2014 Report on the Work of Government pays close attention to health care reform

Date :2014/5/12 13:45:53    Number:7520

The Second Session of the Twelfth National People’s Congress held on Mar. 5, 2014 was convened in the Great Hall of the People and Li Keqiang, the Premier of the State Council, deliver 2014 Report on the Work of the Government.

Contents of the Report are extracted as follows:

一、Review of Work in 2013

We deepened reform of the medical and health care systems. The basic medical insurance system now covers all the population in general, and the per capita government subsidy for rural and urban residents covered by this system increased to 280 yuan. The system of using basic medicines was implemented in over 80% of village clinics. Pilot programs of medical insurance covering major diseases were carried out in 28 provincial-level administrative areas. A trial project was launched to provide emergency assistance for disease treatment. We comprehensively implemented the national project to provide basic public health services. Six million rural women received free pre-pregnancy checkups.

二、General Work Arrangements for 2014

In carrying out our work ahead, we will adhere to the thinking and practices that proved effective in last year's government work and keep improving them. At the same time, we must be keenly aware of the many difficulties and problems on our road ahead. The main ones are: The foundation for sustaining steady economic growth is not yet firm, and the internal impetus driving growth needs to be increased. Risks and hidden dangers still exist in public finance and banking; some industries are heavily burdened by excess production capacity; and the exercise of macro-controls has become more difficult. Increasing agricultural output and rural incomes is becoming more difficult. Air, water and soil pollution is severe in some places, and the task of conserving energy and reducing emissions remains arduous. There are major structural problems constraining employment. There are still many problems which people are unhappy about in housing, food and drug safety, medical services, old-age services, education, income distribution, land expropriation and resettlement, and public order. Serious and major industrial accidents occur frequently. The social credibility system needs to be improved. Some government employees are prone to corruption and some still do not perform their duties with integrity and diligence. Some of these problems have arisen in the course of development and others have occurred because we have not done our work well enough. The government must first examine itself to identify the causes of these problems and work out ways to resolve them. It must follow people's wishes in exercising governance. We must firmly bear in mind our duties and mission, increase our sense of vigilance against potential dangers, be eager to take on challenges, work tirelessly and effectively to solve problems, and truly live up to people's expectations.

Key words: medicine safety supervision and infant formula quality

Workplace safety and market oversight were strengthened. We improved relevant mechanisms, conducted thorough investigations into major workplace accidents and held those involved accountable. As a result, serious and major work-related accidents decreased by 16.9%. We merged food and drug oversight agencies, carried out a campaign to improve food and drug safety, exercised strict oversight over the quality of infant formula in accordance with drug supervision regulations, and strove to ensure that people have access to safe food and drugs.

Ensure that every bite of food we eat is safe

There is nothing more important than human life, so we must always give our full attention to workplace safety. We must strictly enforce laws and regulations on workplace safety, fully implement the responsibility system for it, and resolutely prevent the occurrence of major and very serious work-related accidents. We will energetically improve and maintain market order, continue to carry out targeted clean-up campaigns, and crack down on the manufacture and sale of counterfeit or shoddy goods. We will institute a monitoring mechanism with full public participation which oversees the whole process from production and processing to distribution and consumption and can trace problems to the source. We will improve safety monitoring systems for food and drugs with the involvement of both central and local governments and participation of community bodies. We will strictly follow laws and regulations and comply with standards, and apply the strictest possible oversight, punishment and accountability to prevent and control food contamination and ensure that every bite of food we eat is safe.

Kew words: Smooth drug price and consolidate the national basic medical insurance system

We will deepen medical reform. We will consolidate the national basic medical insurance system and integrate the basic medical insurance system for rural residents with that for non-working urban residents through reform. We will improve the mechanism for the government, employer and employee to share the costs of basic medical insurance. The annual government subsidy for basic medical insurance for rural and non-working urban residents will be increased to 320 yuan per person.

The major disease insurance scheme for rural and non-working urban residents will be introduced nationwide. We will strengthen urban and rural medical assistance and emergency assistance for disease treatment. Trial comprehensive reform of county-level public hospitals will be extended to cover 1,000 counties and 500 million rural residents. We will expand trial comprehensive reforms of urban public hospitals.

We will abolish the practice of compensating for low medical service charges with high drug prices, adjust the prices of medical care and drugs, and create a mechanism for running hospitals by nongovernmental capital. We will consolidate and improve the system of using basic medicines and the new mechanisms for operating community-level clinics. We will improve the system of tiered medical services, strengthen training of general practitioners, and allow doctors to work in more than one medical institution so that people have easy access to quality medical services.

We will improve our capacity to prevent and treat major communicable and chronic diseases and occupational and endemic diseases. The government subsidy for basic public health services will be increased to 35 yuan per person. We will support the development of traditional Chinese medicine and the traditional medicine of ethnic minorities.

We will unwaveringly adhere to the basic state policy of family planning and will implement the policy that allows married couples to have two children if one parent is a single child. We must resolutely press ahead with medical reform and work out a Chinese solution to this global problem so that the Chinese people can enjoy a happier and healthier life.

Key words: We will take strong measures to strengthen pollution prevention and control

We will take strong measures to strengthen pollution prevention and control. We will fully implement the plan for preventing and controlling air pollution, with the focus on mega cities and regions with frequent occurrence of smog. We will start by reducing PM10 and PM2.5 emissions, and focus on the following key areas: improving the industrial structure, raising energy efficiency, reducing vehicle exhaust emissions, and preventing and monitoring wind-borne dust. We will improve the new mechanism involving government, enterprises and the general public, coordinate prevention and control efforts in affected regions, and fully implement the action plan for preventing and controlling air pollution. This year, 50,000 small coal-fired furnaces will be shut down, and we will carry out desulphurization in coal-burning power plants with production capacity of 15 million kilowatts, denitrification in plants with 130 million kilowatts of production capacity, and dust removal in those with 180 million kilowatts of production capacity. Six million old high-emission vehicles will be removed from the roads, spread the use of new-energy vehicles and diesel fuel for vehicles that meets fourth-stage national standards will be provided nationwide. We will implement the clean water action plan, strengthen the protection of sources of drinking water, prevent and control water pollution in key river basins, and carry out land restoration. We will control non-point agricultural source pollution and build beautiful rural areas. We will declare war against pollution and fight it with the same determination we battled poverty.

Expert explanation:

On food safety

Sun Zhongshi: “apply the strictest possible oversight, punishment and accountability “shows the decision of the Government on the food and drug oversight

The Report of the Work of the Government mentioned that “We will strictly follow laws and regulations and comply with standards, and apply the strictest possible oversight, punishment and accountability to prevent and control food contamination and ensure that every bite of food we eat is safe”, showing the attitude of the government to strictly supervise food and drug, which will alarm criminals.

The Report also mentioned “exercised strict oversight over the quality of infant formula in accordance with drug supervision regulations”. The same standards should be applied for both food and drug. Although there are still some delinquents, the quality of infant formula in the current market of China has been improved. We should be confident to our national industries.

He Jiguo: the Report of the Work of the Government indicates the direction to amend the Food Safety Law

The requirements brought forward in the Report of the Work of the Government conform to the food safety regulation and also indicates the direction to amend the Food Safety Law. Most of the problems of food safety result from two aspects, the raw materials and processing course and many of them are related to the morality level and regulation mechanism other than food production technology. The foreign governments succeed in the control of food safety risk through course control. Food safety problems can be founded at any time and be timely controlled within lowest level. To establish traceable food safety system is more effective and economic compared with result inspection.

On health care reform

Cai Jiangnan: the heath care reform should be focused on the level of cities but not counties.

In the global, the health care market should be based on grass roots where most of health care resources and services come from. Only a few patients should be treated in top large-sized hospital. However, the state in China is contrary. The thermosyphon effect of middle- and large-sized comprehensive public hospital in cities becomes stronger and more and more medical resources and patients see doctors in these large third grade hospitals. Since the new health care reform implemented in the year of 2009, such phenomenon has got worse. A large number of third-grade A level hospitals absorb more and more patients by the establishment of sub-hospital and consequently problems such as conflict between doctors and patients becomes more serious every day. The reform of public hospitals should be emphasized these so many large comprehensive hospitals with many problems other than county-level hospitals. It is impossible to solve the problem of expensive medical bills and difficult access to quality medical services only by emphasizing the reform of county-level hospital.

Yu Mingde: the reform improvement of public hospital is too slow and it should be accelerated.

New health care reform has been conducted for five years since the year of 2009. However, the reform of public hospital has still remains the country-level hospital. Hospitals at the second grade or higher are the focus of the whole medical service in China, but they haven’t been reformed. The reform of public hospital in cities is not only the core but also the difficulty points of health care reform. The reform of these hospitals is the changes in the whole medical system and mechanism. Only five third-grade A-level hospitals have been reformed in Beijing, which gained excellent achievements. Why such reform isn’t popularized in China? In my viewpoint, it implies a thinking problem: we shouldn’t delay the reform of system and mechanism due to any excuse. The reform of medical system should be corned on the “four kinds of separation” mentioned in Report to the Seventeenth National Congress of the Communist Party of China, which, however, hasn’t been fulfilled up to now. The health regulation departments should cancel or delegate power to lower levels. Medical resources should be allocated by market other than government.

Niu Zhengqian: the smoothing of drug price implies the regulation on drug price may be released

The Report of the Work of Government puts forward to “adjust the prices of medical care and drugs”, implying to gradually implement the spirit advanced in the third plenary session of 18th CPC, “to perfect mechanism where prices are decided by market and government shouldn’t intervene”. The control on drug prices should be released on certain level. By this way, the lagged reforms such as drug price would be solved. The third plenary session of 18th CPC definitely brings forward to “deepen the reform of economy mechanism around the task that has market to play decisive role in the allocation of resources”. What is market? What is market mechanism? Simply speaking, market mechanism implies price mechanism. It is necessary and most important to adjust the prices of drugs in order to solve problems in pharmaceutical industry. Of course, besides price adjustment, the reform of other matching regulation policies should be implemented to solve all problems.

Liu Guoen: the guideline of health care reform is smoothly implemented and the propelling of reform of public hospital waits for further discussion

At present, the public hospital in China is still the main force in the service chain of health care and consequently, its position is very important. The viewpoint that public hospitals (established by government) should play a key role previewed in the past. The 3rd Plenary Session of 18th CPC shows that market will play a decisive instead of the fundamental role in the national economy. Taking into the consideration of the aforesaid change, we should review whether such government-sponsored model is best from the aspect of economy development and people’s benefit. The new projects of health care reform promulgated by the Council of State in the year of 2009 and 2012 were definitely focused on the “reform of public hospital”. However, when carrying out the health care policies, the reform of public hospital has been tough, as it is concerned with the concrete position of public hospitals, how can public hospitals cooperate with social capitals and how will public hospitals and privatized hospitals be arranged in the future health care market?

On PM2.5

Zhi Xiuyi: strength the research of PM2.5 Index

The Report mentions to declare war against pollution, implying that the government pays high attention to the influence of pollution. I think that some concrete measures should be applied.

It is important to set up corresponding supervision mechanism, without which, it is difficult to reach such target. Supervision from both governments and people are necessary. People are needed to supervise the result of pollution governance.

The setting of long-term target of pollution governance requires long-term planning. Taking U.S.A and England as example, they have tens of years of experience to control pollution and hazy weather. Ten- or twenty-years long-term plan is required to combat pollution and hazy weather.

(Editor in chief: Dong Haiyang)