40 years of reform and opening up

Source: health sector 2018-04-11 from 1978 to 2018, the reform and opening up officially entered its 40th year Looking back on the earth shaking changes in various fields in China, the field of health care is absolutely unique From the first three kinds of "stethoscope, sphygmomanometer, thermometer", to today's "B-ultrasound, spiral CT, blood gas analyzer"; from "barefoot doctor" to top-level experts; from rural clinic to "super hospital".. Forty years of great changes, China's medical and health industry has developed rapidly In 1980, barefoot doctor: a symbol of the era of rural cooperative medical system, rural three-level medical prevention and health care network, barefoot doctor system, has been hailed by the World Health Organization as the three magic weapons of rural health work in China In the 1980s, the reform of China's economic system started from the countryside, and the old rural cooperative medical system lost its support and gradually disintegrated The Chinese model, known as "barefoot doctors", has gradually faded out of the stage Stethoscope, sphygmomanometer and thermometer are the three kinds of village doctors in the 20th century In 1981, the average life expectancy in China was 67.9 years old According to the development of China's health and human rights progress, the average life expectancy in China increased from 67.9 years in 1981 to 76.5 years in 2016, and the maternal and infant mortality rates decreased significantly In 1985, it was called the first year of medical reform In 1985, the State Council approved and transmitted the report on several policy issues of health work reform drafted by the former Ministry of health in August 1984 The basic idea of medical reform in this period is to "decentralize the power and transfer the benefits, expand the hospital's autonomy, open up and invigorate, and improve the efficiency and benefits of the hospital" All kinds of hospitals at all levels have carried out reforms from point to surface, from shallow to deep, from single to comprehensive At this stage, the hospital reform is mainly reflected in the following aspects: the implementation of the contract management responsibility system; the reform of the hospital leadership system, the implementation of the president responsibility system; the implementation of the labor and personnel system reform with the main contents of the fixed number of staff, the appointment contract system of cadres and employees, strict attendance and linked with salary and bonus, and the establishment of a certain range of talent flow system The former Ministry of Health decided to stop using the name "barefoot doctor" Those who have passed examinations and examinations and reached the level of doctors become "village doctors" In 1992, Shenzhen took the lead in the reform of the staff hospital system, which started the reform of China's medical system In September of that year, the State Council issued several opinions on deepening health reform, which requires: reforming health management system, broadening health financing channels, improving compensation mechanism; transforming operation mechanism, promoting reform of labor and personnel and wage system; further expanding the autonomy of medical and health units, so that the units really have the right of labor and personnel arrangement, decision-making power of business construction Management right of operation and development and distribution right of salary and bonus In 1998, the State Council issued the decision on the establishment of the basic medical insurance system for urban workers, which requires the establishment of a basic medical insurance system covering all urban workers in the country, combining social co-ordination and personal accounts This marks the beginning of the reform of medical insurance for urban workers in China, and also the beginning of the construction of social medical insurance system to adapt to the socialist market economy 2001 In October 2001, China issued several opinions on improving the compensation mechanism of urban medical institutions and implementing the compensation policy, proposing to adhere to and improve the two-line management method of hospital drug revenue and expenditure, gradually reduce the proportion of drug revenue in business revenue, actively and steadily promote the pilot work of changing hospital outpatient pharmacy into drug retail enterprise, and a series of weakening the compensation of drug revenue to hospital Action In October 2002, the decision of the Central Committee of the Communist Party of China and the State Council on further strengthening rural health work clearly pointed out that we should "gradually establish a new rural cooperative medical system focusing on the overall planning of major diseases" In 2009, China made an important strategic plan to deepen the reform of the medical and health system, and established the new agricultural cooperation as the basic medical security system in rural areas At the turn of spring and summer in 2003, China suffered a sudden SARS epidemic At the end of the SARS epidemic, the central government announced a substantial increase in funding for health and epidemic prevention, Building Centers for disease prevention and control at all levels throughout the country, especially in rural areas At the same time of fighting against SARS, it also caused the reflection and Discussion on the fairness of medical service in the industry Some scholars believe that the lack of government investment in health care has brought great pressure on medical institutions By reducing government investment, market-oriented medical reform has transformed the public medical institutions that used to rely on state financial subsidies into profit seekers Zhang Yichi, the first 1.3 billion Chinese citizen who was four years late, was born at 0.02 a.m on January 6, 2005 in Beijing maternity hospital (Liu geyu / Vision China) Shanghai Shenkang hospital development center in 2005, the separation mode of hospital management and management began to appear in China In September of the same year, Shanghai Shenkang hospital development center and Jiangsu Wuxi hospital management center were successively established On May 12, 2008, a 7.8-magnitude earthquake occurred in Wenchuan, Sichuan Province The earthquake was obvious in Chengdu Jinjiang District obstetrics and Gynecology Hospital moved the pregnant woman to the outside The husband accompanied his wife and gave her a loving kiss (Guo Xin / Vision China) 2009 In 2009, the opinions of the CPC Central Committee and the State Council on deepening the reform of the medical and health system (referred to as the "new medical reform plan") was issued From 2009 to 2011, five reforms were focused on: first, accelerating the construction of the basic medical security system; second, initially establishing the national basic drug system; third, improving the basic medical and health service system; fourth, promoting the gradual development of basic public health services The fifth is to promote the pilot reform of public hospitals By the end of 2017 and 2017, the number of people covered by basic medical insurance in China has exceeded 1 billion 350 million, and the coverage rate has stabilized at more than 95% In 2017, the per capita financial subsidy standard for basic medical insurance for urban and rural residents was increased to 450 yuan, 375 new drugs were added to the medical insurance catalog, the scope of coverage was continuously expanded, and the proportion of reimbursement was constantly increased On the basis of universal coverage of basic medical insurance, a serious illness insurance system for urban and rural residents was established, covering 1.05 billion people The proportion of reimbursement for compliance medical expenses for seriously ill patients increased by about 12 percentage points on average On March 13, 2018, the State Council's major reform plan was put forward According to the plan, the national health and Health Commission will be established, the national health and Family Planning Commission will not be retained, the leading group office of the State Council for deepening the reform of the medical and health system will not be established, the National Medical Security Bureau will be established, the State Administration of market supervision and administration will be established, the State Drug Administration will be established separately, and the State Food and Drug Administration will not be retained On March 31, 2018, Boao super hospital, located in Boao Lecheng International Medical Tourism Pioneer Area, opened Boao super hospital is positioned as a mixed ownership general hospital with first-class hardware, first-class discipline and first-class management It is an exploration of the system and mechanism for holding medical institutions and an innovation of hospital management It will provide international advanced medical services for patients at home and abroad