Several Opinions of the Leadership Group for Deepening the Medical and Health System Reform under the State Council on Further Promoting the Experience in Deepening the Medical and Health System Reform
Several Opinions of the Leadership Group for Deepening the Medical and Health System Reform under the State Council on Further Promoting the Experience in Deepening the Medical and Health System Reform
Several Opinions of the Leadership Group for Deepening the Medical and Health System Reform under the State Council on Further Promoting the Experience in Deepening the Medical and Health System Reform
November 8, 2016
Deepening the medical and health system reform is an important decision made by the Central Committee of the Communist Party of China ("CPC Central Committee") and the State Council and also a major task for deepening reform in an all-round manner and building a moderately prosperous society in all respects. In order to further consolidate and expand achievements gained from the medical reform, the following opinions are hereby proposed with regard to the popularization of experience acquired through the deepening of the medical and health system reform.
I. Significant Progress and Prominent Effects Realized for Deepening the Medical Reform
Since the start of a new round of medical reforms, particularly after the 18th National Congress of the CPC, all places and departments concerned have earnestly implemented decisions and arrangements made by the CPC Central Committee and the State Council, stuck to the core concept that the basic medical and health system shall be made available to the entire population as a public product, adhered to the basic principles of ensuring basic medical and health care services for the people, improving the services provided at the grass-roots level, and developing sound supporting mechanisms, insisted on the basic path of making overall arrangements, highlighting priorities and proceeding in an orderly and gradual way, tackled tough difficulties, firmly pushed forward various work related to the reform, and made great progress and gained prominent effects with regard to the deepening of the medical reform. Such progress and effects are mainly reflected by the facts that a medical insurance system for all people has been basically established as the coverage of basic medical insurance remains stable over 95% with a beneficiary population of 1.3 billion; and that the government subsidy for urban and rural resident medical insurance has been enhanced to CNY420 per capita and the urban and rural resident insurance for serious diseases have been carried out universally, and, as a result, the security level has been increased dramatically. Comprehensive reform of public hospitals has been continuously expanded to a wider scale and in greater depth as the number of prefectures (municipalities) where the comprehensive reform is implemented among public hospitals at prefecture level has reached 1,977 across the whole nation, with the total of pilot cities subject to the comprehensive reform of public hospitals amounting to 200, and a scientific management system and a running mechanism are being developed. The medical and health service system at the grass-roots level has been improved constantly as there is at least a health center in almost each county and a clinic in every village where the service capabilities have obviously been enhanced. The equalization of basic public health services has been substantially advanced and 45 national basic public health service programs in 12 categories carried out, covering the whole life of residents and benefiting millions of people. Besides, the drug supply and security system has been further optimized; the national basic drug system has come into effect, under which it is encouraged to purchase drugs used by public medical institutions provincially online in a centralized, open and transparent way, and a drug price formation mechanism that is oriented to the market will be gradually established. A graded diagnosis and treatment system will be established at a more rapid pace as over half of all prefectures (municipalities) in the whole nation have been subject to the pilot initial diagnosis at the grass-roots level and the consultation rate within a prefecture has reached 80%. The proportion of personal health expenditure to the total health expenditure continues to drop from 40.4% in 2008 to less than 30%; access to basic medical and health services is significantly improved as 80% of residents are able to reach a medical institution in 15 minutes; health conditions of the masses have been dramatically improved as the average expected life span is 76.34 years old, 1.51 years longer than that in 2010, and people's overall health conditions are better than the average status of high-income and middle-income countries, and high health performance has been realized with a relatively small amount of investment. It has been proved that the reform of medical and health systems has been deepened in the right direction through powerful measures along clear paths, with the reform outcome widely beneficial to the masses, and has played an important role in solving problems of seeing a doctor, improving people's physical qualities, maintaining social equity and justice, and promoting economic and social development.
Under the vigorous leadership of the CPC Central Committee and the State Council, the medical reform has been deepened with the focus gradually shifted from laying a solid foundation to improving qualities, from constructing the framework to developing systems, and from making individual breakthroughs to systematic integration and integrated advancement, with a constantly improved top-down design. Local authorities keep improving their initiatives and creativities and gradually are tackling key issues and difficulties, and a number of typical areas have been prominent in addressing extremely tough issues and making explorations and innovations, forming lots of experience and practices that are practicable, reproducible and propagable.
At present, as the deepened medical reform has waded into the deep-water zone and reached the crucial stage, the adjustment of interests is becoming more complicated and contradictions within the institutional mechanism have become prominent. During the critical period of the reform surmounting obstacles and getting through troubles, the practice of summarizing and popularizing good practices and mature experience learned from the deepening of the medical reform in the preliminary stage and giving full play to the demonstrative, breaking-through and leading effects of typical experience on the overall reform is beneficial to further efforts to unify thinking, bolster conviction and tackle tough circumstances, innovate institutional mechanisms and eliminate interest-related barriers, accelerate the improvement of the basic medical care system and realize the target of everyone's entitlement to basic medical care services, so as to lay a solid foundation for advancing the construction of Healthy China and building a moderately prosperous society.
II. Applying Typical Experience and Driving the Development of the Medical Reform in Depth and Breadth
1. Building up a powerful leadership system and a coordinated working mechanism for health care, medical insurance and pharmaceuticals to provide an organizational guarantee for the deepening of the medical reform
(1). Strengthen the leadership of party committees and governments in regard to the medical reform. Top leaders of local party committees and governments at all levels shall take charge of the deepening of the medical reform. Comrades or a comrade mainly in charge of party committees and governments shall act as the head of the leadership team for the medical reform, give full play to the role of the leadership team for the medical reform in overall planning and coordination, and earnestly implement the governments' responsibilities for the medical reform in respect of the leadership, guarantee, administration and supervision.
(2).
......
November 8, 2016
Deepening the medical and health system reform is an important decision made by the Central Committee of the Communist Party of China ("CPC Central Committee") and the State Council and also a major task for deepening reform in an all-round manner and building a moderately prosperous society in all respects. In order to further consolidate and expand achievements gained from the medical reform, the following opinions are hereby proposed with regard to the popularization of experience acquired through the deepening of the medical and health system reform.
I. Significant Progress and Prominent Effects Realized for Deepening the Medical Reform
Since the start of a new round of medical reforms, particularly after the 18th National Congress of the CPC, all places and departments concerned have earnestly implemented decisions and arrangements made by the CPC Central Committee and the State Council, stuck to the core concept that the basic medical and health system shall be made available to the entire population as a public product, adhered to the basic principles of ensuring basic medical and health care services for the people, improving the services provided at the grass-roots level, and developing sound supporting mechanisms, insisted on the basic path of making overall arrangements, highlighting priorities and proceeding in an orderly and gradual way, tackled tough difficulties, firmly pushed forward various work related to the reform, and made great progress and gained prominent effects with regard to the deepening of the medical reform. Such progress and effects are mainly reflected by the facts that a medical insurance system for all people has been basically established as the coverage of basic medical insurance remains stable over 95% with a beneficiary population of 1.3 billion; and that the government subsidy for urban and rural resident medical insurance has been enhanced to CNY420 per capita and the urban and rural resident insurance for serious diseases have been carried out universally, and, as a result, the security level has been increased dramatically. Comprehensive reform of public hospitals has been continuously expanded to a wider scale and in greater depth as the number of prefectures (municipalities) where the comprehensive reform is implemented among public hospitals at prefecture level has reached 1,977 across the whole nation, with the total of pilot cities subject to the comprehensive reform of public hospitals amounting to 200, and a scientific management system and a running mechanism are being developed. The medical and health service system at the grass-roots level has been improved constantly as there is at least a health center in almost each county and a clinic in every village where the service capabilities have obviously been enhanced. The equalization of basic public health services has been substantially advanced and 45 national basic public health service programs in 12 categories carried out, covering the whole life of residents and benefiting millions of people. Besides, the drug supply and security system has been further optimized; the national basic drug system has come into effect, under which it is encouraged to purchase drugs used by public medical institutions provincially online in a centralized, open and transparent way, and a drug price formation mechanism that is oriented to the market will be gradually established. A graded diagnosis and treatment system will be established at a more rapid pace as over half of all prefectures (municipalities) in the whole nation have been subject to the pilot initial diagnosis at the grass-roots level and the consultation rate within a prefecture has reached 80%. The proportion of personal health expenditure to the total health expenditure continues to drop from 40.4% in 2008 to less than 30%; access to basic medical and health services is significantly improved as 80% of residents are able to reach a medical institution in 15 minutes; health conditions of the masses have been dramatically improved as the average expected life span is 76.34 years old, 1.51 years longer than that in 2010, and people's overall health conditions are better than the average status of high-income and middle-income countries, and high health performance has been realized with a relatively small amount of investment. It has been proved that the reform of medical and health systems has been deepened in the right direction through powerful measures along clear paths, with the reform outcome widely beneficial to the masses, and has played an important role in solving problems of seeing a doctor, improving people's physical qualities, maintaining social equity and justice, and promoting economic and social development.
Under the vigorous leadership of the CPC Central Committee and the State Council, the medical reform has been deepened with the focus gradually shifted from laying a solid foundation to improving qualities, from constructing the framework to developing systems, and from making individual breakthroughs to systematic integration and integrated advancement, with a constantly improved top-down design. Local authorities keep improving their initiatives and creativities and gradually are tackling key issues and difficulties, and a number of typical areas have been prominent in addressing extremely tough issues and making explorations and innovations, forming lots of experience and practices that are practicable, reproducible and propagable.
At present, as the deepened medical reform has waded into the deep-water zone and reached the crucial stage, the adjustment of interests is becoming more complicated and contradictions within the institutional mechanism have become prominent. During the critical period of the reform surmounting obstacles and getting through troubles, the practice of summarizing and popularizing good practices and mature experience learned from the deepening of the medical reform in the preliminary stage and giving full play to the demonstrative, breaking-through and leading effects of typical experience on the overall reform is beneficial to further efforts to unify thinking, bolster conviction and tackle tough circumstances, innovate institutional mechanisms and eliminate interest-related barriers, accelerate the improvement of the basic medical care system and realize the target of everyone's entitlement to basic medical care services, so as to lay a solid foundation for advancing the construction of Healthy China and building a moderately prosperous society.
II. Applying Typical Experience and Driving the Development of the Medical Reform in Depth and Breadth
1. Building up a powerful leadership system and a coordinated working mechanism for health care, medical insurance and pharmaceuticals to provide an organizational guarantee for the deepening of the medical reform
(1). Strengthen the leadership of party committees and governments in regard to the medical reform. Top leaders of local party committees and governments at all levels shall take charge of the deepening of the medical reform. Comrades or a comrade mainly in charge of party committees and governments shall act as the head of the leadership team for the medical reform, give full play to the role of the leadership team for the medical reform in overall planning and coordination, and earnestly implement the governments' responsibilities for the medical reform in respect of the leadership, guarantee, administration and supervision.
(2).
......