The Four Systems of the Opinions of the Central Government and the State Council on Deepening the Reform of the Medical and Health Care System

Establishing a basic medical and healthcare system covering urban and rural residents

Constructing a public ****health service system, a medical service system, a medical security system, and a drug supply security system covering urban and rural residents to form a four-in-one basic medical and healthcare system. The four systems complement each other, supporting 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 care, 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 the ability to deal with emergencies in public **** health incidents, and promote the gradual enjoyment of equalized basic public **** health services by urban and rural residents.

Defining the scope of public **** health services. Define the national basic public **** health service program, and gradually increase the content of the service. Local governments are encouraged to increase the content of public **** health services on the basis of the centrally stipulated service items, in accordance with the level of local economic development and prominent public **** health problems.

Improving 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. Strengthening the construction of first aid systems in urban and rural areas.

Strengthening health promotion and education. Medical and health institutions and institutions, schools, communities and enterprises 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 is incorporated into the planning for the construction of new socialist countryside, promoting the construction of sanitary cities and civilized villages and towns, and continuously improving the sanitary environment for urban and rural residents in terms of their living and working conditions.

Strengthening health supervision services. It vigorously promotes environmental hygiene, food hygiene, occupational hygiene, school hygiene, and the hygiene of migrant workers and other mobile populations.

(E) further improve the medical service system. Adhere to the principle of running medical services with non-profit medical institutions as the mainstay and for-profit medical institutions as supplements, and with public medical institutions as the dominant ones and non-public medical institutions **** the same development, and build a reasonably structured medical service system that covers both urban and rural areas.

Vigorously develop the rural medical and health service system. Further improve the rural medical and health service network with county-level hospitals as the leader and township health centers and village health offices as the foundation. County hospitals, as medical and health care centers within the county, are mainly responsible for basic medical services and the rescue of critically ill and emergency 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 frequent diseases, and undertake the business management and technical guidance of village health offices; village health offices are responsible for 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 promoting rural health care infrastructure and capacity building, the government focuses on running county hospitals and running a health center in each township, taking various forms of support for the construction of village health rooms, so that each administrative village has a village health room, vigorously improving rural health care conditions and improving 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 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".

Sound 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 emergencies and difficult illnesses, medical education and scientific research, and the guidance and training of grass-roots health personnel. Large hospitals that are in a position to do so, in accordance with the requirements of regional health planning, can promote the rational flow of medical resources through trusteeship and reorganization.

Establishing a mechanism for division of labor and collaboration between urban hospitals and community health service organizations. Urban hospitals drive the sustainable development of community health services through technical support and personnel training. At the same time, comprehensive measures such as enhancing service capacity, lowering fees and raising reimbursement rates have been taken to guide the sinking of general diagnosis and treatment to the grassroots level, and to gradually realize community-based first-aid, 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 belonging to 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.

To 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 by Chinese medicine. In grassroots medical and health services, vigorously promote appropriate technologies in Chinese medicine. Adopting policies to support the development of Chinese medicine, and promoting the inheritance and innovation of Chinese medicine.

Establishing a system for urban hospitals to provide counterpart support for rural health care. Developed regions should strengthen counterpart support for the development of medical and health care in poor and ethnic minority areas. Large urban hospitals should establish a long-term and stable system of counterpart support and cooperation with county-level hospitals, adopting clinical services, personnel training, technical guidance, equipment support and other means to help them improve their medical standards and service capabilities.

(VI) Accelerating the construction of the medical security system. Accelerate the establishment and improvement of a multi-level medical security system with basic medical security as the mainstay, supplemented by other various forms of supplementary medical insurance and commercial health insurance, covering urban and rural residents.

Establishing 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*** all make up the basic medical insurance system, covering the urban employed population, the urban non-employed population, the rural population, and the urban and rural population in difficulty, 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 a basic medical insurance management system that integrates urban and rural areas.

Encouraging trade unions and other social organizations to carry out various forms of mutual medical assistance. Encourage and guide various organizations and individuals to develop social charitable medical assistance.

The basic medical insurance system for urban workers, the basic medical insurance system for urban residents, the new rural cooperative medical system and the urban-rural medical assistance system are well connected. It is actively working on the transfer and continuation of basic medical insurance relations, with a focus on rural and urban migrant workers, and improving medical settlement services in other places, with a focus on retirees resettled in other places. Properly solving the basic medical insurance problems of rural migrant workers. Migrant workers who have signed labor contracts and established stable labor relations with enterprises should be included in the basic medical insurance system for urban workers in accordance with national regulations that specify the responsibility of employers to make contributions; other migrant workers should, according to the actual situation, participate in the new type of rural cooperative medical care in the place where they are domiciled, or in the basic medical insurance for urban residents in the place where they are working.

Actively developing commercial health insurance. Commercial insurance organizations are encouraged to develop health insurance products to meet different needs, simplify claims procedures, facilitate the masses, and meet diversified health needs. Encourage enterprises and individuals to solve the needs beyond basic medical insurance by participating in commercial insurance and various forms of supplementary insurance. Under the premise of ensuring fund safety and effective supervision, the government actively promotes the purchase of medical insurance services, and explores the commissioning of qualified commercial insurance organizations to handle various types of medical insurance management services.

(VII) Establishing and improving the drug supply guarantee system. Accelerate the establishment of a drug supply guarantee system based on the national basic drug system, to ensure the safety of the people's medication.

Establishing a national basic drug system. The central government uniformly formulates and publishes a national catalog of essential medicines, and reasonably determines the varieties and quantities in accordance with the principles of necessity, safety and efficacy, reasonable price, ease of use, and equal emphasis on both traditional Chinese and Western medicines, and taking into account the characteristics of China's use of medicines, and with reference to international experience. A production and supply guarantee system for essential medicines will be established, giving full play to the role of the market mechanism under the government's macro-control; essential medicines will be procured through public bidding and unified distribution, reducing intermediate links and guaranteeing basic medicines for the public. The State sets retail guide prices for essential medicines, and within those guide prices, the people's governments at the provincial level set uniform procurement prices for their regions based on bidding. The use of basic medicines will be standardized, and guidelines for the clinical application of basic medicines and prescription sets for basic medicines will be formulated. Urban and rural primary medical and healthcare institutions should all be equipped with and use basic medicines, and other types of medical institutions should also make basic medicines their preferred medicines and determine the proportion of their use. Basic drugs are all included in the basic medical insurance drug reimbursement catalog, the reimbursement rate is significantly higher than non-basic drugs.

Regulate the production and circulation of drugs. Improve the pharmaceutical industry development policy and industry development planning, strict market access and drug registration and approval, vigorously regulate and rectify the order of production and circulation, promote pharmaceutical enterprises to improve the independent innovation capability and optimization and upgrading of the structure of the pharmaceutical industry, the development of modern logistics and chain management of pharmaceuticals, and to promote the integration of pharmaceutical production and distribution enterprises. Establishing a rural drug supply network for the convenience and benefit of farmers. Improve the drug reserve system. Support the production of special and emergency medicines in small quantities. Standardize drug procurement and resolutely combat commercial bribery in the purchase and sale of medicines. Strengthen the monitoring of adverse drug reactions and establish an early warning and emergency response mechanism for drug safety.