After the reform of medical service prices, will the price of seeing a doctor go up? Detailed explanation of the National Medical Insurance Bureau

Recently, the National Medical Insurance Bureau and other eight departments issued the "Deepening Medical Service Price Reform Pilot Program" (hereinafter referred to as the "Pilot Program"), clearly identifying five pilot cities to advance the medical service price reform in an orderly manner.

The price of medical service is the charging standard of medical service items for patients by medical institutions, including outpatient, hospitalization, various examinations, treatments, inspections, surgical items, etc., involving 1.4 billion people, 7.87 million medical staff and more than 50,000 medical institutions .

What is the reform? Will the price of seeing a doctor go up? In response to the hot issues that everyone is concerned about, the relevant persons in charge and relevant experts of the National Medical Insurance Administration accepted interviews with reporters.

The burden of seeing a doctor will not increase

"Deepening the reform of medical service prices is not simply a matter of price adjustments, nor is it a unilateral price increase to replace reforms." When asked whether it would increase the burden of medical treatment, the relevant person in charge of the National Medical Insurance Bureau said bluntly.

Regarding the adjustment of service prices, the above-mentioned person in charge revealed that: there must be holdings and pressures, ups and downs, and no flooding; a sensitive and effective price dynamic adjustment mechanism should be established so that the rhythm of price changes is controlled by starting conditions and constraints. , You can’t increase as you want, and then increase again; to make the price stand up to the test of monitoring, assessment and evaluation, the price that should be lowered must be lowered in time.

Chen Qiulin, deputy director of the Scientific Research Office of the Institute of Contemporary China of the Chinese Academy of Social Sciences, believes that the overall idea of ​​the reform is to control the burden of medical expenses for the people. This is a structural adjustment, not a total reform. The burden of patients' medical care is generally stable.

"The overall reform will not increase the burden on patients." Liao Cangyi, an assistant professor at the School of Political Science and Public Administration of China University of Political Science and Law, agreed. I feel that medical treatment is cheaper, and some people think that medical treatment is expensive. Don’t worry, the relevant departments will provide protection through the scope and method of medical insurance reimbursement."

"Even, people may not feel the change in the price of medical treatment in a short time." Chen Qiulin believes that medical insurance is the payer of medical services, and the adjustment of medical service prices is to free up more room for medical insurance costs, and the final thing is the medical insurance fund. Internal optimization, such as increasing reimbursement items, allows more people to benefit from medical insurance.

At the same time, it is necessary to straighten out the price comparison relationship. For example, pediatrics, nursing, and other weak disciplines with historically low prices and insufficient medical supplies, "need policy incentives"; complicated surgery and other difficult and high-risk medical services, "need to appropriately reflect price differences"; outstanding distinctive advantages, functional efficacy Obviously, TCM medical services "need inheritance, innovation and development"; inspection and treatment items with a high proportion of equipment depreciation "need to squeeze out water."

The National Medical Insurance Bureau has made it clear that supporting measures must be improved to ensure the overall stability of the burden of the masses. Do a good job of assessing the feasibility of price adjustments beforehand, and not deviate from the basic premise of controlling the excessive growth of medical expenses and improving social benefits; analyze the impact of price adjustments during the event, focusing on groups with special difficulties; coordinate afterwards, and incorporate the price adjustment part into medical insurance payments as required Scope.

Does not directly affect the income of medical staff

Does reforming the price of medical services mean that the income of medical staff will increase?

Several interviewed experts said that there is no direct relationship between the income of medical staff and the price of medical services and the income of medical services.

"The income of medical staff is mainly affected by the salary management system of public hospitals and the hospital's internal performance distribution plan. How the hospital distributes and rewards different departments and medical staff is determined by the hospital." Liao Cangyi told reporters.

The "Pilot Plan" clearly establishes a medical service price formation mechanism that fully participates in medical institutions and reflects the value of technical labor services, adheres to the public welfare attributes of public medical institutions, establishes a reasonable compensation mechanism, mobilizes the enthusiasm of medical staff, and promotes the innovative development of medical services.

"The price reform of medical services is an important part of the joint reform of medical, medical insurance, and medicine. Although it does not directly affect doctors' income, there is a linkage relationship." Chen Qiulin said, "In other words, the process of price adjustment will be more reflected. The technical labor value of medical staff."

Judging from the survey results, in the past two years, all localities have focused on increasing the prices of diagnostic, surgical, nursing, and traditional Chinese medicine services that focus on technical labor.

The above-mentioned person in charge of the National Medical Insurance Bureau revealed that how to better reflect the value of technical labor services that the majority of medical staff care about requires strengthening coordination between medical service price reform and public hospital salary system reform, and reasonable determination of public hospital salary levels and distribution mechanisms. Dividends are transmitted to the majority of medical staff, and it is also necessary to avoid directly linking medical staff salaries with project prices and income-generating capabilities.

Guide public hospitals to "practice their internal skills"

Some people believe that deepening the reform of medical service prices is to "patch" the reform of centralized procurement of pharmaceuticals and consumables, and make up for the unreasonable income squeezed out by the latter through price increases in medical services.

The above-mentioned person in charge of the National Medical Insurance Bureau made it clear that this is inaccurate. Centralized procurement with a large amount is aimed at the "sale with gold" of pharmaceuticals and consumables, which has reduced the unreasonable burden of the people and won a window for reform of the price of medical services. However, the two reforms do not rely on price cuts and price hikes to shift, switch, and move medical expenses, and they cannot be a simple "seesaw" relationship.

In the past ten years, my country's public hospitals have developed rapidly. The medical income of public hospitals and the medical insurance funds and financial subsidies flowing to public hospitals have maintained an average annual double-digit rapid growth.

"In the future, the development mode of public hospitals will shift from scale expansion to improving quality and efficiency." said the person in charge.

In other words, deepening the reform of medical service prices will further push public hospitals to "enhance quality": First, the value of technical labor services is "measured". By abolishing the drug consumables bonus, centralized purchasing and other measures, to suppress the proportion of drug consumables revenue, and promote the development of medical and medical technology disciplines based on technical labor services. The second is the "signal light" for optimizing the allocation of medical resources. For example, for complex projects such as difficult and high-risk surgical projects, public hospitals are introduced to participate in price formation, and price adjustments will be more flexible and targeted; for general service projects such as diagnosis and nursing care, the government will strengthen the price benchmark and price adjustment rhythm Control. The third is a "booster" for public hospitals to practice their internal skills. The reform of public hospitals in standardizing diagnosis and treatment behaviors, controlling costs and expenses has become a key to open the window of medical service price adjustments and expand the total price adjustments. It has added mechanism guarantees for public hospitals to demand dividends from reforms and benefit from management.