subsidy funds should be mainly used for serious illness pooling funds, and can also be appropriately used for small medical expenses subsidies to improve the level of cooperative medical subsidies; Third, the compensation scheme should be balanced, and the difference between adjacent counties should not be too big; Fourth, the adjustment of compensation scheme should be implemented from the new year to maintain the continuity and stability of the policy.
Six, strengthen the cooperative medical management capacity building.
Pilot counties (cities, districts) should strengthen institutional construction and management. It is necessary to solve the problem of establishing cooperative medical service institutions according to regulations, and at the same time support insurance companies to participate in the pilot cooperative medical care. According to the basic principles and policy requirements of the new rural cooperative medical system, the rights and obligations of relevant government departments, agencies (insurance companies) and designated medical institutions are clarified, the legitimate rights and interests of participating farmers are guaranteed, and convenient and good services are provided for farmers. It is necessary to continue to strengthen the policy and business training of cooperative medical management personnel and handling personnel, and improve the management ability of cooperative medical care. It is necessary to speed up the informatization construction of cooperative medical care, gradually realize online audit and reimbursement, supervision and information transmission, and strengthen standardized management. The financial departments of pilot counties (cities, districts) should include the personnel and working funds of the agencies in the annual budget to ensure that they are not allowed to be extracted from the cooperative medical fund. Local people's governments at all levels should provide appropriate start-up funds for newly-added pilot counties (cities, districts). The central government will support the pilot work in the central and western regions through special transfer payments.
Seven, to further solve the problem of poor farmers to see a doctor.
It is necessary to establish and improve the rural medical assistance system and make a good connection with the new rural cooperative medical system. Increase the support of governments at all levels for medical assistance funds, give full play to the leading role of civil affairs departments, mobilize social forces such as the Red Cross, foundations, charities and various enterprises and institutions, and raise funds through multiple channels. Further improve relevant policies and measures, clarify the scope of assistance, improve the level of assistance, and focus on solving the problems of rural five-guarantee households and poor families. While helping the recipients to participate in cooperative medical care, appropriate subsidies shall be given to the part of medical expenses that is too heavy and unbearable for individuals. In view of the fact that poor families in rural areas have low incomes and great difficulties in life, more preferential policies are given to rural aid recipients in the pilot work of the new rural cooperative medical system. Through the coordination and complementarity of the new rural cooperative medical system and medical assistance, the outstanding problem of poor farmers' difficulty in seeing a doctor can be solved.
Eight, strengthen the supervision of rural medical services.
Health administrative departments at all levels should strengthen the supervision of the service behavior and expenses of medical institutions, take effective measures to curb the unreasonable growth of rural medical expenses, and reduce the burden of medical expenses on farmers. It is necessary to establish the entry and exit system of designated medical institutions of cooperative medical care and introduce competition mechanism; Formulate the catalogue of basic drugs and diagnosis and treatment of cooperative medical care, strictly stipulate the proportion of drugs and diagnosis and treatment expenses outside the catalogue to the total medical expenses, and implement the patient review and signature system; Strictly control the growth of average hospitalization expenses and average outpatient expenses of designated medical institutions, and control the proportion of drug income in the income of designated medical institutions. It is necessary to strengthen the supervision of township hospitals and safeguard the public welfare nature of public hospitals. Attach importance to and strengthen the application of Chinese medicine and ethnic medicine, include qualified Chinese medicine medical institutions in the scope of designated medical institutions, and include appropriate Chinese medicine and Chinese medicine diagnosis and treatment items in the catalogue of basic drugs and diagnosis and treatment of cooperative medical care to meet the needs of farmers for Chinese medicine and ethnic medicine. The competent price department shall, jointly with the administrative department of health, explore and formulate feasible rural medical service project specifications and medical price standards.
Nine, continue to strengthen the rural drug supervision and supply network construction.
Continue to strengthen the construction of rural drug supervision network, promote the construction of rural drug supply network, make full use of existing networks and personnel, establish a drug supply and marketing system and supervision system suitable for rural reality, standardize drug supply and marketing channels, strengthen quality supervision, and severely crack down on illegal drug business activities. Gradually promote the centralized procurement or follow-up procurement of drugs in rural medical and health institutions; It can also be purchased by county-level medical institutions or township hospitals for village clinics; Encourage pharmaceutical chain enterprises to extend to rural areas and implement centralized distribution to rural primary medical institutions. Through the establishment of various forms of rural drug supply channels, farmers are guaranteed to use drugs safely, effectively and economically.
Ten, accelerate the construction of rural health service system.
Strengthen the construction of rural medical and health infrastructure and improve the rural medical and health service system and network at the county, township and village levels. Incorporate the rural health service system into the Eleventh Five-Year Plan, focus on strengthening the capacity building of county and township medical and health institutions, and give appropriate support to the construction of village clinics in poverty-stricken areas in the central and western regions and areas with serious and serious diseases. Governments at all levels should set up a public health center in each township, which is managed by the county government. Where conditions permit, rural community health service institutions can be established according to the actual situation by integrating existing health resources to better undertake public health work such as disease prevention and control, basic medical care and health education in rural areas. All localities should combine the reform of township institutions, clarify the responsibilities of township public health work and put them in place. Governments at all levels should establish and improve the rural health fund guarantee mechanism in accordance with the principle of clear responsibilities and reasonable burden.
Eleven, strengthen the construction of rural grassroots medical and health teams.
Strengthen the training of rural grassroots health technicians, establish a lifelong education system, and improve the professional knowledge and skills of rural health personnel. Medical colleges and universities should strengthen the training of health professionals facing the needs of rural areas and expand the pilot program of directional enrollment. Study and formulate preferential policies for the promotion of rural health technicians' professional titles, and encourage rural health technicians to work with peace of mind. In order to establish a long-term mechanism for urban health to support rural areas, urban hospitals should regularly send medical staff to county hospitals and township hospitals to help carry out medical services and technical training. Before a city doctor is promoted to an attending or deputy chief physician, he must have served in a county or township medical institution for 1 year. After obtaining the doctor's practice certificate, the newly recruited university graduates from urban medical and health institutions will serve in rural medical and health institutions in batches 1 year. The length of service can be calculated as the time that city doctors must serve in rural areas before they are promoted to attending and deputy chief physicians. County hospitals should also establish a fixed-point assistance system for township medical institutions. It is necessary to formulate policies to guide medical college graduates to engage in voluntary service in rural grassroots.
Twelve, strengthen the organization and leadership of the new rural cooperative medical system.
All localities should take the establishment of a new rural cooperative medical system as an important measure to safeguard farmers' health rights and interests, improve farmers' comprehensive quality, effectively solve the "three rural issues" and build a new socialist countryside, put on the work schedule, raise awareness, strengthen leadership, organize all forces and actively support this work. All relevant departments should clarify their responsibilities, strengthen coordination and cooperate closely. Health departments should give full play to the role of competent departments and strengthen management and policy guidance; The financial department should strengthen the audit and supervision of fund raising and use; The agricultural department should cooperate with the publicity and promotion work, assist in the management of fund raising and supervise the use of funds; Civil affairs departments should do a good job in rural medical assistance and support the establishment and improvement of cooperative medical care; Food and drug supervision departments should strengthen drug supervision in rural areas and cooperate with the healthy development of the pilot work of the new rural cooperative medical system; The administrative department of traditional Chinese medicine should attach importance to the advantages and functions of traditional Chinese medicine in the new rural cooperative medical system. It is necessary to strengthen the publicity and guidance of public opinion, strive for the understanding and support of the whole society, and mobilize the enthusiasm of farmers to participate in cooperative medical care. Through unremitting efforts, we will gradually establish a new rural cooperative medical system that conforms to China's national conditions, rural economic development level and farmers' medical and health needs.
hygiene department
National Development and Reform Commission (NDRC)
Ministry of Civil Affairs
the Ministry of Finance
Ministry of Agriculture
Food and drug administration
Chinese medicine bureau