Medical payment network - on March 10, health care reform from sporadic explore gradually toward full implementation. The economic information daily, the reporter learned that, in 2017 will be fully promote the reform of medical insurance payment methods, in public hospitals at the county level and the pilot city public hospital comprehensive advancement by macro-reforms, capitation payment and total prepaid composite payment method reform.
According to data released by the ministry of finance, 2016, the national fiscal health expenditure of 1.3154 trillion yuan, 120.1 billion yuan higher than final accounts of 1.1953 trillion yuan in 2015, an increase of 10%, 3.2% higher than the national fiscal spending growth 6.8%, accounting for the proportion of national fiscal expenditure increased from 6.8% in 2015 to 7%. In 2017, continue to medical and health care as a financial investment in key areas, increasing government investment in health. On the investment direction and stick to the principle of "unified planning, highlight the key", focus on increasing the basic medical insurance, public health and basic medical and health care in areas such as inputs, and leaning to disadvantaged groups and poor areas.
But as reform into GongJianQi and deep water area, benefit pattern adjustment is more complicated. Treatment of primary health care financing and sustainability adjustment mechanism is not strong, the continually increasing of medical expenses and other issues still exist. From 2008 to 2015, China's total health expenses rose from 1.4535 trillion yuan to 4.0975 trillion yuan, an average annual growth of 16%. At the same time, our country in some parts of the medical insurance fund deficit, sustainability of the health care system test.
Experts believe that in the economic downward pressure is bigger, GDP growth is slowing, the total health expenses can no longer continue to maintain rapid growth in the last few years, otherwise will lead to an unsustainable health care system.
And according to the established goals, in 2017, the national public hospital medical expenses growth to below 10%, to 2020, the growth rate steady at a reasonable level.
In order to solve this problem, the reporter understands, in the next step of reform, the Treasury will comprehensively promote the reform of medical insurance payment. In public hospitals at the county level and the pilot city public hospital comprehensive advancement by macro-reforms, capitation payment and total prepaid compound payment method reform, give full play to the medical insurance fund to standardize and guide the medical staff and for controlling the excessively rapid increasing of medical expenses. At the same time, to set control target. Set the national medicine growth rate the annual total cost control target, and combining with the layers of decomposition, the around as an important reform achievements appraisal indicators.
It is understood that our main medicare payments is a "pay by project". Risk under this payment method, medical treatment charge is mainly borne by the payer,, hospital need not bear the risk, this may cause excessive diagnosis and treatment, increasing medical costs. Representatives of the economic information daily, reporter interview, commissioner, said the medicare payment reform will change the payer has been passivity and because of the unreasonable payment method bring unnecessary health care spending, and encourage hospital to control medical expenses, reverse the past "ailment rectification, the situation of excessive medical treatment.
The CPPCC national committee, ho in liaoning medical school dean he wei said that health care payment reform of medical system reform has a positive role. "Baton", a good payment could guide the medical institutions to provide basic medical services, reasonable reversed transmission of medical institutions, medical record home page, a clinical pathway to regulate coding and medical record management, in accordance with the law of evidence-based medicine to establish modern hospital management system.
The CPPCC national committee, chairman of insurance giant, Martin Dai Hao suggested that will cover all payment reform of medical institutions and medical services, gradually reduce pay according to the project. Advocate the disease health management at the same time, through disease prevention and recovery to reduce the incidence of a disease, so as to radically reduce health-care spending. Establishing and perfecting the "balance retention, reasonable overruns share" incentive constraint mechanism, to stimulate medical institutions to improve service efficiency and quality.
In addition, for the sustainability of China's health care system pressure, the personage inside course of study points out, investigate its reason, on the one hand, from the imperfection of the financing mechanisms, excessive financing responsibilities and government focus to the unit, the high proportion of the burden of government, Parts of reimbursement ratio, on the other hand is a rapid increase, more than 90% staff reimbursement.
In order to solve this problem, the Treasury officials said that this year will continue to improve the health care financing and reimbursement ratio adjustment mechanism, enhance the sustainability of the system. One is to reasonably adjust the government, unit and individual financing allocation proportion. The second is to perfect personal accounts, gradually develop outpatient cost as a whole. 3 it is to adhere to the principle of moderate protection, avoid excessive competition security level of developed countries, guide the masses to form reasonable expectations. At the same time, vigorously develop commercial health insurance. |
