Never allow oral implantation to become a "cash cow" related charges are planned to be specially treated

　　Recently, the National Medical Security Bureau has solicited opinions from the public regarding the special treatment of dental implant medical service charges and consumable prices.
It plans to standardize dental implant medical services and consumables charging methods, carefully organize the centralized procurement of dental implant consumables, and implement a comprehensive dental implant charging system.
Governance
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Experts interviewed by a reporter from the "Rules of Law Daily" believe that based on the perspective of public interests, dental implants are the hardest hit areas in China where "seeing a doctor is expensive"
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One of the difficulties in carrying out special price governance for dental implants is that dental implant consumables and dental implant medical services are "indistinguishable from medical consumption", and there is an inflated price
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The cost of medical care is inflated and the price is inflated.
It is difficult to control chaos.
According to common understanding, dental implant refers to a method of repairing missing teeth, and its cost depends on the price of consumables and medical service charges
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On August 18, the National Medical Security Administration announced the "Notice on Carrying out Special Treatment of Oral Implantation Medical Service Fees and Consumables Prices (Draft for Comment)" (hereinafter referred to as the "Draft for Comment"), which is open to the public for comments
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It is worth noting that as early as May this year, the National Health Commission and other 9 ministries and commissions jointly issued the "Key Points of Correcting Unhealthy Practices in the Field of Pharmaceutical Purchase and Sales and Medical Services in 2022" to standardize the charges for dental medical services and consumables.
Medical institutions that provide dental services but do not participate in the procurement of dental implant consumables by the provincial alliance carry out key inspections
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Deng Yong, a professor at the Law Department of Beijing University of Traditional Chinese Medicine and a researcher at the National Institute of Traditional Chinese Medicine Development and Strategy, believes that with the improvement of people's living standards and the deepening of population aging, more attention has been paid to oral health , but there has been a long-term charge in the field of oral implantation.
Problems such as non-standardization and heavy cost burden have become a major pain point in people's livelihood
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To this end, all parties strongly call for orderly rectification, price reduction and burden reduction in the field of oral implantation
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According to Liang Jialin, editor-in-chief of the "National Health Policy 2050" academic platform, dental treatment is closely related to almost all urban and rural residents.

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Based on the perspective of public interest, dental implants are the hardest hit area in our country, which is "expensive to see a doctor"
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In addition, although the medical industry is fully competitive, there is a high degree of information asymmetry, asymmetry in diagnosis and treatment rights, and asymmetry in the right to speak between the supply and demand sides of the oral implant industry.
The supplier does not necessarily have the motive to lower prices independently, and the patient's right to health cannot be fully guaranteed.

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Therefore, it is necessary and timely for the National Medical Insurance Administration to organize special governance in the field of oral implantation
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According to the "Draft for Comments", the first problem that the National Medical Insurance Administration plans to solve is to standardize the charging methods for dental implant medical services and consumables, and to promote the "separation of technology and consumption" for dental implant medical services in an orderly manner
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This means that in the future dental implant medical services, consumables have the price of consumables, and medical services have the charging standards for medical services
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In this regard, Liang Jialin explained that the main difficulty in carrying out special price management for dental implants at present is that dental implant consumables and dental implant medical services are often "indistinguishable from medical consumption" and there are inflated prices
.
To this end, the National Medical Insurance Administration is currently conducting a nationwide price survey to ensure that industry data is complete, authentic and timely
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"Aiming at all mainstream categories of dental implant medical services, implant systems, and crown products, and supervising consumables products and medical services at the same time, can we prevent 'pressing the gourd and floating the scoop' - passing on the artificially high pricing of consumables to medical services
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" Liang Jialin said
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Increase price supervision and improve medical transparency index Excessive charges for medical services are one of the pain points of expensive dental implants
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In this regard, the "Draft for Comments" proposes to strengthen the price regulation of medical services such as dental implants
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Local medical security departments should focus on single conventional planting, and clarify the price regulation target of the whole process
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In Deng Yong's view, the "Draft for Comments" sets out specific and clear requirements
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For public medical institutions, in areas where government-guided price management is implemented for oral implant projects such as implant placement fees, crown placement fees, and bone graft surgery fees, the medical security department will re-formulate and announce government-guided prices while standardizing the price items
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For private medical institutions, the prices of dental implants and other services are subject to market regulation, and the pricing should follow the principles of fairness, lawfulness, good faith, and consistent quality and price, and proactively publicize the price level in obvious areas, and ensure the authenticity, timeliness, and quality of public information.
completeness
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Private medical institutions should strictly regulate prices, and must not use false subsidies or low-price advertising to deceive patients
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Deng Yong believes that dental implant surgery is very technical, so in the cost of dental implant medical services, the cost of dentists is relatively high
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Therefore, strengthening the price regulation of medical services such as dental implants will reduce the unreasonable charges of dentists, but at the same time, it is necessary to highlight the technical labor value of dentists in the entire dental implant service
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According to Liang Jialin's observation, medical services are different from general service industries in that they are dominated by suppliers ( hospitals and doctors).
Under the premise of information asymmetry and driven by profit-seeking motives, whether it is a public or private hospital, the supplier may Implement induced consumption and improper medical behavior
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Liang Jialin believes that the way out to solve the problem lies in the respect of market laws in the management of charges for dental implants
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On the one hand, limit the micro-price intervention of the competent authorities in medical institutions, such as compiling medical service price indexes for public hospitals, setting price adjustment trigger conditions and price adjustment coefficients, and creating a fair and predictable policy environment for private hospitals; Medical transparency, publicizing the cost, price, and efficacy information of medical institutions, accepting the supervision of the general public, especially medical patients, and removing the "soil" for medical institutions to implement induced medical treatment and improper medical treatment
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"When oral medical institutions can benefit from high-quality and affordable services, there is no incentive to charge excessive fees from patients
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" Liang Jialin said
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Centralized procurementSqueeze out water and strengthen the warning of abnormal price.
Regarding the price of consumables, the "Draft for Comments" proposes to carefully organize the centralized procurement of dental implant consumables, and establish an inter-provincial procurement alliance for dental implant consumables
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So, will the implementation of centralized procurement of dental implant consumables in the future make the price of dental implants "big dive"? In Deng Yong's view, the centralized procurement of dental implant consumables will squeeze out the artificially high price of dental implant consumables
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For example, Ningbo City, Zhejiang Province limits the price of consumables to 1,000 yuan for domestic production and 1,500 yuan for imports, and the medical service fee for medical institutions (level 2 and below) is set at 2,000 yuan, a price reduction of 60%; Bengbu City, Anhui Province , the cost of dental implant materials (including a crown and a set of implants) decreased by an average of 84.
17%, and the highest decrease was 89.
5%.
Among them, the lowest price of dental implants was only 950 yuan
.
Deng Yong believes that, on the whole, consumables only account for about one-third of the charges for dental implants, and medical services account for about two-thirds
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Therefore, the centralized procurement of dental implant consumables will reduce the price of dental implants, but it is unlikely that the price will "make a big dip"
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According to Liang Jialin's observation, the centralized procurement of dental implants revealed a new policy signal
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Oral medicine is the main track of private medical care in China.
It has long been characterized by strong rigid demand, weak supervision, and high profits
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Dental implants are high-value consumables commonly used in dentistry
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For the first time, private medical institutions have been included in the unified collection of dental implants, which helps to form a closed loop of supervision and allows public and private medical institutions to face an equal regulatory environment
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"In addition, the National Medical Insurance Bureau has carried out centralized procurement in the fields of non-medical insurance and private medical care, which is equivalent to blocking the profiteering space of consumable manufacturers and dental medical institutions
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This means that the regulators are reaching a consensus and will never allow public and private medical institutions.
Use dentistry as a 'cash cow' that earns people's money
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" Liang Jialin said
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Dental implant collection is not without problems
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Deng Yong believes that dental implants belong to the centralized procurement outside the medical insurance catalog, and it is a major problem to mobilize the enthusiasm of medical institutions to participate in the centralized procurement of dental implant consumables
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Therefore, to promote the active participation of medical institutions in centralized procurement, it is necessary to analyze the advantages such as cost saving brought by centralized procurement, and at the same time, “implement a differentiated price policy for public medical institutions that refuse to report the volume or the reporting rate is insufficient” based on the public The policy of the actual situation of the hospital will increase the enthusiasm of public hospitals to participate in centralized procurement, play a leading and exemplary role, and promote the active participation of private institutions
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The National Medical Insurance Bureau to carry out special governance can not be a temporary move
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Deng Yong suggested that the normalization of dental implant medical service charges and consumable price management should be realized, which requires comprehensive management of dental implant charges and the establishment of a long-term governance mechanism in the future
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In this regard, the "Draft for Comments" proposes that local medical security departments should take the prefectures and cities as units to establish a price abnormality warning system for oral implants, report more price complaints, the price is significantly higher than the local average, and refuse or passively participate in implantation.
Medical institutions at all levels and various types of dental collections are included in the price abnormality warning list
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Medical consumption is not divided into high prices, and it is difficult to control chaos .
Medicine and traditional Chinese medicine health .
　　Increase price supervision and improve medical transparency index hospitals .
　　Centralized procurement and procurement squeeze out water and strengthen price abnormality warning