On strengthening the opinions of the medical liability insurance work 
 
 
The 2014-07-11 national health and population and family planning commission of the People's Republic of China

The medical hair [2014] no. 42 

        Provinces, autonomous regions and municipalities directly under the central government health and family planning commission (health bureaus), the justice department (bureau), the financial department (bureau), the administration of traditional Chinese medicine, the xinjiang production and construction corps health bureau, justice bureau, bureau of finance, each protects inspect bureau: 
 
        For further implementation of the CPC central committee and state council on maintain normal medical order, the important policy-making deployment of building a harmonious doctor-patient relationship, improve the people's mediation as the main body, the court mediation, people's mediation and judicial mediation, the medical risk sharing mechanism of organic combination of "insurance" three mediation system, give full play to the medical liability insurance as the main form of medical risk sharing mechanism in resolving medical disputes, the important role of medical risk management, further improve the medical liability insurance system in our country, improve the medical liability insurance rates and medical liability insurance service levels. Now on strengthening medical liability insurance work put forward the following opinions: 
 
        One, fully understand development of medical liability insurance for the important role of building a harmonious doctor-patient relationship 
 
        Relationship between medical and health undertakings of hundreds of millions of people health, relationships, happiness is a major livelihood issues. Marketization of insurance as a transfer of risk sharing mechanism, help each other in all aid mechanism and social management mechanism, in the protection of the legitimate rights and interests of both doctors and prevent to resolve medical disputes, the construction of a harmonious doctor-patient relationship has positive meaning and important role: 
 
        (a) effectively protect the legitimate rights and interests both doctors and build a harmonious doctor-patient relationship. Medical liability insurance is a liability to pay compensation to the economy of a medical institution shall be liable in accordance with the law, for compensation in accordance with the contract of insurance. Use to solve the problem of medical liability insurance means the way to build a third party and channel, is advantageous to the party in a timely manner to get economic compensation, is conducive to better clear the rights and obligations of both doctors in medical disputes, the construction of a harmonious doctor-patient relationship. 
 
        (2) to prevent defuse doctor-patient contradiction, maintain normal medical order. Insurance as a "third party" power, with the effective combination of medical dispute mediation mechanism, transfers from medical institutions in handling medical disputes to the medical institutions, in accordance with the rules of conciliation, disposal and claims in accordance with the law, to prevent and defuse doctor-patient contradiction, guarantee normal medical order. 
 
        (3) improve the medical risk management level, improve the health care industry risk management system. Insurance is a market economy under the condition of basic means of risk management. The development of medical liability insurance, the use of insurance price leverage effect of incentive and constraint, is conducive to actively guide the medical institution changing ideas, improve the medical risk prevention consciousness; Promote medical institutions to strengthen internal management, improve the medical service quality and management level, so as to prevent and reduce the occurrence of medical disputes, improve the overall ability of medical risk management. 
 
        Second, strengthen organizational leadership, raise the level of medical liability insurance rates and insurance services 
 
        Health family planning at the provincial level administrative, judicial administration, finance, insurance regulation and management of traditional Chinese medicine and other departments to realize the important significance to do a good job of medical liability insurance, strengthen the organization and leadership, actively strive for local party committee, government's support, established by the relevant departments to participate in the working mechanism of medical liability insurance, and the formation of manages concertedly, collaboration and mutual promoting work situation. Local government departments should actively coordinate, strive for construction of medical liability insurance system, medical dispute mediation policy support, to adhere to the principle of government guidance, orderly operation, for the sustainable development of medical liability insurance, to create a good environment. 
 
        Family planning administrative department of public health, management department of traditional Chinese medicine to unified organization, promoting all kinds of medical institutions, especially the public medical institutions should be guaranteed that all. By the end of 2015, the national tertiary public hospital rate shall be 100%; A secondary public hospital rate shall be 90% above; Around to actively carry out the pilot and explore for grassroots medical institutions of medical treatment risk sharing mechanism, promote the government actively join medical institutions at the grassroots level, reduce the risk of medical institutions and medical personnel professional; Ginseng protect actively encourages and guides the public medical institutions. At the same time, vigorously promote the development of medical accident insurance and other relevant coverage, gradually consummates our country medical risk sharing mechanism. 
 
        All kinds of medical institutions to establish a mechanism, medical quality and safety incidents and responsibility share of medical damage occurs, related to liability and medical personnel assessment, rewards and punishments hook, raise awareness of the responsibility of medical staff. 
 
        The judicial administration department should strengthen the medical disputes, the guidance of people's mediation work perfect network, improve the quality of the team, adhere to and the rule of law with the rule of law thinking way to resolve medical disputes; Medical disputes to accept the people's conciliation committee, in accordance with the medical disputes, mediation in medical institutions did not attend the medical liability insurance refused to mediation, do the medical dispute mediation work covers all medical institutions; To perfect the work system and process, to standardize the mediation agreement is made, improve the working mechanism of combined adjustment to compensate, and to the medical dispute mediation agreement as one of the claims according to the insurance company. 
 
        Local financial departments should enhance the support of medical liability insurance, to ensure the medical liability insurance medical risk sharing role into full play; Medical institutions for medical liability insurance premiums can be raised in the row in the medical expenses. 
 
        Insurance regulators to strengthen the supervision and management of insurance institutions and examination work, guide the insurance institutions to further improve medical liability insurance contract, terms, according to the balance of payments, the principles of small profit, scientific and reasonable set medical liability insurance rate, enhance the medical liability insurance products attractive and adaptability; Guide the medical liability insurance business of insurance institutions to increase investment, introduce and train professional and technical personnel, good internal work, conscientiously do a good job in risk control and insurance services; Guide rational competition, strengthen supervision, in accordance with the serious deal with violation of the securities market and damage of medical institution and the lawful rights and interests of patients with behavior. 
 
        Case review, insurance agencies shall regularly carry out insurance premium floating adjustment according to the medical institutions risk profile; According to the risk characteristics of the medical institution innovation to develop targeted insurance products, gradually expand the security content and scope, and meet the diversified and multi-level medical institutions of insurance demand; Based on medical dispute mediation agreement and so on, in a timely manner to carry out the claim work, simplify the procedure of claims, optimize the claims process, improve the service ability and level. 
 
        Third, strengthen the coordination and jointly promote the medical liability insurance work thorough development 
 
        Medical liability insurance is an important part of medical risk sharing mechanism in our country. Health at all levels to family planning administrative, judicial administration, finance, insurance supervision and management department of traditional Chinese medicine to further strengthen the leadership, organization of medical liability insurance work and driving dynamics, give full play to the government's policy guidance and leading role, strengthen cooperation, careful deployment, steady progress. 
 
        To support insurance institutions, through early intervention of medical dispute processing work, mediation medical disputes through various channels, form the medical dispute mediation and insurance claims a good situation of complement each other, promote each other. To strengthen medical institutions and insurance institutions and organizations of the third party to mediate communication cooperation, by conducting risk prevention in advance, matter supervise, afterwards to mediate claims, etc, to prevent and resolve medical disputes. To establish and perfect a long-term mechanism, and actively explore and promote the medical and health industry insurance effective way of further cooperation, gradually build system of information reporting system and regular contact, timely communication and feedback of medical quality safety, insurance claims and other data and information, research to solve the problems in time, promote the sustained and healthy development of medical liability insurance. 
 
        Fourth, strengthen the experience summary, actively explore conforms to China's national conditions of medical risk sharing mechanism 
 
        In recent years, around the adjust measures to local conditions to explore the various forms of medical risk sharing mechanism, including the implementation of medical dispute prevention and disposal of local laws or decrees, clear their quest to establish a system of medical liability insurance; Health administrative, judicial administration, insurance regulation, family planning management of traditional Chinese medicine and other departments jointly issued more supporting system, determine the framework of medical liability insurance underwriting, claims service standard, etc; Encourage medical institutions with respect to its property, personnel and other package insured, the insurance company to provide comprehensive insurance and risk management plan; In order to establish insurance co-insurance body form such as share the medical risk. These practices have made certain achievements, accumulated some successful experience. 
 
        Health family planning at the provincial level administrative, judicial administration, finance, insurance regulation and management of traditional Chinese medicine and other departments to carry out investigation and study, timely summary and reference to the mature experience, take positive and effective measures to promote the establishment and improvement of the local economic development, the medical service level and the level of insurance business, coordinated with deepening the reform of medical health system of medical risk sharing mechanism. 
 
        Fifth, strengthen propaganda guidance, build good social atmosphere medical liability insurance 
 
        Local health family planning administrative, judicial administration, finance, insurance regulation and management of traditional Chinese medicine and other departments to play their respective advantages, through various channels and ways, targeted to carry out the medical liability insurance and medical disputes and insurance policy propaganda knowledge popularization activities, guide the various medical institutions to improve their risk prevention awareness and active use of insurance tools to deal with medical risk and medical disputes of the initiative and self-consciousness, constantly improve the medical liability insurance coverage, create a good social atmosphere for the medical liability insurance development. 
 
        Six, strengthening supervision inspection, to ensure the medical liability insurance work carried out 
 
        Related departments in all localities should rely on to create a "peace hospital" activity platform, advance medical liability insurance in accordance with the work, the requirements of the relevant set specific work plan, refine the workflow, constantly improve and perfect the medical liability insurance the supporting mechanism, medical liability insurance work smoothly and orderly. 
 
        Health administrative departments of family planning and management department of traditional Chinese medicine to medical institutions for medical liability insurance as the main form of medical risk sharing mechanism is included in the "peace hospital appraisal system", we will deepen reform of the medical and health system evaluation system; To establish service level and service capabilities of insurance institutions insurance evaluation mechanism, promote insurance institutions shall provide medical institutions and patients with standard and efficient claims service, continuously improve the quality of service. 
 
        Provincial family planning administrative, judicial administration, finance, insurance, health supervision and management of traditional Chinese medicine and other departments should combine their own actual, earnestly implement the work requirements, constantly sum up the experiences of good practices, careful study to solve difficulties and problems, timely and relevant information will be submitted to the state health and family planning commission, the ministry of justice, ministry of finance, China insurance regulatory commission and state administration of traditional Chinese medicine. 

The national health and family planning commission of justice ministry of finance
The China insurance regulatory commission of the state administration of traditional Chinese medicine
On July 9, 2014