Medical reform, let the whole people share the "health dividend"
Cartography: Zhang Fangman
If you open the column,
Without national health, there will be no overall well-off society. At the National Health and Wellness Conference held recently, General Secretary of the Supreme Leader emphasized that people’s health should be placed in a strategic position of giving priority to development, and efforts should be made to ensure people’s health in an all-round and full-cycle manner. Promoting the construction of a healthy China is a solemn commitment of the Party to the people, and it is also an important livelihood project and popular project. Starting from today, this newspaper will open a column of "Healthy China", reporting vivid practices and typical experiences of various localities and departments from all directions and angles around key tasks such as popularizing healthy life, optimizing health services, improving health protection, building a healthy environment and developing health industries, advocating a healthy and civilized lifestyle, guiding the whole society to establish a sense of great health, making the concept of healthy China deeply rooted in people’s hearts, and supporting a well-off society in an all-round way with the health of the whole people.
It is difficult and expensive to see a doctor, and a question about people’s livelihood affects hundreds of millions of people.
The people have a call, and the government should respond. After the start of the new round of medical reform, especially since the 18th National Congress of the Communist Party of China, the CPC Central Committee with the supreme leader as the general secretary has stood at the strategic height of the long-term development of the Chinese nation, comprehensively deepened the reform of the medical and health system, and insisted on ensuring the basics, strengthening the grassroots and building mechanisms. The reform has changed from individual soldiers to coordinated advancement, and the policy superposition effect has gradually emerged, and the difficulty and expensive medical treatment have been significantly alleviated, and the people have more sense of gain and happiness. The proportion of urban and rural residents’ personal health expenditure in the total health expenditure continues to decline, with minor illness, serious illness and serious illness guaranteed, and the health level continues to improve, and the whole people share the "health dividend".
Practice has proved that sticking to the Chinese way to solve the worldwide problem of medical reform has opened up a road of health and healthy development in line with national conditions and provided a strong support for a healthy China.
Graded diagnosis and treatment saves money and worry-
200 cities to carry out family doctor contract service
"Save money, time, effort and worry!" Speaking of the benefits of graded diagnosis and treatment, Ding Qiming, a retired old man in Gulangyu Community, Xiamen City, Fujian Province, smiled. Ding Qiming, 77, suffers from chronic diseases such as diabetes and hypertension. With the help of a team of family doctors, hypertension, hyperglycemia and hyperlipidemia have all stabilized. "Now I walk briskly."
Ding Qiming told reporters that before the reform of graded diagnosis and treatment, Gulangyu had few medical staff, low level and incomplete drugs. No one believed that the disease could be cured on the island and they all went to the big hospitals in the city to see a doctor. By boat, by car and queuing for registration, it takes half a day to see a doctor, which is very painful. If the ferry stops in bad weather such as typhoon, you can’t go to the other side. After the implementation of graded diagnosis and treatment, residents can see a doctor in the community hospital on the island, avoiding the fatigue of travel. Ding Qiming said: "In the past, my heart was not good. I have seen it in major hospitals and the treatment was ineffective. The community arranged an expert consultation for me, and one-on-one careful treatment, and my situation soon stabilized. "
"Chronic diseases first, linkage from top to bottom, and joint management by three divisions" is a graded diagnosis and treatment model actively explored by Xiamen, which realizes the shift of the focus of health work. Large hospitals are "willing to let go and let go", primary medical and health institutions are "willing to take over and stay" and the masses are "willing to go and stay". Yang Shuzhen, director of the Xiamen Municipal Health Planning Commission, said that the "three divisions" refer to specialists in large hospitals or specialized hospitals, general practitioners in grass-roots institutions and health managers from grass-roots units. The patient signed a contract with the "Third Division" to obtain family doctor services. The signing fee is 120 yuan every year, of which 100 yuan is borne by medical insurance, and residents only need to pay 20 yuan. With the implementation of the "three divisions co-management" model, the "wartime state" of long-term overcrowding in large hospitals has obviously eased. In 2015, the average waiting time for tertiary hospitals in Xiamen was reduced from 40 minutes to less than 10 minutes.
Since the start of the new round of medical reform, the construction of graded diagnosis and treatment system in China has been promoted in an orderly manner. All localities focus on improving the ability of primary medical services, and take common diseases, frequently-occurring diseases and chronic diseases as breakthroughs to gradually guide the sinking of high-quality medical resources. More than 1,600 tertiary hospitals across the country have established counterpart support relations with more than 3,800 county-level hospitals, and strive to make ordinary people look after their illness at their doorsteps, forming a virtuous circle of "minor illness at the grassroots level, serious illness at the hospital, and rehabilitation back to the grassroots level". This year, 200 pilot cities for comprehensive reform of public hospitals will carry out family doctor contract service. By the end of the year, the coverage rate of urban family doctor contract service is expected to reach more than 15%, and the coverage rate of key population contract service will reach more than 30%.
Liang Hong, a professor at the School of Social Development and Public Policy of Fudan University, pointed out that it is an important measure to set up a contract service system for family doctors in line with China’s national conditions and form a medical treatment model of "first consultation at the grass-roots level, two-way referral, quick and slow division and up-and-down linkage". Only by changing the supply mode of medical and health services and the behavior of people seeking medical treatment can the medical center of gravity return to the grassroots level, and the goals of controlling medical expenses, improving health management effect and improving service satisfaction can be achieved.
Serious illness insurance is a timely help-
The actual reimbursement rate increased by 10 percentage points.
Recently, Ms. Wang from Jiaozuo, Henan Province, came to the People’s Hospital of this city to receive the money reimbursed by her husband during his lifetime. Previously, her husband died in hospital due to septic shock, with a total cost of more than 208,000 yuan, excluding more than 110,000 yuan for reimbursement of new rural cooperative medical insurance and serious illness insurance, and more than 17,000 yuan for reimbursement of serious illness supplementary medical insurance, which is a special preferential medical treatment for people in need in Jiaozuo City. Up to now, there are nearly 900 people in difficulty who have been reimbursed by supplementary medical insurance for serious illness in the city.
Supplementary medical insurance for serious illness is the third level of medical insurance after basic medical insurance and serious illness insurance. Jiaozuo City will link the supplementary medical insurance for serious illness with the basic medical insurance and serious illness insurance. If the hospitalization expenses of the needy people are less than 15,000 yuan after being reimbursed by the basic medical insurance, they will be reimbursed by the supplementary medical insurance for serious illness; More than 15 thousand yuan, urban and rural residents’ serious illness insurance compensation, by the serious illness supplementary insurance to give a second reimbursement.
Ning Ji, executive deputy director of Jiaozuo Medical Reform Office, said: "The supplementary medical insurance for serious illness has increased the reimbursement rate of the whole medical expenses by 10% to 15%, and the personal burden has dropped below 25%, which is a timely help to the needy people."
Since the start of the new round of medical reform, China has built the largest basic medical security network in the world in a relatively short period of time, achieving full coverage of the basic medical insurance system. Among them, the financial subsidy standard for basic medical insurance for urban and rural residents has increased from 80 yuan per capita in 2008 to 420 yuan in 2016. In 2015, the reimbursement rate of hospitalization expenses within the policy scope was about 81% for employees’ medical insurance, and about 75% for urban residents’ medical insurance and the new rural cooperative medical system.
Full implementation of serious illness insurance for urban and rural residents is an important institutional arrangement to solve the poverty caused by serious illness. In 2015, more than 4 million seriously ill patients benefited and paid 24.4 billion yuan for serious illness insurance. The actual reimbursement rate of seriously ill patients has generally increased by more than 10 percentage points on the basis of basic medical insurance, and the phenomenon of poverty caused by illness has been effectively alleviated. At the same time, establish a disease emergency rescue system. By the end of 2015, more than 400,000 acute and severe patients with unknown identity or inability to pay had been rescued. Medical assistance for serious and serious diseases will be widely carried out, and the target of assistance will be expanded from low-income recipients and destitute dependents to low-income recipients and seriously ill patients from poor families due to illness.
Online registration is easy to see a doctor-
The appointment rate of tertiary hospitals reached 32.1%.
This summer, Zhang Yanjun from Datong, Shanxi, took his son to Beijing Children’s Hospital. According to old experience, if you hang an ophthalmologist number, if you don’t find a "number trafficker", you will have to queue up in the middle of the night, sometimes even for a few nights. Therefore, he even prepared the Mazar and the mattress. To Zhang Yanjun’s surprise, the registration hall that used to be like a farmer’s market became very quiet. On the self-service machine, he easily hung up the expert number of the next day.
Since September 1, Beijing Children’s Hospital has cancelled the registration of outpatient windows and implemented a comprehensive appointment for non-emergency treatment. This means that except for emergency, all patients need to make an appointment through mobile APP, WeChat, telephone, internet or on-site self-service machine. The Beijing Municipal Hospital Administration said that 22 top three hospitals will cancel on-site registration this year and implement a comprehensive appointment system for non-emergency treatment. In the future, the "long queue of registration" in Beijing’s top three hospitals is expected to disappear, and patients no longer have to wait in line to register.
In 2015, the National Health and Family Planning Commission issued the "Action Plan for Further Improving Medical Services", and decided to use three years to strengthen medical management, improve service processes and innovate measures to facilitate people’s medical treatment in the national medical and health system, so that people can truly feel the effectiveness of medical reform. By the end of 2015, 1,238 tertiary hospitals across the country had established information bases to provide information inquiry and push services for patients; 660 tertiary hospitals settle accounts through mobile APP, WeChat payment, etc., reducing the number of patients queuing and shortening the queuing time. This year, tertiary hospitals across the country will fully implement appointment diagnosis and treatment services and provide a variety of appointment diagnosis and treatment methods.
With the popularity of "internet plus Health Care", online registration, remote consultation, mobile phone inquiry, mobile payment, etc., patients’ medical experience has been significantly improved. Jin Xiaotao, deputy director of the National Health and Family Planning Commission, said that making health data "run more roads" and making people "run less errands" is the development direction of big data application in health care. Based on the contract service of family doctors, China will basically realize that urban and rural residents have standardized electronic health records and fully functional health cards, and focus on promoting the application of Internet health consultation, online appointment and triage, medical insurance network settlement in different places, and expanding the service capacity of medical institutions.
Cao Xuetao, president of China Academy of Medical Sciences, said: "Using health care big data to expand service channels, extend and enrich service content can better meet the health needs of ordinary people." In 2020, everyone in China will have electronic health records and health cards, which will be the largest health big data in the world. In the future, everyone’s data from birth to death will be completely recorded, which will help to build a service system integrating prevention, treatment, rehabilitation and health management, and provide life-cycle health services for 1.3 billion Chinese. (Reporter Bai Jianfeng Shen Shaotie)