The State Council promotes the reform of medical and health system and speeds up the improvement of universal medical insurance

The main work arrangement of deepening the reform of the medical and health system in 2013 is the key year for deepening the reform of the medical and health system and comprehensively implementing the 12th Five Year Plan In order to clarify the task objectives, strengthen the organization and leadership, implement the work responsibilities, and continue to promote the reform in depth, the main work arrangements for 2013 medical reform are proposed I General requirements We will thoroughly implement the spirit of the 18th National Congress of the Communist Party of China, take the scientific outlook on development as the guide, strengthen reform and innovation, adhere to the direction of serving the people's health, adhere to the basic principles of prevention first, rural areas as the focus, Chinese and Western medicine as the focus, adhere to the basic principles of ensuring the basic level, strengthening the grass-roots level, and building the mechanism, comprehensively implement the 12th Five Year Plan for medical reform, and strive to accelerate and improve the nationwide medical insurance system, consolidate and improve the basic The drug system and the new mechanism for the operation of primary medical and health institutions, actively promote the reform of public hospitals, make overall plans for supporting reforms in basic public health services equalization, allocation of medical and health resources, medical management by social capital, medical and health informatization, drug production and circulation, medical and health supervision system, consolidate the existing achievements, and make new breakthroughs in key areas and key links 。 2 Tasks (1) accelerate and improve the national health insurance system 1 Consolidate and expand the coverage of basic medical insurance, and steadily improve the level of security The insured rate of basic medical insurance for employees (hereinafter referred to as employee medical insurance), basic medical insurance for urban residents (hereinafter referred to as urban residents medical insurance) and new rural cooperative medical insurance (hereinafter referred to as new rural cooperative medical insurance) is more than 95% The medical insurance for urban residents and the government subsidy standard for the new rural cooperative medical system have been raised to RMB per capita per year, and the individual payment level for urban and rural residents has been raised accordingly We will encourage local governments where conditions permit to actively explore and establish financing mechanisms that are commensurate with the level of economic development Within the scope of medical insurance and new rural cooperative medical insurance policies, the proportion of inpatient payment increased to over 70% and 75% respectively, further narrowing the gap with the actual proportion of inpatient payment, and appropriately improving the treatment of outpatient medical insurance (the Ministry of human resources and social security and the health and family planning commission are respectively responsible The department ranking first is the leading department, which is responsible for taking the lead for each department respectively, the same below) 2 Actively promote the construction of the safeguard and rescue mechanism for major and major diseases We will implement the guiding opinions on the development of serious illness insurance for urban and rural residents (FGS [2012] No 2605) issued by the development and Reform Commission and other six departments, and promote the pilot project of serious illness insurance for urban and rural residents We will continue to carry out pilot programs to safeguard 20 major diseases, including childhood leukemia We will improve the urban and rural medical assistance system Strengthen the connection between all kinds of security systems (the Ministry of human resources and social security, the health and Family Planning Commission, the development and Reform Commission, the Ministry of finance, the Ministry of civil affairs and the CIRC are responsible for this.) 3 Actively promote the construction of the disease emergency rescue system Implement the guidance of the general office of the State Council on the establishment of the disease emergency rescue system (GBF [2013] No 15), formulate the relevant documents on the management of the disease emergency rescue fund and the standards and first-aid norms for the urgent and serious injuries and injuries requiring emergency treatment To guide all localities to establish disease emergency rescue funds and formulate implementation plans All sectors of society are encouraged to participate in the emergency rescue of diseases 4 Deepen the reform of medical insurance payment system In combination with outpatient service, we will carry out the reform of payment according to head, serious outpatient disease and inpatient disease Actively promote the establishment of negotiation mechanism and payment mechanism for purchasing services between medical insurance agencies, medical institutions and drug suppliers Establish and improve the assessment and quality supervision system, prevent the simple decomposition of quota indicators, prevent the decomposition of medical services, shuffle patients, and reduce service quality Gradually extend the supervision of medical insurance on medical service of medical institutions to the supervision of medical service behavior of medical personnel (the Ministry of human resources and social security and the health and family planning commission are respectively responsible for) 5 Improve the management ability and service level of basic medical insurance We will make unified plans to promote the standardization of basic medical insurance and the construction of information systems We will improve the level of fund co-ordination and encourage local governments where conditions permit to explore provincial co-ordination Improve the management and service ability of medical insurance institutions Summarize the practical experience, vigorously promote the settlement of medical treatment in different places, and gradually promote the direct settlement of medical treatment in different places in the province Choose to pilot in some provinces to explore the establishment of cross provincial real-time medical settlement mechanism (the Ministry of human resources and social security and the health and family planning commission are respectively responsible for) 6 Continue to encourage the government to purchase services and entrust qualified commercial insurance institutions to handle medical security management services Enterprises and individuals are encouraged to purchase supplementary insurance for serious commercial diseases Encourage commercial insurance institutions to develop health insurance products other than basic medical insurance (in the charge of the health and Family Planning Commission, the Ministry of human resources and social security, the development and Reform Commission and the Insurance Regulatory Commission) 7 Integrate the management responsibilities of employee medical insurance, urban residents medical insurance and the new rural cooperative medical insurance, do a good job in the integration period, and ensure the smooth operation of the system (in the charge of the central office, the Ministry of human resources and social security, and the health and Family Planning Commission) (2) consolidate and improve the basic drug system and the new mechanism for the operation of primary medical and health institutions In accordance with the requirements of the opinions of the general office of the State Council on consolidating and improving the basic drug system and the new mechanism of grass-roots operation (GBF [2013] No 14), all localities should formulate specific implementation measures by the end of 2013, comprehensively implement them, and promote the continuous deepening of grass-roots medical reform, so as to promote reform, consolidate achievements and expand effectiveness 8 Implement the 2012 national essential drug catalogue Strictly regulate local supplementary drugs Guide grass-roots medical personnel to standardize the use of essential drugs, strengthen the basic drug knowledge training of grass-roots medical personnel, and regard it as an important content of competitive employment and professional assessment of grass-roots medical personnel We will strengthen the training of basic drug clinical application guidelines and prescription sets, and cover all government-run primary health care institutions by the end of 2013 We will improve the basic drug reserve system We will gather information on drugs with uncertain dosage, infrequent production and supply, further promote the establishment of a normalized shortage drug reserve mechanism, and focus on ensuring the supply of infectious disease treatment drugs and first-aid basic drugs (in charge of the health and Family Planning Commission, the Ministry of human resources and social security, the Ministry of industry and information technology, and the Bureau of traditional Chinese Medicine) 9 Continue to promote the implementation of the basic drug system in the village clinics Non governmental primary medical and health institutions are encouraged to implement the basic drug system through government purchase of services and other means (in charge of the health and Family Planning Commission, the Ministry of Finance and the Ministry of industry and information technology) 10 Innovate the performance appraisal mechanism Encourage the introduction of third-party assessment, strengthen quantitative assessment and effect assessment, and link the assessment results with the total amount of performance pay, financial subsidies, medical insurance payments, etc., and with the income of medical personnel All localities should proceed from the reality, on the basis of steady implementation of performance-based pay, appropriately increase the proportion of incentive performance-based pay, and reasonably open the income gap (in charge of the Ministry of human resources and social security, the health and Family Planning Commission and the Ministry of Finance) 11 Improve the stable and long-term multi-channel compensation mechanism We will implement the financial subsidy policy for the operation of primary medical and health institutions, incorporate the current balance of payments subsidy of primary medical and health institutions into the financial budget and implement it in full and on time We will ensure that funds for basic public health services are earmarked for their own purposes, and that they are not withheld, misappropriated or misappropriated General diagnosis and treatment fees shall be fully implemented Give full play to the compensation function of medical insurance payment (in charge of the Ministry of finance, the health and Family Planning Commission, the Ministry of human resources and social security, and the development and Reform Commission) 12 Continuously improve the service capacity of the grass-roots level We will continue to support the construction of grass-roots medical and health institutions, and carry out projects to improve the service capacity of grass-roots TCM More than 85% of community health service centers, more than 70% of township health centers, more than 60% of community health service stations and village health offices can provide TCM services We will launch a pilot project to build revolving dormitories in township hospitals We will continue to carry out targeted training of free medical students We will continue to support the construction of standardized clinical training bases for general practitioners (in charge of the development and Reform Commission, the Ministry of finance, the Ministry of human resources and social security, the health and Family Planning Commission, the Ministry of education, and the Chinese medicine bureau) 13 Increase the implementation of rural doctors' compensation policies In principle, about 40% of the basic public health service tasks should be assigned to the village health office Give full play to the compensation function of NCMS to village clinics The central government has established a subsidy mechanism for village clinics to implement the basic drug system, and local governments at all levels should adopt the way of quota subsidy to give special subsidies We will promote the implementation of rural doctors' pension policies (in the charge of the health and Family Planning Commission, the Ministry of finance, the Ministry of human resources and social security, and the development and Reform Commission) 14 Basically complete the long-term debt resolution work of primary medical and health institutions, and resolutely stop the occurrence of new debts (in charge of the Ministry of Finance and the health and Family Planning Commission) (3) actively promote the reform of public hospitals 15 Comprehensively summarize and evaluate the work experience of the first batch of county-level public hospitals (including traditional Chinese medicine hospitals, the same below) comprehensive reform pilot determined by the state, and study and solve the new problems in the reform We will launch the second batch of pilot projects for comprehensive reform of county-level public hospitals The reform of county-level public hospitals should focus on the establishment of long-term compensation mechanism, the establishment and improvement of corporate governance structure, the promotion of medical price reform, the deepening of personnel distribution system reform, the control of medical expenses, the increase of the proportion of personnel expenditure in business expenditure, and the improvement of medical personnel treatment (in charge of the health and Family Planning Commission, the central editorial office, the development and Reform Commission, the Ministry of finance, the Ministry of human resources and social security, and the Bureau of traditional Chinese Medicine) 16 Improve the service capacity of county-level hospitals We will focus on improving the medical treatment capacity of major diseases, improve the diagnosis and treatment standards and clinical pathways, and strive for the diagnosis and treatment of most major diseases in county-level hospitals We should improve the ability of county-level hospitals to make initial diagnosis for some complex diseases, and do a good job of referral with tertiary hospitals To guide county-level hospitals to set up special posts according to regulations and introduce high-level talents in urgent need Establish and improve the long-term cooperation and assistance mechanism of counterpart support for county-level hospitals in urban hospitals, continue to implement the training project for key doctors in county-level hospitals, and train no less than 6000 key talents (including clinical technical backbone of traditional Chinese Medicine) for county-level hospitals Strengthen the capacity building of clinical departments (in charge of the health and Family Planning Commission, the development and Reform Commission, the Ministry of finance, the Ministry of human resources and social security and the Bureau of traditional Chinese Medicine) 17 Expand and deepen the pilot reform of urban public hospitals We will deepen the comprehensive reform of the system and mechanism, with the elimination of the mechanism of "medicine for medical treatment" as the key link, in accordance with the requirements of the separation of political affairs, management and management, medicine, profit-making and non-profit, and with the reform of the compensation mechanism and the establishment of a modern hospital management system as the starting point Make clear the functional orientation of public hospitals Actively control the unreasonable increase of medical expenses Supervise the implementation of hospital financial accounting system, strengthen cost management, and incorporate hospital cost and expense control into the performance appraisal of public hospitals The pilot areas shall be given certain autonomy in terms of income distribution, pricing and drug procurement (in charge of the health and Family Planning Commission, the central editorial office, the development and Reform Commission, the Ministry of finance, the Ministry of human resources and social security, the Ministry of education, the state owned assets supervision and administration of traditional Chinese Medicine) 18 Continue to implement measures to facilitate and benefit the people We will further develop quality care services,