The equity of health service in China, poor accessibility, masses medical burden is heavy, difficult to see a doctor and expensive prominent. In recent years, from the grass-roots public hospitals reform experience, and the party's eighth session of the Fifth Plenary Session of the new requirements for the deepening of the reform of the medical and health system, in need of medical, health care, medicine "medicine three linkage, get rid of drugs to support medical, reform of the medical insurance payment, personnel salary system reform, encourage social do medical, policy and market of various control and utilization, and to meet the people's growing diversified health service demand.
To speed up the reform of medical insurance system. To speed up the integration, improve the fairness of the basic medical insurance system. To break the limit and the employment situation of urban and rural residents, urban and rural segmentation of the three types of basic medical insurance system and gradually integrated into a system of urban and rural integration, promote the rational flow of urban and rural elements, to avoid the imbalance and the convergence of the treatment system of urban in the process of research. The establishment of medical insurance payment rate dynamic adjustment mechanism and adapt to economic development. Play a fundamental role in the allocation of resources in the health care medicine. Health care play a "third party purchase" advantages, promote the establishment of health insurance agencies and medical institutions, pharmaceutical suppliers negotiating mechanism and purchase services. The reform of Medicare payment mechanism payment system, and actively implement DRGs, capitation and other complex payment methods, incentive to enhance health insurance for medical behavior The proportion of common disease Medicare payments to the grassroots medical institutions, to promote the formation of grading treatment system. Active coping with the aging of society, the implementation of long-term care insurance.
Characteristics of Vocational and social change the characteristics of the industry with the establishment of the medical personnel salary system. To accelerate the business unit personnel to the chief, to the preparation, dissolution and prepare by supporting policy treatment, the implementation of physicians practicing filing system, the medical personnel, medical personnel free flow. The implementation of post salary system to the post salary according to the performance reward, the doctor's income and patients to the doctor's degree of recognition, and the title has nothing to do. Reasonable to improve medical personnel salary level (social average income of 6 - 8 times). In Beijing, for example, grassroots medical staff average income of only 8 million to 10 million yuan, and the doctor does not match, become the basic reform is urgently needed to break through the bottleneck.
Increase the practitioner training efforts. GP is core of grading treatment system, at present our country grass-roots medical practitioners exist problems of low quantity and quality is not high. To increase investment, by the government to undertake training doctors in training costs and wages, improve the hospital send representatives to attend the training enthusiasm. Sound general practitioner education, continue to education and training system, guarantee the basic medical and health institutions have qualified general practitioners are optional, available.
The establishment of public hospital management, the new operating mechanism. The establishment of a modern management system of public hospitals. The implementation of the tube to separate, separate affairs, reasonable definition of the government as the investor holding duties of supervision and public hospital operation and management autonomy rights, enterprise management can be implemented in public hospitals, improve the operational efficiency of hospital management. To emphasize the people-oriented, prominent human nature and scientific service infrastructure. And the system construction of the hospital should be from the actual needs of patients, the medical quality, patient safety, patient rights and other aspects, focusing on the needs of mental patients, to strengthen health education communication between doctors and patients and their families. And establish the patient centered hospital evaluation system, the implementation of independent in the hospital, the health administrative departments of the third party evaluation for medical safety, quality, management efficiency, patient satisfaction, comprehensive appraisal, appraisal Results and Medicare payment proportion hook. The adjustment of the prices of medical service, the implementation of the separation of medicine, work together to build a reasonable medical expenses sharing mechanism with total prepaid health insurance policy. Adhere to the dominant position of the hospital in the purchase of medical products, to carry out the province (city) in drug centralized purchasing, unified pricing), play a group of bulk purchasing advantages, down virtual high drug prices and procurement information security of open and transparent.
Encourage social do medical, meet public multi-level demand for health services. Strictly control the number of public hospitals, the size of the abolition of special needs services in public hospitals, public hospitals and social capital cooperation specification, expand social do medical to the survival and development of space. Broaden access, fewer restrictions on approval, break shehuibanyi "glass door" intensify "spring door. To provide support for the financial funds of basic medical and health services, social do non-profit medical institutions, reduce the social do medical operating pressure. Improve the social do medical credit system, establishing trustworthy incentive and failure joint disciplinary mechanism, promote social do medical business according to law, standardize their operations and business integrity.
(deputy head of Mentougou District of Beijing City, the author for the member)