Super Medical Insurance Bureau will lead the procurement of medical equipment | How to change?

On the 4th of June, the medical network officially announced on May 31 that the National Medical Security Bureau was formally listed and its leadership team members were officially released. Hu Jinglin, Ren Shi, Shi Zihai, Chen Jinyu, and Li Yuren are the deputy directors.

Among the new members of the National Bureau of Medical Insurance, Hu Jinglin was formerly the Deputy Minister of Finance, Shi Zihai was the Director of the Price Division of the National Development and Reform Commission, Chen Jinwei was the Director of the Medical Insurance Department of the Renmin Social Department, and Li Weiyuan was the Director of the Basic Health Division of the Wei Chi Planning Commission.

In comparison, Chen Jinyi’s previous work has the tightest relationship with health care and has the most connection. He has also made repeated remarks on the future of medical insurance reform and medical insurance.

Last May's '13th China Health Industry Summit Forum', last November's 'Financials' annual meeting, Chen Jinxi gave speeches on medical insurance topics. Last year's "Financial Economics" magazine and last April's "China Health Journal" also published an article on Chen Jinxi's topic on medical insurance.

As a member of the new members of the MEPC's newest team, Medicare, we can also see the future policy direction of the Super Medical Insurance Bureau from the judgments of Chen Jinxi about the direction of the medical insurance reform.

1. A basic judgment: The income of the medical insurance fund will no longer grow at a very high speed, but the expenditure will still grow at a very rapid rate, which will lead to the long-term gap risk of the medical insurance fund. Medical insurance needs to play a controlling role.

'Under the new economic norm, the long-term growth of China's economy that can sustain more than 6% growth is a goal that needs to be achieved. Medical fundraising is tied to economic growth, so in the long run, the income of the medical insurance fund should not be too high to deviate from GDP growth. Overburdened social security will erode the power of economic development.

Medical consumption has a strong demand expansion impulse under the influence of the third-party payment mechanism of medical insurance. In addition, the overall lack of medical resources and structural imbalances in China will inevitably have a high growth period. It is estimated that medical consumption can be controlled at about 10%, which should be a very good result. .

6% and 10% represent the long-term trend risks of the health insurance fund's operation. Resolving this risk can neither be achieved by raising the rate, nor can it be reduced by treatment. Only quality management can be used to contain waste, resource allocation can be used to reduce costs, and interest can be reduced. Game to achieve fund balance. '

The steady increase in income ("health insurance fund") and the ultra-high growth in expenditure have brought about a gap in medical insurance. Under this circumstance, medical insurance funds are facing the risk balance of funds and long-term sustainable problems. To meet this challenge, Medical insurance must control medical services and medical consumption, and play its own role in the promotion and stimulation of medical and health development.

2, another basic judgment: Over-treatment is ubiquitous, and medicine In the product market, there are also problems with bad money driving away good money. With the prudent medicine, good drugs are difficult to sell, and technological innovation is not dependent on foreign countries. This is related to the way in which health insurance is purchased.

'In all medical consumption, such as 2 trillion, 30% is wasted, over-medical, in the process of bringing about social transformation, is a lot of enterprise Development, but the quality is worrying. '

“In the past decade, China's medical service and pharmaceutical market have shown rapid development and overall quality has shown a good trend. However, there are also general supply shortages and the quality of worrying reality. There is a general over-treatment and shortage of resources, and there is a 'God'. Medicines' phenomena of selling hard and good medicines. '

'If improperly purchased, the cost performance does not match, and the medical industry Show Bring negative effects, resulting in bad money expelling good money, that is, cost-free, not high-quality, non-directional purchases. For example, medication, what drugs are paid, so the Chinese pharmaceutical market has produced a worldwide strange Fetus - Abuse of antibiotics and miscellaneous medications, Unreasonable use of medications in terminal configuration, Bad coins expelled good money.

'There was analysis that the best medicine sold in China was not the best medicine. The most used technology was not Chinese technology but foreign technology.'

'Current, China drug Innovation has entered a new stage, but China's medical technology innovation is lagging far behind the world. If China’s huge medical insurance funds are used to purchase foreign drugs and technology, then how can we continue to support China? health The foundation of the industry?'

3, A basic proposition: Medical insurance needs to move from passive payment to strategic purchase, how much money a doctor can't afford to pay for a list, to buy higher quality products, to buy innovative products, and to push forward negotiations more extensively (for example, The National Drug Negotiation Procurement and the Launch of the Pilot Four Big Value Consumables National Negotiation Procurement) and Group Buy.

'In the payment of medical insurance, it is necessary to gradually move from passive payment to strategic purchase, so as to obtain lower-cost, more reasonable and more valuable medical security services, including the selection of medicines, medical institutions, and medical service quality. As well as the balance of resources, it can meet the needs of popularization and promote the positive development of consumer medical services. It is truly possible to eliminate the bad money from the good currency, and to eliminate the good money from the bad money.'

'To move toward strategic purchases, medical insurance also needs to tie in with medical reforms to achieve community purchases, purchase of innovative service models, and purchase of innovative drugs.'

'We must clearly emphasize the higher quality and valuable medical insurance purchase target. Medical insurance can't simply follow the patient's ass to pay for the bill, or what price the doctor will pay for the list, but to pay for the service quality and drug quality as medical insurance. The primary basis for this is to make this basis public and form a strong orientation.

'Strategic thinking on future investments should be used to strengthen the direction of medical insurance purchases. It is necessary to persist in problem orientation, break existing taboos, and focus on future improvement, and consider current purchases as a strategic investment for the future.'

'With basic improved family doctor services, the current level is difficult to meet the needs of basic medical services, but the current purchase is precisely the investment for future growth. The purchase of services for private medical institutions is focused on more fully Competition. '

'Products and technologies with extremely high clinical innovation value may not be available now, but given the alternative nature of drugs and the group's purchase inquiry mechanism, we now have to pay a certain amount of money, which is undoubtedly of current quality improvement and fund performance. Significant improvement, and more importantly, support for future value innovation incentives have a strong social significance.

'We must deepen the integration of medical insurance system, unified management, fund pooling, and data concentration, and we must promote group purchase and medical insurance negotiations more extensively.'

'More introduction of negotiations and group purchases, through negotiations and group purchases, to achieve medical insurance trends improvement and overall optimization, leading value orientation.'