Recently, the Tianjin Municipal People's Government issued the "Tianjin Deepening Medical and Health System Comprehensive Reform 2017 Key Tasks" (hereinafter referred to as the task), promoting the construction of medical complexes, improving the operating mechanism of public hospitals, and controlling the unreasonable growth of medical expenses and promotion. The Beijing-Tianjin-Hebei coordinated medical and health development, vigorously promoted information construction, vigorously developed social medical treatment, and promoted the reform of medical service prices, and other 27 medical system reform tasks were deployed.

Among them, the "Task" proposed: coordinating the centralized procurement of medical supplies and medical insurance payment. Exploring the implementation of a department to centrally manage the centralized procurement of medicines and consumables, price negotiation and medical insurance payment, and achieve an orderly connection and smooth transition, promote the docking of the city's medical insurance drug catalogue and the national medical insurance drug catalogue, and explore the establishment of medical insurance payment standards and the country. The lowest-cost linkage mechanism will further reduce the burden of medical expenses for insured personnel and reduce medical costs. ((The Municipal Human Resources and Social Security Bureau takes the lead, the Municipal Health Planning Commission, the Municipal Market Supervision Committee, and the Municipal Development and Reform Commission are responsible for the division of responsibilities)

This seems to refer to the practice of Fujian Province in the province of medical reform. In September 2016, Fujian took the lead in setting up a provincial-level specialized medical insurance institution, the Fujian Provincial Medical Insurance Management Committee Office (referred to as the Provincial Medical Insurance Office), which will The Planning Commission, the Provincial Civil Affairs Department, the Provincial Department of Finance, the Provincial People's Office, the Provincial Department of Commerce, the Provincial Price Bureau and other departments and medical insurance related functions are uniformly assigned to the Medical Insurance Office, and the relevant medical insurance management functions are coordinated by one institution, and the medical funds are The chains are connected on one platform.

As of February this year, Sanming, Ningde, Fuzhou, Xiamen, Zhangzhou, Quanzhou, Longyan, Nanping, Putian and other nine districts and cities in Fujian have all established medical insurance bureaus. In the integration of medical insurance management responsibilities, all districts and cities will simultaneously promote the “three guarantees” of the medical insurance management system and establish a municipal medical security fund management center.

If the speculation is good, Tianjin may also set up an institution like the Medical Insurance Office to integrate the functions that were originally dispersed in multiple departments into the scope of their own functions and powers, and the medical insurance department will uniformly play the "medicine, price, and insurance". Concentrate on the advantages, integrate the drug bidding of the health department and the medical price management function of the price department, and define the four major responsibilities of the medical insurance supervision hospitals, doctors, drug circulation and medical prices, and form a synergy advantage for the hospital's economic operation supervision.

At the same time, the "Task" emphasizes: We must improve the regulation and distribution mechanism for the supply of medicines and consumables. Fully implement the “two-vote system” for drug purchases from production enterprises to distribution enterprises, from circulation enterprises to medical and health institutions, and explore medical and health institutions and production enterprises to directly settle the payment for medicines and consumables, and the settlement and distribution of production enterprises and distribution enterprises. The "one-vote system" of fees reduces the intermediate links and reduces the false high prices. By increasing the concentration of distribution companies through competition, the number of distribution companies in 2017 will be reduced by one-third, effectively reducing distribution costs. Establish a production and distribution enterprise interview system, improve the level of drug distribution management and service efficiency, improve the management of shortage drug distribution, and ensure the distribution of basic drug distribution. Establish a dynamic monitoring and over-warning mechanism for shortage of drugs, focusing on the supply of low-cost drugs, emergency drugs and children's drugs. Exploring the establishment of a traceable and measurable mechanism for drug information, supervising the trading behavior of both the supply and demand sides on the market-based platform, so that the transaction information can be traced throughout. (The Municipal Health and Family Planning Commission takes the lead, the Municipal Medical Reform Office, the Municipal Market Supervision Committee, the Municipal Commercial Committee, the Municipal Human Resources and Social Security Bureau, and the Municipal Development and Reform Commission are responsible for the division of responsibilities)

The "two-vote system" was listed as the key task of this year's medical reform, pointing to both medicines and medical consumables.

In terms of the "two-vote system" of drugs, it is required that from September 1 this year, all drugs sold in Tianjin public medical institutions will be included in the "two-vote system" management, and other medical institutions are encouraged to implement "two in drug procurement." After the "two-vote system" is administered, the production enterprises can sell the drugs to the circulation enterprises, and the circulation enterprises should directly sell them to the public medical institutions. If it is necessary to entrust other drug circulation enterprises to carry out the distribution, the circulation enterprise must provide the drug delivery order, and no purchase or sale may occur between them. For centralized procurement of drugs, it is necessary to confirm that the drug purchase channels meet the requirements of the “two-vote system” before entering the city's drug procurement platform and participating in centralized procurement. Pharmaceutical production (circulation) enterprises involved in centralized drug procurement must make a commitment to implement the “two-vote system”, otherwise they may not participate in procurement (except for products that do not implement the two-vote system).

For the "two-vote system" of medical consumables, the time progress requirement is not mentioned in the document. However, just before this year, Tianjin’s proposed “two-vote system” of consumables was disclosed. The document here also directly states that it is necessary to "explore the consumables one-vote system". This shows at least that Tianjin is indeed pushing the "two-vote system" and "one-vote system" of consumables, but the specific landing time remains to be seen.

In addition, the "Task" clearly stated that this year, the distribution enterprises should be reduced by one-third. The task is led by the Municipal Health Planning Commission, and the major elimination of distributors will become a major trend in Tianjin.

It is worth noting that the Tasks mentioned in the promotion of the reform of medical service price reform that it is necessary to cancel the 3% bonus of disposable medical consumables, which is led by the Tianjin Development and Reform Commission. The time schedule requirement is “December 2017”. Therefore, Tianjin will be one of the few provinces to take the lead in promoting the “zero-plus” reform of consumables.

Attached

Notice of the General Office of the Tianjin Municipal People's Government on Printing and Distributing the Key Tasks for the Comprehensive Reform of Tianjin's Deepening Medical and Health System in 2017

The people's governments of all districts, committees, bureaus, and subordinate units:

With the consent of the Municipal People's Government, the "Tianjin Deepening Medical and Health System Comprehensive Reform 2017 Key Tasks" will be printed and distributed to you. Please follow suit.

Tianjin Municipal People's Government Office

July 17, 2017

2017 is an important year for implementing the spirit of the National Health and Wellness Conference and implementing the 13th Five-Year Plan for deepening the reform of the medical and health system. It is the first year to comprehensively promote the comprehensive reform of the city's deepening of the medical and health system. To deepen the work of medical reform, we must fully implement the spirit of the Eighth Central Committee, the Third Middle School, the Fourth Middle School, the Fifth Middle School, and the Sixth Plenary Session of the Eighteenth Central Committee, and thoroughly implement the spirit of the important speeches of General Secretary Xi Jinping and the new ideas, new ideas and strategies of governing the country. To the important requirements of the "three efforts" of Tianjin's work, conscientiously implement the decision-making and deployment of the Party Central Committee and the State Council, and firmly implement and implement the new development concept around the implementation of the "five in one" overall layout and the "four comprehensive" strategic layout of Tianjin. In accordance with the health and health work guidelines under the new situation, we must accurately grasp the structural reform requirements of the supply side, adhere to the development ideology centered on the people, adhere to the "big health" concept, and promote the health of the whole people as the fundamental purpose. The five systems of grading diagnosis and treatment, modern hospital management, universal medical insurance, drug supply security, and comprehensive supervision will promote the reform of related fields, focus on strengthening the grassroots level, highlight the basics, focus on building mechanisms, safeguard public welfare, and promote medical, medical insurance and medicine. Medical linkage, effectively transforming the results of reform into the health and well-being of the people Get a sense, to create a healthy city.

In accordance with the "Notice of the General Office of the State Council on Printing and Distributing the Key Tasks for Deepening the Medical and Health System Reform in 2017" (Guo Dang Fa [2017] No. 37) and the "Tianjin Deepening Medical and Health System Comprehensive Reform Plan", the medical reform will be deepened in 2017. The key tasks are arranged as follows:

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