Is it a blessing or a curse to cancel the bonus of Chinese medicine decoction pieces?

On October 26, the State Council issued the opinions of the CPC Central Committee and the State Council on promoting the inheritance, innovation and development of traditional Chinese medicine (hereinafter referred to as the opinions), which mentioned in the opinions on improving and improving the management system and mechanism of traditional Chinese medicine that "research and cancel the relevant work of adding traditional Chinese medicine Pieces" There has been a lot of controversy about whether to cancel the addition of Chinese herbal pieces As soon as this news came out, the industry has received many responses Some insiders pointed out that this will hit the enthusiasm of practitioners, and is not conducive to the development of Chinese Herbal Pieces industry There are also industry insiders pointed out that the price of Chinese herbal pieces may enter the era of standardization The more patients benefit, the more hospitals sell, the more they lose? On May 19, 2006, the national development and Reform Commission, together with the Ministry of finance, the Ministry of health, the drug administration and other ministries and commissions, issued the opinions on further rectifying the price order in the drug and medical service market (fgjg [2006] No 912), which stipulated: "the markup rate of Chinese herbal pieces shall be controlled within 25%." At present, China has completely broken the mechanism of supplementing medicine with drugs, actively explored various effective ways to carry out reform, cancelled drug addition, and reduced the proportion of drugs However, most of the specific reform programs around the country exclude Chinese herbal pieces, mainly because the price formation mechanism of Chinese herbal pieces is special Compared with western medicine and traditional Chinese medicine, traditional Chinese medicine pieces are easy to be consumed in grasping and storage, and a lot of human resources are needed in dispensing In addition, traditional Chinese medicine pieces have very high requirements for storage conditions In order to prevent Chinese medicine pieces from moth, mildew and discoloration, a large area of ventilated warehouse is required Air conditioning, dehumidifier, refrigerator and other equipment are also required, with high operation and management costs However, in some areas, in order to reduce medical costs, Chinese herbal pieces have been included in the scope of canceling the bonus In 2013, Xiamen cancelled the addition of Chinese herbal pieces, and then determined that the proportion of Chinese herbal pieces was 13% at the 2016 Xiamen medical reform special meeting On October 17, 2019, due to the 13% addition rate and the increase of related medical service costs, Xiamen health and Health Commission and medical insurance bureau plan to restore the proportion of Chinese herbal pieces to 25% In 2015, Dongguan also included Chinese Herbal Pieces in the scope of canceling drug addition Because the addition rate of Chinese herbal pieces is 25% higher than that of Western medicine, and there is more room for patients to benefit Many patients go to the hospital specially to buy Chinese herbal pieces Although there are financial subsidies and increase the cost of relevant diagnosis, treatment and inspection, the hospital says that the more they sell, the more they lose Take Dongguan Hospital of traditional Chinese medicine as an example In the first quarter of 2015, the revenue was reduced by 1.94 million yuan, which was mainly due to the lack of subsidies for the consumption of drugs, which needed to be borne by the medical institutions themselves General hospitals and traditional Chinese medicine hospitals are the largest consumer market of Chinese herbal pieces Some insiders say that the cancellation of the addition of Chinese herbal pieces may expand the demand on the surface, but in fact it will not increase the hospital's income, and will reduce the enthusiasm of medical institutions to use Chinese herbal pieces In recent years, with the continuous development of Chinese Herbal Pieces industry, a large number of Chinese Herbal Pieces enterprises that have passed GMP certification and have begun to take shape have sprung up In 2018, the market scale reached 273.4 billion yuan In addition to the continuous expansion and upgrading of the industrialization and marketization of Chinese herbal medicine, to some extent, it is also inseparable from the promotion of good policies such as retaining the addition of Chinese herbal pieces Without reasonable supporting compensation and The incentive mechanism and the cancellation of the bonus will not be conducive to the development of Chinese Herbal Pieces industry The price mechanism of traditional Chinese medicine service will be further improved At the same time, in the opinion, it is proposed that: guided by the clinical value, focusing on the superior service and characteristic service of traditional Chinese medicine, we should strengthen policy support and improve the price formation mechanism of traditional Chinese medicine service When adjusting the price of medical service, we should pay more attention to the price of medical service which embodies the value of technical service of medical staff, such as traditional Chinese medicine We will improve the payment methods of medical insurance in line with the characteristics of traditional Chinese medicine We will improve the coding system of TCM syndrome classification, which links up with international disease classification Select diseases with obvious advantages of traditional Chinese medicine, clear treatment path and clear cost in batches, pay by disease, and reasonably determine the payment standard We will encourage and guide grass-roots medical and health institutions to provide appropriate TCM services by means of capitalizing on some chronic diseases and improving relevant technical specifications Timely include qualified medical institutions of traditional Chinese medicine into designated medical institutions of medical insurance We will actively include appropriate medical service items of traditional Chinese medicine and traditional Chinese medicine into the scope of medical insurance Commercial insurance institutions are encouraged to develop insurance products such as traditional Chinese medicine for the treatment of diseases These opinions indicate that the price mechanism of TCM services will be further improved, or the loss caused by the cancellation of bonus will be compensated by adjusting the price of TCM services This also means that the economic operation mechanism of hospitals with Chinese medicine as their characteristics will change With the decrease of the proportion of Chinese medicine, the "technology based medicine" will become the mainstream, which will encourage the improvement of Chinese medicine medical technology and service level, and promote the innovation of more Chinese medicine service projects For patients, after the price of Chinese herbal medicine drops, they are likely to face the increase of medical service price They need to increase government investment, improve the medical insurance system, and give more support from commercial insurance Editor in charge | 37 statement: this point of view only represents the author himself, not the 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