I. Joint efforts in healthcare reform
1. We strengthened healthcare reform organization and leadership, as well as top-level design. Healthcare institutions and personnel adjustment are advancing step by step.
2. We strengthened planning, guidance and input.
The budget layout for 2014 national healthcare (including family planning) spending stood at 1 trillion yuan ($162 billion), an increase of 9.62 percent over the previous year. The central government spent 303.8 billion yuan on medical and healthcare services, up 14.34 percent.
3. We strengthened institutional reform.
(1) We established a scientific compensation and public welfare-oriented operation mechanism;
(2) We strengthened and improved community-level health institution operation mechanism;
(3) We improved universal healthcare system;
(4) We established and improved safeguard mechanism against major critical diseases.
4. We paid attention to publicity and guidance
(1) We publicized and interpreted major healthcare reform policies and documents when they were issued;
(2) We publicized common practices and experience in healthcare reform;
(3) We strengthened analysis of public opinion on healthcare reform, and responded to public concerns.
II. We made overall plans and pushed reforms
1. We accelerated public hospital reform and pushed for establishment of new operation mechanism.
(1) We focused on county-level public hospital reform and held special meetings t. We issued opinions on pushing for county-level public hospital reform and initiated a second group of candidates for the reform, bringing the number of pilot counties (cities) to more than 1,300. We held 24 training sessions for county-level public hospital reform. A total of 66 percent of counties (cities) nationwide revoked the system where drugs were sold at higher prices than wholesale by the end of 2014.
(2) We expanded pilot programs on urban public hospital reform and added 17 new pilot cities. We brought growth rate of diagnosis and treatment costs down from 9.14 percent to 5.34 percent, and hospitalization costs from 12.71 percent to 3.95 percent.
2. We vigorously pushed for nonpublic medical service development.
(1) We relaxed control over market access. The number of nonpublic medical facilities reached 439,000, accounting for 45 percent of the total and 22.3 percent of the national outpatient services.
(2) We opened medical service costs at nonpublic medical institutions, and let market regulate medical service price. We allowed nonpublic medical institutions to carry out personalized medical services and the same payment and reimbursement policies as public medical facilities.
(3) We cleared unreasonable regulations.
(4) We pushed for doctor multi-sited license. Approximately 170,000 urban hospital doctors practiced medicine in facilities in counties and villages.
(5) We pushed ahead pilot programs on national contact points for nonpublic medical service development and public hospital reform.
(6) The development and reform commission sped up drafting of guidance documents for boosting nonpublic medical service development.
3. We steadily boosted universal healthcare development and built a safety net for the public to seek medical treatment.
Subsidies for urban resident medical insurance and new rural cooperative medical system were raised to 320 yuan per capita. Hospitalization reimbursement rate reached 80 percent in employee insurance, 70 percent in urban resident medical insurance, and 75 percent in new rural cooperative medical system.
(1) We pushed for implementation of serious illness insurance for urban and rural residents. A total of 16 insurance companies have undertaken serious illness insurance in 27 provinces, covering about 700 million people.
(2) We deepened medical insurance payment reform, strengthened medical insurance supervision and management, and boosted long-distance medical settlement management and service.
(3) We improved safeguards against major critical diseases, set up emergency assistance systems in 30 provinces, and launched medical assistance for major critical diseases in 14 provinces.
(4) We sped up the development of commercial medical insurance, whose premium hit 158.7 billion yuan in 2014, up 41.3 percent from a year earlier.
4. We deepened comprehensive reform of community-level medical and healthcare institutions, consolidated and improved essential drugs and the new community-level operation mechanisms.
(1) We cemented and improved the essential drugs system.
(2) We established safeguards for the supply of drugs in shortage.
(3) We deepened comprehensive reform at the community level.
(4) We stabilized rural doctor teams.
5. We deepened drugs circulation reform and standardized the circulation.
(1) We improved drug procurement at public hospitals.
(2) We pushed for drug prices reform.
(3) We standardized drug circulation and operations.
(4) We upgraded drug circulation service and efficiency.
6. We made overall planning of reforms and let policy produce the best effects.
(1) We actively promoted health legislation work.
(2) We optimized medical and healthcare resources distribution.
(3) We continued implementing the basic public health services.
(4) We strengthened the development of medical informatization.
(5) We strengthened health personnel team building.
(6) We strengthened supervision of medical and healthcare industry, and stepped up law enforcement and inspection.
(7) We focused on making use of traditional Chinese medicine.
(8) We strengthened science and technology support.
(9) We established and improved evaluation, carried out mid-term assessments and reform monitoring in the national 2011-2015 plan, and studied mechanisms where a third party participates in healthcare reform assessment.
III. Existing difficulties and problems in healthcare reform
1. Institutional innovation needs to be strengthened.
2. Reform coordination needs improvement.
3. Efforts need to be stepped up to push reform.
4. External factors are bringing profound influence on deepening healthcare reform.