Caught the difficulties of medical reform

â–¡Reporter Sun Meng Wang Dan Liu Pinganâ–¡

“In the government’s work report, the prime minister’s report on medical and health care has been condensed compared to last year and the previous year, but the content was more specific and deeper. The report accurately captured the requirements for this year's work. Lived many difficulties and problems in the medical improvement process.” At the group discussion on March 5th, talking about the contents of the government's work report on the development of health care reform and health care, the NPC deputies and the CPPCC members all had similar feelings. .

â– More medical insurance investment should be added Li Li, deputy to the National People's Congress and the director of the Department of Health of Jiangxi Province, believes that the funding level for the new rural cooperative medical system will be raised from 120 yuan to 200 yuan, and the public health fund will be raised from 15 yuan to 25 yuan, significantly increasing The input shows that the government attaches great importance to the health of the people.

Even so, Huang Jun, a member of the National Committee of the Chinese People's Political Consultative Conference and professor at Nanjing Medical University, believes that these investments are still insufficient. “I figured it out. After the increase in subsidies, the proportion of Medicare payments to the total medical expenses will increase from more than 20% to more than 30%, but from a global perspective, this ratio is still relatively low, and foreign countries generally have 50 %, or even higher. Compared to last year and last year, the state’s investment in education has increased by 25%, science and technology has increased by 27%, and the growth in health has been less than 10%.” Huang Jun said that in the issue of people’s livelihood, the state’s The investment in health care should also be further increased to increase coverage.

Yang Jinsheng, a member of the National Committee of the Chinese People's Political Consultative Conference and deputy director of the Acupuncture and Moxibustion Institute of the Chinese Academy of Traditional Chinese Medicine, pays more attention to the "function of commercial insurance in improving the social security system" proposed by the government work report. "Let medical science have more room for development and meet more diversified medical security and other types of health care needs, we must encourage commercial health insurance, major illness insurance, health insurance to join the medical insurance system, so as to improve the medical security system. "Yang Jinsheng said.

â–  To "boldly explore" more "top design"

The government’s report “encouraging local governments to explore boldly the hospital management system, pricing mechanism for medical service pricing, and regulatory mechanisms” has also sparked the enthusiasm of the members of the government.

“Last year, I went to several provinces and cities to see the pilot reform of public hospitals. I feel that the government is just like the referee of the running competition. With an order, all localities are starting to run, but they are running in all directions.” Sun Jianfang, deputy director of the Institute of Dermatology of the Chinese Academy of Medical Sciences and member of the Chinese People's Political Consultative Conference, said that there are many tricks and methods in public hospital reform pilots everywhere, but there are also some disorderly situations caused by various spontaneous explorations. I am afraid that at the end there is not much experience that can be promoted.

"Public hospital reform should first consider doing top-level design." Sun Jianfang said that reform itself is an innovative process, and national, provincial, and municipal levels should make their own strategic decisions, battle decisions, and tactical decisions, otherwise they will easily fall into " Below, wait for the above policy, and wait for the following experience. For a specific pilot unit, it may not be able to obtain recognition and due compensation at the expense of the specific pilot unit, which will lead to serious injury and even change from “pioneer” to “martyrs”. On the implementation of the basic drug system, Sun Jianfang believes that compensation for medical institutions must keep up.

â–  The multi-point practice policy needs to be detailed In the government work report's work requirements for 2011, encourage the social capital to run medical treatment, improve and promote the multi-practice doctor's practice list as a goal and task. In response, Fan Li, a member of the National Committee of the Chinese People's Political Consultative Conference (CPPCC) and vice president of the People's Liberation Army General Hospital, was very touched. She said: "After the introduction of this policy, a lot of corresponding policies will also be needed to limit the number of problems that will follow." (Conversion 2nd Edition) (Continued from the first edition)

Fan Li said that we only have 2.4 million doctors, but we have to serve 1.3 billion people. Now that the medical professionals of large hospitals have a large amount of medical work, we must conduct more practice. Can the doctor's energy and ability be able to withstand? What kind of people can practice more? What kind of conditions do organizations have to practice more? If there is no restriction on the cooperation methods of doctors and multi-practice institutions, will it be easy to cause some problems and disputes? Who is responsible for any problems?

Fan Li believes that after the big policies come out, there must be institutional restrictions on specific aspects such as administrative management, distribution of medical resources, and cooperation mechanism among various hospitals, so as to effectively avoid “losing their own land,” Planted other people's fields."

■ The development of Chinese medicine should follow its own laws. The government work report emphasized that the development of Chinese medicine should "implement all supportive measures." In this regard, Wang Xudong, member of the National Committee of the Chinese People's Political Consultative Conference and director of the Institute of Chinese Medicine Literature at the Nanjing University of Traditional Chinese Medicine, said that Chinese medicine must follow its own rules when “going forward”. Take the evaluation system of Chinese medicine scientific research achievements, in the current evaluation system, many of the review experts are from Western medicine. They use a set of modern medical science research thinking to assess the results of traditional Chinese medicine, and they must also have experimental links in scientific research and design. Many doctors are forced to act against the laws of Chinese medicine.

â–  "This question is expert."

Ma Zongfu, deputy mayor of the National People's Congress, deputy mayor of Xianning City, Hubei Province and dean of the School of Public Health of Wuhan University, believes that the government work report has specifically raised the average life expectancy at the age of one year. This is a very intrinsic test.

Why is this question very expert? Because per capita life expectancy is a comprehensive indicator, not only medical care but also various social support systems such as soft and hard environments are the result of overall social progress. Mao Zongfu said that he was particularly concerned about the prime minister’s unwavering commitment to common prosperity and efforts to narrow the gap between public services in the region. Public health services are an important part of public services. This point is far-reaching and the regional development is not balanced. Beijing and Shanghai are like Europe and old-style border areas are like Africa. This kind of development cannot be sustained. To narrow the gap, we must change the mode of development and achieve a balanced development, which will fundamentally promote the transformation of the mode of development of health. Reliance on clinical treatment alone to increase life expectancy at 1 year is too expensive, too expensive to consume, extremely difficult and not worth the candle.

Mao Zongfu believes that in terms of health, it is now necessary to do a good job of preventing diseases and implement health promotion. The allocation of medical and health resources should be more inclined to prevent. Mao Zongfu also noted that the report stated that next year, education investment will account for 4% of GDP, and science and technology R&D investment will account for 2.2%, while there is no rigid index for health investment. As a deputy to the National People's Congress in the field of health, he feels that he has the responsibility to call for health investment in legislation.