Medical news network November 17th in mid November, the national development and Reform Commission issued "on deepening the reform of the price mechanism and comprehensive opinion" (hereinafter referred to as the "opinions"), proposed to consolidate the results of the drug addition to cancel, cancel further medical supplies and optimization of adjusting the price of medical services; to speed up the new medical service price project acceptance audit, promote medical research and development of new technologies application; expand by disease, according to the service unit charge range and quantity.
The content of "opinion" is related to the medical field, and should be regarded as the exploration and transitional policy in the process of reform. It should also be adjusted with the process of medical insurance payment reform.
In the current payment structure, according to disease packing fee and capitation payment proportion is still relatively limited, paid by the project still exists. Therefore, medical supplies plus system similar to the role of drug addition: on the one hand, solve the problem of income of medical institutions, but on the other hand, has formed a "to inspect the medicine" and "supplies to make doctors distortion. The reasons and policy objectives of implementing the cancellation of consumables addition are also discussed.
Cancel the drug addition, the implementation of the ratio of drug control and total control of drug procurement budget and other initiatives to promote the hospital after the emergence of drug and medical supplies as one falls, another rises "ends sticking out" phenomenon, as the medical service price adjustment are not fully in place, an alternative compensation hospital income decline, triggered a new reform in "yaobu" the problem also caused commercial bribery and excessive examination, excessive medical illness, increased the difficulty of reform. In the absence of large-scale implementation of total medical insurance control, according to disease payment, capitation payment and other new payment methods become dominant, the abolition of medical consumables addition has a strong practical significance, and the same as the zero drug addition system, is to serve the long-term goal of the new medical reform.
What should be paid special attention to in the implementation of the policy of zero rate of consumables is to what extent should we interfere? If there are consumables projects with different quality levels and technical content, the contents of medical insurance payment coverage should be reasonably defined. The existence of self paid items will lead the medical institutions to profit and overtreatment through the payment of the project, but it is also the right to give the patients and doctors the right to choose the right consumption level. Hospital use and management of consumables also exist costs, how should this part of the cost to compensate? This problem is in fact consistent with the drug problem.
As the payment of medical insurance has become the main body of hospital revenue, the management requirements of medical insurance fund for hospital must be embodied in the management of medical consumables, and the management department will still face the core problem of medical service price adjustment and reconstruction of hospital compensation mechanism.
In addition, we should be alert to the implementation of the policy of zero rate of consumables, resulting in a decline in the income of disguised compensation hospitals in the field of consumables such as "two bargaining". Frankly speaking, the implementation of consumables Zero rate also appears "simple and brutal", in the short term has a positive effect, but the shortcomings of this operation is also obvious.
In the long run, through the reform of medical insurance payment methods, medical quality management and other initiatives, is committed to make drugs, medical supplies become medical service costs, the formation of reasonable use of medical institutions, consciously control the use of incentive and restraint mechanisms.
