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Chen Jian Feng: How will the 3rd Plenum Reform Healthcare

2013-12-18
The theme of the Third Plenum Decision was comprehensively deepening reform. This means that deepening medical reform will be taken into account in the Five Integrated Areas of reform, which include economic, political, cultural, social and ecological. Generally speaking, the Third Plenum Decision enhances the level of overall planning in the comprehensive reform of health care by emphasizing the reasoning for unifying urban and rural areas, proposes explicit requirements for the government to establish mechanisms, accelerates the requirements for the reform of public hospitals, and designs the entire integration of the medical service system. Specifically, compared to some important documents such as Reports of the 18th Chinese Communist Party Congress, the section on health care reform in the Twelfth Five-Year Plan and the 2013 National Health Work Conference, there are several major differences. First, it is about comprehensive reform in five key areas. Second, it is the first time to stress co-ordination in the documents of the CPP Central Committee. In addition, the five areas will no longer be reformed independently, which enhances the importance of comprehensive reform. Secondly, the wording of a “networking of urban and rural primary health care services” is also new, compared with the wording of “county, township, and village three-tier rural health care service network and the urban community-based health service system” embodies the important direction of the future development of urban-rural integration, which is part of the new pattern of the urbanization strategy. Thirdly, the acceleration of public hospital reform is highlighted, and concerning the cancelling of “subsidizing medical services with profits from drug sales”, public hospitals at the county level are not distinguished from the urban public hospitals, with the same requirements for both. Fourthly, in the implementation of government responsibilities, the requirements have been put forward “to establish a scientific evaluation mechanism on healthcare performance and talent development and personnel salary system adapted to the characteristics of the industry”. These requirements, based on the implementation of government-run healthcare and the strengthening of government supervisory responsibilities, highlight the government responsibility of establishing a public operating mechanism. “The adaptation to the characteristics of industry” distinguishes medical and healthcare from general public institutions in terms of the reform of personnel distribution system. The fifth aspect is about classifying diagnosis and treatment. For the first time the subject who has established a contract service relationship with local residents extended from “General Doctor” to “Community Doctor”, which will expand the scope of implementation for the “Initial Diagnosis Health System”. It is also clarified for the first time that informatization methods will make high-quality medical resources flow vertically, and also use some mechanism innovations such as the U.S. National Resident Matching Program as references. (The author, an economics PhD student at the National School of Development of Peking University, has carried out research on macroeconomics, health economics and medical informatization). The author exclusively authorized this article to Sina Finance. Please don’t reprint. The comments don’t represent views of our website.