Review on the effectiveness of China's health reform in the past year the burden of grassroots medical treatment

Health reform, the relationship between people's livelihood, affect the public. The 2010 is the key year for the reform and the difficult.　　Around the "protection of basic, strong grass-roots, the establishment of mechanisms", the medical and health system reform steadily forward, the results continue to show that the people in the medical treatment to feel more affordable. The basic medical security system initially covers more than 1.2 billion urban and rural residents story: one day in September 2010, Zhang Jianwu, community resident of Baotou Friendship No. 18th in Inner Mongolia Autonomous Region, came to the Community Health Service center to buy medicine. Zhen Zhang Wu more than six years, deafness more than 20 years, and detect diabetes, every month to the Community Health Service center to two or three trips. "Although often see a doctor, but spend not too much money, most through Medicare reimbursement, old worry."　　"Zhang Jianwu said. The basic medical insurance system of our country takes urban workers ' health insurance, urban residents ' health insurance, new farming and rural medical assistance as the main body. At present, the basic medical security system covering all residents of urban and rural areas has been preliminarily formed, covering more than 1.2 billion urban and rural residents.　　National health insurance and urban residents insurance coverage of 429 million; close bankrupt state-owned enterprises retirees and workers in difficult enterprises to cover the issue of the basic solution; The number of new farming unions reached 834 million, and the rate of participation continued to stabilize more than 90%. Health-care subsidy standards improved. Urban residents ' health insurance and new agricultural and rural government subsidy standards increased to 120 yuan per person per year, urban workers health insurance, urban residents health care and the new agricultural combination of the maximum payment limit is generally increased to local workers annual average wage, urban residents disposable income and the average peasant income of about 6 times times,　　The proportion of hospitalization expenses reimbursement in urban residents ' insurance and new farming policies in most areas is increased to 60%, about 80% of the overall planning area to carry out urban residents ' health insurance and new rural Integration Outpatient Department, Guangzhou, Zhuhai, etc.　　In the 2010, the Great sickness relief system made 4,600 of children with congenital heart disease, leukemia and other diseases received timely treatment, the urban and rural medical aid object extends from Wu Bao Zhuolu to other special hardship groups, and the relief content extends from hospitalization assistance to outpatient assistance gradually.　　At the same time, new progress has been made in the construction of institutional mechanisms such as the transfer of basic medical insurance relationship and the clearing of hospitals, urban and rural planning and entrusted handling. The burden of grassroots medical treatment reduces the average price of basic drugs down by about 30% stories: September 2, 2010, the Liu'an Yuan District of the Anhui Province of bronchitis, the peasant Zhoshiyu came to the hospital. To his surprise, he bought the same medicine, spending only 42 yuan, half as much as before. This is due to the introduction of the basic drug system from September 1. Zhoshiyu sigh: "A lot of drugs are cheap, health reform to farmers brought benefits!" "2010, the National basic drug system in the country about 60% of the government to carry out primary health care institutions, drug implementation of zero-rate sales, the average price of basic drugs down about 30%, Anhui, Jiangxi and other 8 provinces (district, city) took the lead in the province to push away." The policy of basic medical insurance reimbursement is significantly higher than that of non-essential drugsWidely implemented, the basic Drug Clinical application guide and prescription set in more than 80% counties (cities, districts) have been promoted and applied. At the end of December 2010, our country has promulgated the basic Medicine procurement guidance and the primary medical and Health Organization compensation opinion, the primary medical and health Organization posts, the performance appraisal, the multi-channel compensation, the personnel allocation and so on the system mechanism reform also has obtained the different degree progress.　　More than 20 provinces (districts, municipalities) completed the basic level of medical and health institutions staff establishment standards approved, 11 provinces (district, city) primary health care institutions performance pay cash in place.　　The primary medical and health institutions that implement the basic drug system generally present the good momentum of decreasing the average cost of attending a hospital, decreasing the daily cost of hospitalization, and "two descending and one liter" of outpatient service, and the new operating mechanism of primary medical and health institutions is gradually established and formed. Four into urban and rural residents health to be managed the grassroots general practitioner team to enrich the story: November 18, 2010, 80-year-old Ding Ruiying into Hubei province Wuhan Hanyang District second Bridge Community Health Service Center. After hanging the number, her "family doctor" Luo Chunxia has been waiting in the general Out-patient office. Luo Chunxia Two Half-day and nurses, young volunteers to form a "Family doctor Health Service Working group" to provide residents with chronic disease management, health education, counseling and other services to the area of responsibility.　　Under the care of "family doctor", Ding Ruiying is in good health. In the 2010, the archives rate of health files of urban and rural residents reached 48.7% and 38.1% respectively, the system management rate of the national pregnant and lying-in women under 3 years of age reached 84% and 81.5% respectively, and the rate of hospital delivery in rural areas exceeded 96%. More than 35 million hypertensive patients, 9.1 million diabetics and 1.7 million patients with severe psychosis were standardized management.　　Each province (district, city) per capita basic Public health service funding average of 17.4 yuan, 9 types of basic public health services and 7 major public health services for urban and rural residents free of charge. People under 15 years of age, hepatitis B vaccine replant, women of childbearing age "two cancer" examination, cataract free fuming surgery, change stove and toilet and other major public health services projects over the completion of the annual scheduled tasks.　　In 2010, the new HIV/AIDS transmission block project was implemented smoothly, the HIV/AIDS transmission block rate of more than 75%. The medical staff of primary health care institutions have been enriched.　　16,000 grass-roots medical staff carry out the training of general practitioner. In addition, the pilot reform of public hospitals has been fully launched. The 16 national focal points identified by the central government have been fully activated by the pilot units identified by the cities and provinces (districts, municipalities). There are 1200 hospitals in the whole country with outpatient appointments, peak visits and visits, more than 3,800 hospitals to promote quality nursing services, and more than 1300 hospital pilot clinical pathway management. Over 50% of the pilot counties (cities, districts) have realized the horizontal resource sharing of institutions such as inspection, inspection or pathology centers. December 2010, to encourage and guide social capital to organize and develop medical institutions documents issued formally, promoteInto the formation of a diversified medical pattern. Hospital more convenient medical insurance reimbursement standards will improve the story: January 20, 2010, holding a new social security card, Beijing Xicheng residents Wang Jinping into Beijing Traditional Chinese medicine hospital. Wang Jinping said: "Before going to the hospital, all have to own first Xianchan, the year-end reimbursement often cannot find the bill." Now it's all right, just pay the part that's enough!　　"This doctor spent nearly 200 yuan, Wang Jinping only paid more than 40 yuan, the rest through social security card immediately settled." At present, more than 90% of the regions in China have realized the immediate settlement of medical expenses in the district of basic medical insurance, and 1/2 and 1/3 of them have realized the real time settlement of the municipal and provincial medical expenses. It is gradually solved that the problem of health care transfer and settlement of medical treatment in different places. Fujian, Jiangsu, Hunan, Guangdong and other 8 provinces in the first to achieve the provincial network of long-distance medical care settlement. The reform of Medicare payment mode is widely carried out everywhere. The overall level of basic medical security is continuously improved, with about 60% of the region realizing urban basic medical insurance, the city-level co-ordination, Beijing-Tianjin-Shanghai and Tibet to achieve provincial (city, district) level of co-ordination.　　Tianjin, Chongqing, Ningxia and Xinjiang and its corps of 35 cities and 142 counties (districts and cities), such as Chengdu and Guangzhou, have implemented basic medical protection and urban-rural co-ordination. Huimin for the people is the direction of health reform. 2010, the central fiscal allocation of health reform funds 138.9 billion yuan, focusing on the expansion of health insurance coverage and improve the level of security, public health services and basic health service system construction. With the further improvement of the basic health service system in urban and rural areas, the grassroots of urban and rural areas can enjoy convenient, effective and inexpensive basic medical and health services without the township and community.　　Public hospital reform pilot to promote the appointment of outpatient clinics, peak visits, no holiday clinics and clinical pathway management, such as convenient measures, so that the people can benefit easily.　　In the aspect of policy guarantee, 7 important supporting documents, such as basic drug purchasing mechanism, compensation mechanism and pilot guidance of public hospital reform, are also introduced. 2011, China's health reform will take a greater step. The urban residents ' health insurance and the new agricultural and rural government subsidy standard will be increased to 200 yuan per person per year; All the government will implement the National basic medicine system in the primary medical and health institutions, and the primary medical institutions shall set up a new operating mechanism, and step away from the mechanism of medicine and medical treatment; , the standard of basic public health service per capita is raised to 25 yuan, and public hospital reform will be strengthened. Newspaper reporter Baijian Patricia Doyle