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Everything for the Health of the People - A Review of the Achievements of Medical and Health System Reform Since the 18th National Congress of the Communist Party

Since the 18th National Congress of the Communist Party, the Central Committee of the Party with Comrade Xi Jinping at its core has started a new journey to build a healthy China, based on the long-term development of the country and aiming for the great rejuvenation of the nation.

2018-11-22 21:18

　　Health is the foundation of happiness.

　　With the improvement of the material and cultural life levels, the public has higher demands for health, not only wanting to see a doctor and get treated well but also hoping to avoid illness and live with vitality. To meet the public's expectations for health, our country has placed greater emphasis on integrity, systematization, and coordination in deepening the reform of the medical and health system, and has further emphasized the "three medical linkages" of medical care, medical insurance, and pharmaceuticals. These foundational measures have strongly supported the health dreams of every Chinese person.

　　Enjoying the guarantee of medical treatment and medication

　　Health first is the strategic basis for the Party and the country to seek development.

　　"The overall health level of the people has reached the average level of middle-income countries, achieving high health performance with relatively low investment, winning widespread praise from the international community." This evaluation comes from a joint research report on China's medical reform released by several domestic and international research institutions, including the World Bank and the World Health Organization, in July 2017.

　　Achieving such accomplishments is not easy, especially for a developing country that is not yet affluent overall.

　　To ensure that the public has guaranteed access to medical treatment and medication, our country's universal medical insurance system has been accelerated and improved, with the insurance coverage rate stabilizing at over 95%. By 2018, the per capita financial subsidy standard for basic medical insurance for urban and rural residents reached 490 yuan, and the reimbursement ratios for outpatient and inpatient expenses within the policy scope stabilized at around 50% and 75%, respectively. Data shows that the proportion of personal health expenditure in total health expenditure in our country has dropped to 28.8%, the lowest level in nearly 20 years.

　　At the same time, our country has fully established a serious illness insurance system for urban and rural residents, which currently covers 1.05 billion basic medical insurance participants. The actual reimbursement ratio of the serious illness insurance system is increased by about 12% on the basis of basic medical insurance reimbursement, benefiting more than 17 million patients.

　　For cancer patients, October 10 of this year is a special day. On this day, the National Medical Security Administration issued a notice that, after more than three months of negotiations with pharmaceutical companies, 17 types of anti-cancer drugs were included in the medical insurance reimbursement catalog, with most imported drug payment standards after negotiations being lower than the market prices in surrounding countries or regions. Previously, to ensure that cancer patients could afford "life-saving drugs," our country has clearly adopted a series of comprehensive measures such as reducing tariffs, accelerating the import and market launch of innovative drugs, strengthening intellectual property protection, enhancing quality supervision, and speeding up new drug research and development, allowing the public to feel a significant decrease in the prices of anti-cancer drugs.

　　This reform is not limited to anti-cancer drugs but also targets all high-priced drugs. Comprehensive reforms are implemented throughout the production, circulation, and use of drugs. In 2017, the total order amount of hospitals nationwide on provincial drug centralized procurement platforms reached 836.9 billion yuan, and compared to before centralized procurement, the prices of most high-priced drugs have significantly decreased.

　　Health is humanity's eternal pursuit. On the road to a moderately prosperous society, no one should be left behind. Since the 18th National Congress of the Communist Party, the Central Committee of the Party with Comrade Xi Jinping at its core has attached great importance to poverty alleviation work, and implementing health poverty alleviation projects is a key battle in winning the fight against poverty.

　　After several years of joint efforts, the proportion of personal payment for medical expenses among rural poor populations has significantly decreased, with over 9 million patients receiving classified treatment, and the scope of serious illness special treatment has been further expanded to cover 21 diseases, including congenital heart disease in children, childhood leukemia, esophageal cancer, gastric cancer, end-stage kidney disease, and lung cancer. 963 tertiary hospitals have established counterpart assistance relationships with all 1180 county-level hospitals in poor counties, with an average of over 30,000 medical staff from urban tertiary hospitals dispatched to county-level hospitals in poor counties each year, outpatient visits exceeding 30 million, and over 500,000 inpatient surgeries performed. 5.81 million households that fell into poverty due to illness have been lifted out of poverty, and the pace of poverty alleviation is basically synchronized with the overall poverty alleviation progress of the nationally registered poor households, making an important contribution to decisive progress in poverty alleviation.

　　Enjoying safe and fair services

　　To safeguard the health of the people, we have an excellent team of physicians.

　　In recent years, the total amount of medical and health resources in our country has continued to increase. By the end of 2017, there were more than 987,000 medical and health institutions in our country, with a total of over 11.74 million medical and health personnel. There were 2.44 practicing (assistant) physicians per 1,000 people, 2.74 registered nurses per 1,000 people, and 5.72 hospital beds per 1,000 people, with a basic grassroots medical and health service system covering urban and rural areas basically established.

　　In the field of health and hygiene nationwide, there are more than 200 academicians and over 60 national masters of traditional Chinese medicine; between 2000 and 2017, medical research has won 597 national awards, including the National Natural Science Award, National Technology Invention Award, and National Science and Technology Progress Award. Among them, Wu Mengchao, Wang Zhongcheng, Wang Zhenyi, Tu Youyou, and Hou Yunde have won the National Highest Science and Technology Award. Clinical service capabilities have significantly improved, major breakthroughs have been made in key diseases and critical technology fields, the international influence of specialties has significantly increased, and the capacity for medical rescue in major events has significantly improved.

　　To provide patients with safe and effective medical services, our country has improved relevant supporting policy documents and institutional norms, successively issuing 18 core system points for medical quality and safety, providing guidance for medical quality management, and gradually improving the national, provincial, and municipal three-level quality control organizational system, directly enhancing the professional level of medical quality management in our country.

　　In our country, due to the imbalance in economic development, there is a significant disparity in medical levels between urban and rural areas and between the eastern and western regions. Now, this gap is gradually narrowing, and more and more people enjoy fair medical services.

　　Lei Kaile, who lives in Yinxing Township, Wenchuan County, Aba Prefecture, Sichuan Province, was treated for a brain injury in a big city hospital for 10 days in October 2016, after which he fell into a coma due to brain herniation. His family brought the 48-year-old Lei Kaile back to the Yinxing Township Health Center, intending to accompany him through his last days. However, after the careful treatment of Dr. Dong Chengyun, the director of the health center, Lei Kaile welcomed his second life a few days later. Compared to eight or nine years ago, the Yinxing Township Health Center has solved the basic medical treatment problems for the surrounding public, with an average annual outpatient volume of about 5,000 people in recent years, while the previous annual outpatient volume was less than 1,000.

　　The changes in this health center are just a microcosm of the improvement of grassroots medical levels in our country. Through the efforts of several generations of medical workers, the development of specialties and medical technology capabilities in our country has shown a "two balances" positive trend—more balanced technical capabilities between regions and more balanced development among specialties. For example, in recent years, urban tertiary hospitals have helped county hospitals carry out nearly 15,000 new technologies and projects, and 50% of county hospitals can now perform complex surgeries such as brain tumor surgeries, cervical spine surgeries, lung lobe and total lung resections, and endoscopic treatment techniques, allowing more grassroots medical service institutions to accommodate patients.

　　Enjoying the benefits brought by medical reform

　　Medical reform is a difficult problem globally. Its difficulty is enough to deter people—it not only means adjustments of many significant interests, affecting the whole body with one hair, but also closely relates to the lives of every citizen. Every reform measure cannot afford to fail. Since 2009, the new round of medical reform initiated by China has attracted worldwide attention.

　　Currently, our country is still facing a complex situation with multiple disease threats coexisting and various health influencing factors intertwined. However, people's livelihood is closely tied to people's hearts; even if the road is thorny, we must move forward courageously. "Centering on people's health"—General Secretary Xi Jinping has set a guiding star for the challenges of medical reform. He emphasized that we must unwaveringly write public welfare on the banner of medical and health undertakings and cannot take the path of complete marketization and commercialization.

　　Since the 18th National Congress of the Communist Party, in order to provide high-quality medical services to the people, the ongoing "Chinese-style medical reform" interprets the people-centered concept, meeting the growing demand for medical services from the public. In 2017, the total number of patient visits to national medical and health institutions was approximately 8.183 billion, an increase of 3.16% and 7.64% compared to 2016 and 2014, respectively; the number of discharges was approximately 243 million, an increase of 7.55% and 16.27% compared to 2016 and 2014, respectively.

　　In order to provide better medical services to the public, in 2015, our country launched the "Action Plan for Further Improving Medical Services". Through optimizing service processes, utilizing information technology, and implementing day surgery measures, it has reduced the number of queues and shortened payment and waiting times. More than 4,100 hospitals can provide information inquiry and push services for patients, which is four times that of three years ago, effectively reducing the repeated queuing and payment situations within hospitals and the number of trips to and from hospitals; all tertiary hospitals and over 80% of secondary hospitals have implemented quality nursing services.

　　In January 2018, the "Action Plan for Further Improving Medical Services (2018-2020)" was released. In the next three years, more people will enjoy the conveniences brought by appointment diagnosis and treatment systems, telemedicine systems, clinical pathway management systems, mutual recognition of examination and inspection results systems, and medical social worker volunteer systems.

　　Medical reform supports the health dream of the people. The "2017 Statistical Bulletin on the Development of Health and Health Undertakings in Our Country" shows that in 2017, the average life expectancy of residents in our country increased from 76.5 years in 2016 to 76.7 years, the infant mortality rate decreased from 7.5‰ to 6.8‰, and the maternal mortality rate decreased from 19.9/100,000 to 19.6/100,000. The main health indicators of our residents are generally better than the average level of middle and high-income countries.

　　What the people expect is what the government aims for. One new policy after another is weaving a health security net for more than 1.3 billion people, enriching the connotation of a healthy China. The "Healthy China 2030" Planning Outline points out that by 2030, the average life expectancy in our country will further increase to 79 years, approaching the level of high-income countries. By then, with the people healthy and the country prosperous, China will surely make greater contributions to the sustainable development of all humanity.

(Reporter Jin Zhenya from Guangming Daily)

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