SCIO briefing on reform and development of health sector in 13th Five-Year Plan period (2016-2020)

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National Business Daily:

During the 13th Five-Year Plan period, what measures have been taken to deepen health system reform to make medical services more accessible and affordable? Thank you.

Yu Xuejun:

I'll take this question. The reform of the health care system is an issue of common concern, especially since the difficulty and high cost of access to medical care remains a major livelihood issue of concern to the public.

During the 13th Five-Year Plan period (2016-2020), the Central Committee of the Communist Party of China (CPC) and the State Council prioritized healthcare system reform on our overall reform agenda. We have made much progress in making medical services more accessible and affordable. 

Regarding accessibility, we focus on rebalancing the distribution of quality medical resources so that more are available at the community level. First, we push the orderly development of regional medical centers as we launched pilot programs in eight provinces so as to upgrade the distribution of high level medical resources across the country. We promoted the construction of health alliances and medical reform in county-level regions. As of now, 84% of county-level hospitals are above Grade II levels. In 2019, up to 90% of patients with common diseases and frequently occurring diseases have sought medical treatment at their local county-level hospitals.

Second, we keep integrating resources and services. We have set up 1,408 medical groups, 3,346 county-level medical alliances, and 3,924 cross-region alliances for disease treatment. We have also promoted the family doctor services, and built more community hospitals on a pilot basis, so as to improve community-level medical services. Third, we keep pushing reforms to delegate power, improve regulation, and upgrade services, and promote the regulated development of the health industry and privately-run hospitals. Fourth, we are also moving faster toward the applications of internet and IT technologies in the healthcare sector, and continuing to scale up tele-medicine services.

In 2019, telemedicine services were carried out nationwide for more than 21,723,000 visits. By the end of 2019, 258 cities and municipalities had implemented a regional medical consultation card. Information technology is used to optimize service processes, and online services such as medical appointments, consultation navigation, and mobile payment are commonly implemented in hospitals above the second level. Over 50% of outpatient services in third tier hospitals are delivered via the online appointment system.

In the area of alleviating the high cost of medical care, we have focused on centralizing medicine procurement in order to lower drug prices. The prices for the first batch of 25 selected drugs were cut by an average of 52% in a pilot program carried out in four municipalities and seven sub-provincial cities. The program was later scaled up across the country. The second batch of selected drugs have also seen their prices cut by an average of 53%. We carried out drug pricing negotiations, applied a zero-tariff policy on imported cancer treatment drugs, improved the national system of essential medicines, regulated drug use, and guaranteed the availability of drugs in short supply. Second, with expanded comprehensive reform in public hospitals, we put an end to the practices of hospitals funding their operations with profits from overpriced drugs, launched pilot programs for modern management in hospitals, and set up a performance evaluation scheme that focuses on quality and the public good. Third, the national medical insurance system has been improved as we established a unified basic health and unified major disease insurance schemes for rural and non-working urban residents across the country. Government subsidies for basic medical insurance is increasing year by year, the medical bill payment mechanism is moving from a fee-for-service model to a comprehensive payment mechanism, the medical treatment system is improving, and commercial health insurance is receiving increased government support.

The 14th Five-Year Plan period will be crucial as we continue to reform the healthcare system. We will strive to make medical services more accessible and affordable to the general public.

Thank you.

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