What major events will happen in primary medical care during the "14th Five-Year Plan" period?

What could not be solved before can now be solved through legal means
.
The grassroots medical reform has experienced ups and downs along the way.
As the main body of this reform tide, the grassroots doctors have a deep understanding
.
Year after year, primary healthcare has moved from the "Entrepreneurial Era" to the "Systemized Era"
.
Today, the systematic construction is taking shape, but with the development of the system and the rapid progress of primary medical care, some new problems have gradually emerged
.
It is said that "the water is clear, there are no fish".
Now that the water is big and there are many fish, the original stable ecosystem of primary medical care has been broken, and it is inevitable that some big fish will eat small fish
.
In some areas, there are even big fish eating small fish in groups.
How can these chaos be alleviated? 01 "14th Five-Year Plan" Urban and Rural New Planning, Outside the Universe On February 9, the State Council Information Office held a regular briefing on State Council policies to discuss the "14th Five-Year Plan for Urban and Rural Community Service System Construction Plan" (hereinafter referred to as the "Plan") Introduce the situation
.
Fu Wei, Inspector of the Primary Health Department of the National Health Commission, pointed out: "Generally speaking, primary health work is still a weak point in the overall work, which is closely related to actively responding to population aging, comprehensively promoting the construction of a healthy China, and comprehensively promoting rural revitalization.
Compared with the new situation and new requirements of the national strategy, there is still a certain gap
.
" In just a few words, he pointed out the various problems of grassroots medical reform
.
How does the Plan intend to address these issues? Some grassroots doctors couldn't help but murmur in their hearts: "How can one "Plan" solve so many problems?" This is a good question.
No matter how large and complete a document is, it is impossible to solve so many problems
.
Moreover, the "Planning" is a large document with outlines and controls, and many details are not interpreted in detail, which also makes some people full of hope when they pick up this document, and they put it down after reading it for a long time without understanding it
.
Since the problems all appear in a group, the solution naturally cannot be single-handedly. .
For the "14th Five-Year Plan", the country has been preparing for many years, and it has already been ahead of schedule, because this big problem requires many solutions and solves many problems at the same time
.
Next, the grassroots doctor commune will lead you to explore and see what mysteries are behind the "Planning", and what supporting preparations have been made by the state in places that cannot be seen outside the documents
.
Behind the macro policy, what details can be grasped by grassroots doctors, which can bring tangible changes to others and themselves
.
02 What should I do if I eat small fish in a group? From the rule of man to the rule of law The basic principles of the "Plan" are clear, adhere to the people as the center, adhere to the main body of the people, and respond to the new expectations and needs of the people
.
Li Lin, a scholar of grassroots medical reform, believes that grassroots doctors are also part of the people, and their needs also need to be met
.
The most annoying thing is the "medical insurance money" that pays the wages of grassroots doctors
.
When some people can't control their greed, the law is the only weapon that checks and balances them now
.
Next month, the state will hand over the weapons to protect the medical insurance fund to the grassroots doctors themselves
.
China's "Interim Measures for the Handling of Reports on the Supervision and Administration of the Use of Medical Security Funds" was officially issued and will come into force on March 1, 2022
.
The grassroots doctors are undoubtedly the ones who know the whereabouts of the medical insurance funds best, and they are also the ones who are the easiest to obtain clues
.
As long as you can provide specific clues on suspected violations of laws, regulations, and rules on the supervision and management of the use of medical security funds, the law will give everyone justice
.
As long as the whistleblower makes a real-name report, the medical security administrative department with processing authority shall inform the whistleblower within 5 working days from the date of making a decision on whether to file the case
.
Today, when law enforcement agencies are also under strong supervision, many cases can be dealt with in a timely manner, especially those with solid evidence, and law enforcement agencies dare not neglect them
.
Don't worry too much about whether it will be exposed
.
In addition, the information of the whistleblower must be kept strictly confidential.
After verification, the medical security administrative department will reward the whistleblowers that meet the conditions for whistleblowing
.
The situation of "report and ignore" has been fully alleviated, and the medical reform will further enhance the level of the rule of law
.
The implementation of the medical reform policy has begun to be closely linked with the law, and institutions and personnel who can use medical insurance funds will be strongly restricted
.
Primary care reform requires both high-level careful design and close cooperation from the grassroots
.
The people are the country, and the supervision of the medical insurance fund is also a "people's war".
The country has gradually devolved the power of promoting medical reform to the people.
If there is a problem and there are reliable clues, it must take up legal weapons to protect itself
.
03 "Three Communities" principle to minimize the gap between establishments The "Planning" clearly defines the "Three Communities" principle of co-construction, co-governance and sharing, to guide market forces, better play the role of the government, build a multi-party participation pattern, and let all the people share development results
.
Li Lin believes that learning Sanming during the "14th Five-Year Plan" period is the highlight
.
The biggest change that Sanming has brought to the grassroots is to give public medical institutions the right to operate, manage and distribute income
.
In particular, the troubles caused by the compilation are more and more obvious.
In the case of more people and fewer people, the trend of solving the gap through market-oriented mechanisms is becoming more and more obvious
.
Measure the value of doctors by labor capacity, not by "seat"
.
Strengthen the ability of medical services, weaken the proportion of personnel identities, and implement human resource management methods of setting fees based on events, supporting them with fees, setting posts based on events, and hiring by post
.
For a long time, the establishment and welfare of public medical institutions have been tied together.
If there is no establishment, unequal pay for equal work is inevitable
.
From the perspective of provincial policies, overhead staffing has gradually become the mainstream, and the benefits and privileges behind the staffing need to be reduced, even including the political status and remuneration of non-staff medical staff
.
Sanming Medical has made this change possible
.
Now all parts of the country have issued documents for learning Sanming, duplicating the operation of Sanming's market-oriented mechanism.
If Sanming's income price (annual salary system) is advanced fast enough, the "unequal treaty" brought about by the establishment will be further compressed
.
In addition, the country has a special inspection team to supervise the battle, so the resistance to reform within each institution is instantly reduced, and the income composition and distribution of the doctor group will be more reasonable
.
4.
Solve the endowment insurance and upgrade the talent team in an all-round way The "Planning" clearly states that it is necessary to establish a post salary system and improve the dynamic adjustment and career growth mechanism, participate in social insurance (including endowment insurance) and enjoy corresponding benefits as required
.
It can be seen that during the "14th Five-Year Plan" period, the pension problem of grassroots doctors will be further improved
.
At the same time, in order to better protect the rights and interests of grassroots doctors, the "Physician Law" will also be officially implemented on March 1
.
Among them, it is clear that physicians working at the grassroots level and in difficult and remote areas shall enjoy allowances and subsidy policies in accordance with relevant state regulations, and enjoy preferential treatment in terms of professional title evaluation, career development, education and training, and commendation and rewards
.
It provides a sound treatment guarantee system, and the "Planning" also encourages college graduates and veterans to go to the village (community) for employment and entrepreneurship
.
In fact, the grassroots are very determined to improve the quality of talents.
By the end of 2020, there were more than 4.
3 million grassroots health personnel nationwide, of which 1.
53 million were practicing or practicing assistant physicians
.
This has brought about rapid changes in academic qualifications, professional titles, and professional structures, injecting strong vitality into the grassroots
.
Li Lin said that the "Plan" clearly states that efforts should be made to improve the capacity of grass-roots health and medical security services, and to do a good job in the prevention and control of infectious diseases, chronic diseases, and children's health care
.
This also echoes China's "2035 Vision Outline", improving the quality and scale of medical staff training, expanding the scale of shortage of doctors in pediatrics and general practice, and the quality of the talent team must be excellent
.
The increasing number of highly educated talents at the grassroots level has allowed clinicians to further strengthen the construction of knowledge systems such as infectious diseases and chronic diseases, and the status quo of focusing on medical treatment and ignoring prevention has also changed rapidly. .
In particular, the impact of the epidemic has brought collective reflection to the industry, and the concept of strengthening prevention will be more deeply rooted in the hearts of the people
.
During the "14th Five-Year Plan" period, there are still many expectations for grass-roots medical care.
The "Plan" and its supporting policies and regulations have given grass-roots doctors more autonomy
.
Only by ensuring that everyone's legitimate rights and interests are not violated, can doctors walk more steadily and go further in their professional career
.
(At the request of the interviewee, Li Lin is a pseudonym in the text)