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Until December 2010, the new medical reform which carried out in 2009 has finished about 2/3, and all policies will carry out in the near future. The whole country is focus on this medical reform’s progress and effects which are related to people’s livelihood.

 

For two years, the keynote of public welfare didn’t change. In the 12^th five-year plan ‘suggestion’ published recently, the characteristic of public welfare are more accurate. In the two years, the basic health care task was finished ahead of the schedule among the five big tasks which were decided by new medical reform. The medical reform is keeping implement, but half of the promotion task of national basic drugs system has not finished and the construction system of primary care health services still have problems. And the equalization of essential public health service should be institutionalized and the reform of public hospital should be pushed forward in order.

 

Two years’ medical reform brought some good results.

 

Two years’ medical reform got remarkable results.

 

On 24^th December, in the 18^th special medical reform session of the standing committee of the 11^th national people’s congress, some relevant heads of ministries provided several groups of data when they answered the committee members’ question.

 

According to the medical reform policy carried out by the state council in April 2009, in 2009 to 2011, our all levels of government should add 850 billion yuan into medical reform which include 331.8 billion yuan invested by central government.

 

Xie xue, the finance minister said, in 2010, all levels of finance department would increase the spending on health care. The national finance department will arrange 443.9 billion yuan as the expenditure budget of health care, which include 138.9 billion yuan invested by Chinese ministry of finance and of which 55.6 billion yuan was used to the health insurance of new rural cooperative medical system; citizens and employees, medical assistance and other basic medical security system construction. And about 30 billion yuan were used in basic and major public health service project and basic medical health care institutions’ construction of urban and rural.

 

Hu Xiaoyi, the vice minister of the people’s insurance department said our nation would gradually enlarge the medical coverage of urban and rural people. The personal medical costs would be reduced to 30%, basic medicine costs would be reduce to 30% and the ratio of residents’ reimbursement would reach to 60%.

 

Zhu Zhixin, the vice director of national development and reform commission said that from the basic drug system carried out in August, more than 50% government-run health care agencies carried out the zero mark-up policy on drug sale. The price of essential medicine has reduced 30% according to the preliminary data.

 

There are still many difficulties in medical reform.

 

Although the medical reform carried out step by step accordance with the plan. But due to the various situations of different places, there are some different problems with the implementation of the medical reform. In the medical reform, there are many problems and the main problem is the raising of funds.

 

The state council said that the goal (which carried out by minister of health Chen zhu in the beginning of 2010  —sixty percent of our nation’s grassroots medical institution would apply the essential drug system at the end of 2010) would be postponed to March 2011. And this was not the first time to postpone the medical reform goal.

 

On 22^nd December, Zhang Ping, the director of national development and reform commission reported the work conditions of the deepen reform of medical and health system to standing committee of the national people’s congress. He said that there have 26000 government-run health clinics in towns and townships and community health service institutions which have carried out the essential drug system at present. It takes 51% of the whole country’s medical reform goals, and the next year’s goal will spread all over the country. But some place reflected that the species of essential drugs are poor; some state guide essential drugs’ price is a little high; the market bidding mechanism of essential drug is nonstandard and the compensation mechanism of basic medical and health institutions is unsound.

 

The essential drug system has been applied for more than one year, but there were many problems in the process of the implementation. And the main problem was reflected in the whole control of the health management system, and this problem could not be solved only by one special reform measure.

 

On 23th December, the 18^th session of the standing committee of the 11^th national people’s congress held a parallel session. Chen Jianguo, the deputy director of the committee for internal and judicial affairs under the national people’s congress said that we should fully understand the medical reform’s arduous, complexity, difficulty and the medical reform plan should not be rush and idealized after the state council’s deliberation of the work condition report of deepen reform of medical and health system. He illustrated that after two year’s application of drug bidding system in Ningxia, the suppliers often adopt variety of means to bribe the units and individuals. And the means of bidding changed from randomly selecting by a few people to randomly selecting by experts. The autonomous regions’ director of drug action should be rotated every two years.

 

At the same meeting, Chen Jingpei, the committee member illustrated that he knew a provincial leader whose grandson continued getting a high fever. They went to the public hospital but they couldn’t get registration. So they seek treatment to other place, and spent more than 10000 yuan for his grandson’s fever.  

 

Reng Maodong, the committee member said that all levels of government invested amount of money to medical career, and the money should be actually and really spent on the masses. But the reality was that people didn’t feel good even though the government has input a lot of money in medical treatment career, they lost their money that they have earned so hard and precise after a few words of the doctors. And he said that the public hospitals’ reform was staying on the experimental level and the theory level.

 

Faced with the question, Chen zhu, the health minister said the related deep system and mechanism of public hospitals’ reform could not be described clearly, but the reform could not adopt the method of ‘sweeping approach’. On the contrary, the reform should have some experimental units at first, and come up with some maneuverability policies and measures after the continuous research, exploration and summary.

 

He proposed that the second-class, tertiary hospitals, community service centers and service stations could construct a longitudinal consortium to work together. And make the high-quality medical resources radiate to communities.

 

The reform content needs new idea.

 

Wang Hufeng, the medical reform research center’s director of Renmin University of China thought that the unified or dispersive purchase of essential medicine need a fair and transparent tender procedure which through the masses’ supervision and participation. There are many problems in grassroots medical field such as the cultivation of talents, the benefit protection of medical personnel, the standard of technologies, the matched policies of hygiene and other aspects. Government should shoulder the responsibility of public health service of primary care system and provide equal service. On the field of medical treatment service, government should support the public medical care institutions and cooperate with nonpublic hospitals and individuals through the method of service purchasing.

 

Some experts thought, the ‘New’ character of new medical reform is not only indicating a new policy in the sequence of time but it should have more new ideas in the reform contents and reform means. When we solve a problem we should find the main error point of an affair. So, the main problem of medical treatment and public health field is the problem of system, not only simply related with the money that invested by government.

 

As one expert said, if compared the medical reform to the dispose of car accident. And suppose that government does not determine the system of loss assessment, settlement of claims and confirmation of responsibility in advance, on the contrary, they bargain with the repair shops when they purchase the spare and accessory parts. This is attending to the trifles and neglecting the essentials, and could not get the last success.

 

 

——Medical Economic News

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