"Sanming mode" may really have to be pushed away
The experience of the "Sanming Model" in the medical reform, the annual salary system, the two-vote system, and the reform of the medical price reform, may further expand the scope.
According to the news circulating in the industry today, Shaanxi Province, Shanghai, Zhejiang Province and Sichuan Province were listed as the second batch of comprehensive medical reform provinces in the relevant work conferences of the special research and comprehensive medical reform pilot provinces. We also learned from multiple sources that individual provinces were indeed listed as reform pilots. At present, Jiangsu Province, Fujian Province, Qinghai Province and Anhui Province are the first four provinces for medical reform.
What are the key tasks for these provinces in the future? The meeting said that the focus of the next step of medical reform is to speed up the establishment of a grading diagnosis and treatment system, summarize and promote the "Sanming medical reform experience", scientifically adjust the price of medical services, comprehensively establish a modern hospital management system, support the encouragement of social forces to run medical treatment, and establish a long-term monitoring mechanism.
Why is the Sanming model likely to be pushed away? According to the industry insider, Ma Xiaowei, deputy director of the State Council Medical Reform Office and deputy director of the National Health and Family Planning Commission, said that the future reforms must be "eight musts":
First, the comprehensive medical reform must be personally responsible by the party and government leaders, and a leader in charge of the "three medical" work.
Second, the basic medical insurance management must implement the "three guarantees in one."
Third, the reform of the circulation field must implement the "two-vote system" to further reduce the "moisture" of the drug prices.
Fourth, the reform of public hospitals must adhere to the "cage for birds" and establish a new mechanism for scientific operation.
Fifth, the mobilization of medical personnel must reform the personnel compensation system and implement the preparation and preparation of the case system.
Sixth, it is necessary to speed up the grading diagnosis and treatment of improving the overall efficiency of the health system.
Seventh, to play the role of medical insurance incentives and constraints, we must increase the efforts to promote the reform of medical insurance payment methods.
Eighth, it is necessary to implement the government's responsibility to adhere to the public welfare of public hospitals.
These eight points are almost all the typical experience of "Sanming Medical Reform". It seems that this model should be fully promoted. The effect of such large-scale promotion is actually uncertain. Not long ago, many friends in the system also said that “Sanming Medical Reform†should be pushed strongly, but the main difficulty lies in:
First of all, how is the legality of the three guarantees? The integration of basic medical insurance for urban residents and the new rural cooperative medical system is underway, and most of the areas are managed by the human welfare department. If the three basic medical insurances are merged and then managed by the financial department, is the function of the medical insurance department going to undergo a large-scale change?
In addition, the "Social Insurance Administration of the State Council is responsible for the national social insurance management work" as stipulated in the "Social Insurance Law" is not to be revised? The administrative costs of reform may not be estimated. As a city, it is not difficult to break through in the management institutions, but it is easy to know how difficult it is to push the entire province or even the country.
Secondly, if you pay attention to the second batch of medical reform provinces mentioned above, you will find that their reform focus and progress are different. For example, in fact, Zhejiang has already opened the medical reform in the province earlier. The main highlight of the reform is the graded diagnosis and treatment, which is very stable in the adjustment of medical service prices. In addition to the responsibility of family doctors, Shanghai's reforms also promote the procurement of GPOs in the field of drug bidding. Shaanxi Province and Sichuan Province have almost no characteristics of their own.
If you follow the above eight points of experience, many provinces may have to re-adjust the existing reform ideas. For example, the main highlight of Sanming Medical Reform is the reduction of circulation in drug procurement, such as the two-vote system, such as the preferential use of the generic drug system. If the pace of reform is above, how can Shanghai's GPOs be adjusted? Can the demand for large and diverse medications be met? For example, the second bright spot of Sanming Medical Reform is to implement the target annual salary system. However, in Shanghai in 2014, it began to promote the target annual salary system, and introduced the standardization workload. The same is the annual salary system. Is the performance appraisal the same? How will Shanghai adjust the salary system reform? These are big question marks in the process of reform implementation.
All in all, the deepwater exploration of this reform still does not see clear rules and cannot predict the results. Observing and watching is probably the best gesture.
Youth Biotech CO,. Ltd. , https://www.youtherb.com