Opinions on Deepening the Reform of the Medical and Health Care System
(March 17, 2009)
In accordance with the spirit of the 17th National Congress of the CPC, and in order to set up a medical and health care system with Chinese characteristics, to gradually realize the goal of basic medical and health care services for everyone, and to improve the health of all the people, we hereby put forward the following opinions on deepening the reform of the medical and health care system. Opinions.
First, fully understand the importance, urgency and arduousness of deepening the reform of the medical and health system
Medical and health care is related to the health of hundreds of millions of people, the relationship between the well-being of millions of families, is a major livelihood issues. Deepen the reform of the medical and health system, accelerate the development of medical and health care, to meet the people's growing demand for medicine and health, and constantly improve the quality of health of the people, is the implementation of the scientific concept of development, to promote the overall coordination of economic and social sustainable development of the inevitable requirements of the maintenance of social justice and improve the quality of people's life is an important initiative, is to build a moderately affluent society in an all-round way and build a harmonious socialist society, a major task. A major task.
Since the founding of New China, especially since the reform and opening up, China's medical and health undertakings have made remarkable achievements, covering urban and rural medical and health service system is basically formed, the ability to prevent and control diseases has been increasing, the population covered by medical insurance has been gradually expanding, the level of health science and technology has been rapidly improved, the health of the masses of the people has improved significantly, and the main health indicators of the population are at the forefront of developing countries. Especially since the major victory in the fight against SARS, government investment at all levels has increased, the development of public *** health, rural health care and urban community health has accelerated, and breakthroughs have been made in the new type of rural cooperative medical care and basic medical insurance for urban residents, laying a good foundation for the deepening of the reform of the medical and health system. At the same time, it should also be noted that the contradiction between the current level of development of China's medical and health services and the people's health needs and the requirements for coordinated economic and social development is still relatively prominent. The development of urban and rural and regional health care is not balanced, the allocation of resources is unreasonable, public **** health and rural, community health care is relatively weak, the medical security system is not sound, the order of the production and circulation of medicines is not standardized, the hospital management system and operation mechanism is not perfect, the government health investment is insufficient, the cost of medicine is rising too fast, the individual burden is too heavy, in this regard, the people's public reflected strongly.
From now to 2020, is China's comprehensive construction of a moderately prosperous society in the critical period, the task of medicine and health work heavy. With the development of the economy and the improvement of people's living standards, the masses will have higher requirements for the improvement of medical and health services. Industrialization, urbanization, population aging, changes in the disease spectrum and changes in the ecological environment have brought a series of new and serious challenges to medical and health work. Deepening the reform of the medical and health system is a strategic choice to accelerate the development of medical and health care, an important way to realize the people's **** to enjoy the fruits of reform and development, and the urgent desire of the general public.
Deepening the reform of the medical and health system is a wide-ranging and difficult social system project. China's large population, low per capita income level, urban-rural, regional disparities, the basic conditions of the primary stage of socialism for a long time, determines the deepening of the reform of the medical and health system is a very complex and arduous task, is a gradual process, the need for a clear direction and framework on the basis of a long period of painstaking efforts and unremitting efforts to explore the gradual establishment of medical and health system to meet the country's national conditions. Therefore, to deepen the reform of the medical and health system, we should not only be determined to push forward, but also carefully organized and steadily implemented to ensure that the reform is carried out smoothly and achieve the desired goals.
Second, deepen the reform of the medical and health system of the guiding ideology, basic principles and overall objectives
(a) deepen the reform of the medical and health system of the guiding ideology. Deng Xiaoping Theory and the "Three Represents" as the guidance, in-depth implementation of the scientific concept of development, from China's national conditions, drawing on international experience, focusing on the realization of the goal of basic medical and health services for all, and focusing on solving the people's most concerned about, the most direct, the most realistic interests of the problem. We will adhere to the public welfare nature of public health care, adhere to the policy of focusing on prevention, focusing on rural areas, and giving equal importance to both traditional Chinese and Western medicine, implement the separation of government affairs, management and administration, medicine, and profit-making and non-profit-making, strengthen the government's responsibility and investment, improve the national health policy, improve the system, strengthen supervision and management, innovate the system and mechanism, and encourage the participation of society, so as to build a basic medical care system covering urban and rural residents, and continuously improve the health level of the entire population. system for urban and rural residents, continuously improve the health of all people, and promote social harmony.
(2) The basic principles of deepening the reform of the medical and health system. The reform of the medical and health system must be based on national conditions, all from a practical point of view, and adhere to the correct principles of reform.
- Adhere to the people-oriented, the maintenance of people's health rights and interests in the first place. Adhere to the medical and health services for the people's health purposes, to protect the people's health as the center, in order to enjoy the basic medical and health services for everyone as the fundamental starting point and finishing point, from the design of the reform program, the establishment of the health system to the construction of the service system to follow the principle of public welfare, the basic medical and health care system as a public **** products to the whole population, and focus on solving the outstanding problems of the people's strong reaction, and strive to achieve All people have medical treatment for their illnesses.
- Adhere to the national conditions, the establishment of medical and health system with Chinese characteristics. Adhere to the basic national conditions, pragmatically summarize the practical experience of the reform and development of medicine and health care, accurately grasp the laws of development of medicine and health care and the main contradictions; adhere to the level of basic medical and health care services in coordination with economic and social development, and with the affordability of the masses; give full play to the role of traditional Chinese medicine (ethnomedicine); adhere to the local conditions, classified guidance, and give full play to the local initiative to explore the establishment of a basic medical and health care system in line with national conditions. basic medical and health care system in line with national conditions.
- Adhere to the unity of fairness and efficiency, and the combination of government-led and market mechanism. Strengthen the government's responsibility in the basic medical and healthcare system, enhance the government's responsibilities in the system, planning, financing, services, supervision, etc., to maintain the public ***** medical and healthcare public welfare, and promote fairness and justice. At the same time, focusing on the role of the market mechanism, mobilizing the participation of social forces, promoting the formation of an orderly competition mechanism, improve the efficiency of health care operations, service level and quality, to meet the people's multi-level and diversified health care needs.
- Adhering to a balanced approach, combining the solution of current outstanding problems with the improvement of the system. Starting from the overall situation, integrating urban, rural and regional development, taking into account the interests of all parties, including the supply side and the demand side, focusing on the combination of prevention, treatment and rehabilitation, and correctly dealing with the relationship between the government, health institutions, pharmaceutical enterprises, medical personnel and the people. It focuses on the long term, innovates institutional mechanisms, and is based on the present, focusing on solving the outstanding problems in medicine and health care. Both focus on the overall design, clear overall reform direction and goals and the basic framework, but also highlight the key points, step by step implementation, actively and steadily promote the reform.
(C) the overall goal of deepening the reform of the medical and health system. To establish and improve the basic medical and health care system covering urban and rural residents, and to provide safe, effective, convenient and inexpensive medical and health care services for the masses.
By 2011, the basic medical security system to fully cover urban and rural residents, the initial establishment of the basic drug system, urban and rural grassroots medical and health service system is further improved, the basic public **** health services have been popularized, the pilot reform of public hospitals to achieve breakthroughs, and significantly improve the accessibility of basic medical and health services, and effectively reduce the burden of the cost of medical care for the residents, and effectively alleviate the "difficult to see the doctor, see the doctor", and the "health care system". The problem of "difficult and expensive to see a doctor" is effectively alleviated.
By 2020, the basic health care system covering urban and rural residents was basically established. The general establishment of a more complete public **** health service system and medical service system, a more sound medical security system, a more standardized drug supply guarantee system, a more scientific medical and health institutions management system and operation mechanism, the formation of a multi-dimensional pattern of medical treatment, everyone enjoys the basic medical and health services, basically adapted to the people's multi-level medical and health care needs, and the health of the masses of the people to further improve.
Third, improve the four major systems of medicine and health, the establishment of a basic medical and health care system covering urban and rural residents
The construction of a public **** health service system covering urban and rural residents, medical service system, medical security system, drug supply security system, the formation of a four-in-one basic medical and health care system. The four systems complement each other, supporting the construction and coordinated development.
(D) comprehensively strengthen the construction of public **** health service system. Establish and improve disease prevention and control, health education, maternal and child health, mental health, emergency treatment, blood collection and supply, health supervision and family planning and other professional public **** health service network, improve the primary health care service network based on the medical service system of the public **** health service function, the establishment of a clear division of labor, information interoperability, resource **** enjoyment, coordinated and interactive public **** health service system, to improve public **** health services and emergency response capacity for public **** health emergencies, and promote urban and rural residents to gradually enjoy equalized basic public **** health services.
Determine the scope of public **** health services. Define the national basic public **** health service program, and gradually increase the content of the service. Encourage local governments to increase the content of public **** health services on the basis of the centrally stipulated service items according to the level of local economic development and prominent public **** health problems.
Improve the public **** health service system. Further define the functions, goals and tasks of the public **** health service system, optimize staffing and equipment allocation, and explore effective forms of integrating public **** health service resources. It has improved the system for the prevention and control of major diseases and the emergency response mechanism for public **** health emergencies, and strengthened the monitoring and preventive control of infectious diseases, chronic diseases, endemic diseases, occupational diseases and birth defects that pose a serious threat to people's health. Strengthen the construction of urban and rural first aid system.
Strengthen health promotion and education. Medical and health institutions and institutions, schools, communities, enterprises, etc. to vigorously carry out health education, make full use of all kinds of media, strengthen the dissemination of health, medicine and health knowledge, advocate a healthy and civilized lifestyle, promote the public reasonable nutrition, improve the public's health awareness and self-care ability.
In-depth patriotic health campaign. Rural sanitation and environmental pollution control into the new socialist countryside construction planning, promote the construction of sanitary cities and civilized villages and towns, and constantly improve the urban and rural residents living, working and other aspects of the health environment.
Strengthen health supervision services. Vigorously promote environmental hygiene, food hygiene, occupational hygiene, school hygiene, as well as migrant workers and other mobile population health.
(E) to further improve the medical service system. Adhere to the non-profit medical institutions as the main body, for-profit medical institutions as a supplement, public medical institutions as the dominant non-public medical institutions *** with the development of the principle of running a medical, construction of a reasonable structure, covering urban and rural medical service system.
Greatly develop the rural medical and health service system. Further improve the rural medical and health service network based on county-level hospitals as the leader, township health centers and village health offices. County hospitals, as medical and health centers within the county, are mainly responsible for basic medical services and the rescue of critically ill patients, and undertake the business and technical guidance of township health centers and village health offices and the further training of health personnel; township health centers are responsible for providing comprehensive services such as public **** health services and the diagnosis and treatment of common and common diseases, and undertake the business management and technical guidance of village health offices; and village health offices undertake the business management and technical guidance of administrative villages. The village health office is responsible for the public **** health services and the diagnosis and treatment of common diseases in the administrative village. Rural villages that are in a position to do so are practicing integrated rural management. Actively promote rural health care infrastructure and capacity building, the government focuses on running county hospitals, and in each township to run a health center, take various forms of support for the construction of village health rooms, so that each administrative village has a village health room, and vigorously improve the conditions of rural health care, improve the quality of service.
Improve the new urban medical and health service system based on community health service. Accelerate the construction of community health service centers as the main body of the urban community health service network, improve the function of the service, in order to maintain the health of community residents as the center, to provide disease prevention and control and other public **** health services, general common diseases and common diseases of the primary diagnosis and treatment services, chronic disease management and rehabilitation services. Transform the community health service model, constantly improve the level of service, adhere to the active service, door-to-door service, and gradually assume the responsibility of the residents' health "gatekeeper".
Improve the functions and responsibilities of various types of hospitals. Optimize the layout and structure, and give full play to the backbone role of urban hospitals in the diagnosis and treatment of critical and emergency cases and difficult illnesses, medical education and scientific research, and the guidance and training of grassroots health personnel. Large hospitals that are in a position to do so can, in accordance with the requirements of regional health planning, promote the rational flow of medical resources through trusteeship and reorganization.
The establishment of urban hospitals and community health service organizations of the division of labor and cooperation mechanism. Urban hospitals drive the sustainable development of community health services through technical support and personnel training. Meanwhile, comprehensive measures such as enhancing service capacity, lowering fees, and increasing reimbursement rates have been taken to guide the general diagnosis and treatment down to the grassroots level, and to gradually realize the first community diagnosis and treatment, hierarchical medical care, and two-way referral. Integration of urban health resources, making full use of the city's existing first- and second-tier hospitals and medical institutions owned by state-owned enterprises and public institutions and social forces to organize medical institutions and other resources to develop and improve the community health service network.
Give full play to the role of traditional Chinese medicine (ethnomedicine) in disease prevention and control, response to public **** health emergencies, medical services. Strengthen the construction of Chinese medicine clinical research bases and Chinese medicine hospitals, and organize and carry out joint research on the prevention and treatment of difficult diseases in Chinese medicine. In grassroots medical and health services, vigorously promote appropriate technologies in Chinese medicine. Adopt policies to support the development of Chinese medicine and promote the inheritance and innovation of Chinese medicine.
The establishment of urban hospitals to support rural health care system. Developed areas to strengthen the counterpart support for the development of medical and health care in poor areas and ethnic minority areas. Large urban hospitals should establish a long-term stable counterpart support and cooperation system with county-level hospitals, and adopt clinical services, personnel training, technical guidance, equipment support, etc., to help them improve their medical level and service capacity.
(F) accelerate the construction of the medical security system. Accelerate the establishment and improvement of the basic medical insurance as the main body, other forms of supplementary medical insurance and commercial health insurance as a supplement, covering urban and rural residents of the multi-level medical security system.
The establishment of a basic medical insurance system covering urban and rural residents. Basic medical insurance for urban workers, basic medical insurance for urban residents, new rural cooperative medical care and urban and rural medical assistance*** together form a basic medical insurance system that covers the urban employed population, the urban non-employed population, the rural population and the urban and rural population in need, respectively. Adhering to the principles of broad coverage, basic protection and sustainability, the system starts by focusing on the protection of major illnesses, and gradually extends to minor outpatient illnesses, with the level of protection being continuously raised. Establishing a multi-channel financing mechanism with clear responsibilities and reasonable burden-sharing among the State, organizations, families and individuals, and realizing mutual social assistance***. With economic and social development, the level of financing and the level of coordination will be gradually raised, narrowing the gap between the levels of protection and ultimately realizing the basic unity of the system's framework. Further improving the basic medical insurance system for urban workers, accelerating the coverage of the employed population, and focusing on solving the basic medical insurance problems of workers and retirees of state-owned enterprises that have closed down and gone bankrupt, enterprises in difficulty, etc., as well as of employees of non-publicly owned economic organizations and flexibly employed persons; and comprehensively promoting basic medical insurance for urban residents in 2009, with an emphasis on solving the basic medical insurance problems of the elderly, persons with disabilities, and children; Fully implementing the new rural cooperative medical care system, gradually raising the level of government subsidies, appropriately increasing farmers' contributions, and improving the ability to provide protection; improving the urban and rural medical assistance system, and providing subsidies to people in difficulty for enrolling in the insurance system and for medical expenses they find difficult to bear, so as to build a solid bottom line for medical protection. Explore the establishment of urban and rural integration of the basic medical insurance management system.