Legal analysis: Sanming City, Fujian Province, as an early pilot city for health care reform, has come out of its own way, and many of its successful experiences are worthy of reference for other places. The so-called "Sanming model" does not have a clear definition, but can be roughly summarized in two aspects: on the supply side of medical services, greatly strengthened administrative control, while clear financial and health insurance spending responsibility. Specifically manifested in the implementation of the annual salary system for deans and medical technicians, of which the dean's salary is fully covered by the financial; at the same time, the development of five categories of 34 assessment indicators, the dean of the comprehensive assessment, the results of the assessment and the dean of the annual salary payment linkage. Among them, the financial responsibility for the expenditure of public hospitals only hardware investment (capital construction and large equipment purchases, etc.) and the dean's salary. Sanming has also imposed strict controls on the distribution of medicines and tightly controlled the prescribing authority of doctors. On the demand side of medical services, Sanming has implemented citywide coordination of three types of health insurance funds and reforms such as outpatient coordination and single-patient payment.
In June 2013, the three types of health insurance agencies, including urban workers' health insurance, residents' health insurance and new rural cooperative insurance, were integrated into a medical insurance fund management center. The center is subordinate to the municipal government and is temporarily managed by the finance department (mainly due to the fact that management responsibilities have not yet been consolidated at the national level). The citywide integration and the management of the health insurance administration by the financial sector are notable features of Sanming's reform. Sanming City, Fujian Province, health care reform to address the "medicine for medicine" and "rip off patients" of the persistent problems, with a combination of resolute reversal of the mechanism of public hospitals to generate income and profit, the initial establishment of a new system to protect the public welfare of the medical system, so that the hospitals and doctors to return to their duties to save lives and help the injured.
Legal basis: "on the further promotion of Fujian Province and Sanming City to deepen the experience of medical and health system reform notice" Deepening medical, medical insurance, pharmaceutical "three doctors" linkage reform. Sanming City, in accordance with the idea of vacating the cage and exchanging the bird and the path of vacating space, adjusting structure and ensuring convergence, deepens the "three medical" linkage reform, implements the joint price-limit procurement of medicines and consumables, and, in accordance with the principles of total amount control, structural adjustment, ascending and descending, and gradually puts in place the vacated space to ensure that the public benefits, and focuses on adjusting the prices of medical services accordingly, establishing a dynamic adjustment mechanism, and establishing an effective mechanism for adjusting prices. medical service prices, establish a dynamic adjustment mechanism, optimize the revenue structure of hospitals, and establish a new mechanism for the operation of public welfare. in 2018, the proportion of medical service revenue (excluding revenue from drugs, consumables, inspections, and laboratory tests, hereinafter the same) of public hospitals at the second level and above in Sanming City reached 42% of the medical revenue. Fujian Province comprehensively followed up on the pilot of centralized procurement and use of medicines organized by the State, implemented sunshine procurement of medical consumables, and promptly adjusted medical service prices accordingly. The Fujian Provincial Medical Electronic Settlement Center realizes the direct payment and settlement of the medical insurance fund to the pharmaceutical enterprises.