Strengthening medical and health services, in-depth reform of the medical security system is the people's most concerned about the most direct and most realistic problems. China **** the Sixth Plenary Session of the 16th Plenary Session considered and adopted the "decision on a number of major issues in building a harmonious socialist society" clearly put forward to "strengthen medical and health services, improve people's health". "Adhere to the public welfare nature of public *** health care" and "build a basic medical and health-care system that covers both urban and rural residents, and provide safe, effective, convenient and inexpensive public *** health care and basic medical services for the masses." This points to the direction for deepening the reform of the medical security system.
"Expensive" and "difficult to see a doctor" problem has been a social concern, the masses reflect the strong hot issues, affecting the construction of a harmonious socialist society. Currently, the main manifestations of "expensive" and "difficult" medical care are: medical costs have risen faster than the growth rate of economic development, the increase in medical expenditures has exceeded the expectations of the masses (especially when compared with the growth rate of wage income or pensions), the quality of medical services has improved disproportionately to the expectations of the masses and the increase in expenditures, and the quality of medical services has improved disproportionately to the increase in medical expenditures. The increase in the quality of medical services is disproportionate to the public's expectations and expenditures, the irregularities in the medical market and the corruption that exists in certain hospitals and medical personnel have caused a crisis of confidence among the public, as well as the difficulty in paying for medical care among the people in difficulty who are "impoverished because of illness" and "impoverished because of illness", and so on. etc. Excessive medical care provided by some hospitals on their own initiative or blindly demanded by patients is also one of the causes of "expensive medical care". However, the most important reason is that the capitalization and operation mechanism of medical institutions can no longer adapt to the needs of maintaining public welfare under the conditions of a market economy, and the relevant research and reforms are seriously lagging behind, which has led to the concentration of conflicts in the "difficulties in accessing medical care" and the "high cost of accessing medical care". Elderly people with many illnesses, or the poor and rural patients with serious illnesses, the problem of "expensive medical care" is particularly prominent.
The main reasons for these problems are:
First, the existing health care system design lacks a holistic approach. Although the problem of medical insurance was solved at the time, as the situation developed, the lack of uniformity in the insurance programs, the large differences in treatment, the urban-rural dichotomy, and the difficulty of transfer have become more and more prominent.
Secondly, the existing urban medical insurance system design has the following deficiencies: First, due to the lack of institutional constraints resulting in management loopholes. The first is the lack of institutional constraints resulting in management loopholes, such as the emergence of the supply side of the phenomenon of "large prescriptions, large checkups" and so on. Second, there is a lack of flexibility in regulation. Although the system stipulates that the billing benchmark is unlikely to be adjusted according to the level of economic development, it is unlikely that it will be adjusted year after year in actual operation, and the gap will become wider and wider as it accumulates over a number of years. Thirdly, the efficiency of the use of funds is not high. Fourth, the positive significance of controlling health insurance costs has not become the supply and demand side of the **** knowledge, hospitals in the investment and financing reform has not been deepened, is still pursuing the maximization of profits.
Third, health care reform and the development of the pharmaceutical industry and health insurance reform has not been synchronized. In recent years, health care and the pharmaceutical industry has developed rapidly, but the level of medical and health care development and socio-economic support capacity and the ability of all parties to bear the relatively low formation of contradictions. Development needs financial support, but the long-term confusion of the hospital's funding channels have not changed; public **** insufficient financial input so that the hospital to raise funds only through the provision of medical services to obtain a surplus, the hospital is facing the dilemma of the development of the hospital and the control of medical costs pressure.