Farmers 20 kinds of serious diseases will be included in the **

After three years of medical reform, China has established one of the world's largest medical security networks. However, due to the relatively low level of protection, the burden on many patients with serious diseases is still heavy, especially in rural areas, because of the protection of the new rural cooperative medical system. The level is low, and the phenomenon of returning to poverty due to illness still exists.

At the on-site promotion conference of medical insurance for major diseases of rural residents held on November 15th, the Minister of Health Chen Hao said that he will ensure that he basically completes three tasks before the end of February 2013, namely, to consolidate and improve children's leukemia and congenital heart diseases. The work of medical care at the level of the two diseases was carried out; medical protection work for six diseases such as end-stage renal disease was pushed away in an all-round way; and medical protection trials for 12 diseases such as lung cancer were carried out in an all-round way.

Expand the coverage of serious illness

“Consolidating the level of protection for two major illnesses across the country, six major diseases have been fully implemented, and 12 diseases have been piloted for medical security. The trial will be conducted in 311 county-level hospitals in one-third of the new rural cooperative co-ordination.” The Department of Medical Administration Deputy Director Yao Jianhong said in an interview.

Yao Jianhong said that the six diseases to be fully promoted include: end-stage renal disease, breast cancer for women, cervical cancer, severe psychosis, opportunistic AIDS infection, multi-drug resistant tuberculosis, etc.; 12 diseases that will be piloted include: : Lung cancer, esophageal cancer, gastric cancer, colon cancer, rectal cancer, chronic myeloid leukemia, acute myocardial infarction, cerebral infarction, hemophilia, type I diabetes, hyperthyroidism, cleft lip and palate.

By the end of 2011, more than 230,000 patients with major diseases such as childhood leukemia, congenital heart disease, and end-stage renal disease had been treated. In the first three quarters of this year, more than 650,000 patients were included in the new rural cooperative medical insurance coverage for major diseases and received corresponding compensation. The actual compensation rates for congenital heart disease and leukemia in children were 77% and 74%, respectively. The actual compensation ratio for six types of diseases such as end-stage renal disease was 67%, and the actual compensation ratio for 12 newly added pilot diseases such as lung cancer was about 59%. .

"To make a serious illness guarantee, the first is to have money. At present, the level of funding for the new rural cooperative medical system has reached 300 yuan per capita. At the same time, we must also do a good job of three convergences, link up with the medical reform policy, and link up with the urban and rural residents' illness insurance, first by the new The rural cooperative reimbursement, if it reaches urban and rural residents with serious illness insurance, is reimbursed with serious illness insurance; in addition, it must be linked with civil assistance, such as two diseases, the new rural cooperative reimbursement 70%, assistance 20%, and personal commitment is only 10%.” Yao Jianhong explain.

Zhu Hongming, the Director of the Department of Cooperative Medical Services of the Department of Health of the Ministry of Health, said that at present, the level of funding for the new rural cooperative medical system is 300 yuan per capita, and it is only 250 billion yuan in the country. The money for the new rural cooperative medical system is not enough. "Two major illnesses plus six major illnesses are stressful for the new rural cooperative funds."

"The condition of disease selection is of great social impact; the treatment effect is definite, the prognosis is good; the cost is controllable; the new rural cooperative fund is affordable." Zhu Hongming said.

The Ministry of Health’s “Opinions on Accelerating the Promotion of Medical Assistance for Major Diseases in Rural Areas” pointed out that the actual compensation ratio of the new rural cooperative medical system to the relevant diseases should, in principle, reach about 70% of the limited cost of the province (region, city).

At present, Jiangxi Province has implemented six free major treatments (children with congenital heart disease, leukemia, cataracts, cleft lip and palate, uremia, and severe psychosis), and 15 other diseases have been fully promoted, reimbursing treatment at secondary medical institutions. The proportion is 75%, the reimbursement rate in the tertiary medical institutions is 70%, and the rest is assisted by the civil affairs.

In Shandong, 2013 will be funded with an average of 15 yuan per person for serious illness insurance funds, and the province will raise 978 million yuan for the purchase of major illness insurance. The insurance company will determine through bidding.

Escort 20 kinds of illness protection

With the expansion of illnesses, it is not only money, but also medical services and supervision at the grassroots level.

"For the protection of the 20 major diseases to be launched, we have put in place four protection mechanisms. One is a hierarchical diagnosis and treatment system. This is a guarantee of medical services. The second is the protection of medicines and consumables. We must rationally select essential medicines, and the main consumables must be unified. Purchasing; Third, the protection of financial funds, 80% of the new rural cooperative funds by the government, which has considerable protection; the other is the system protection. "Yao Jianhong said.

Jiao Yahui, Director of the Department of Medical Management of the Ministry of Health, told the newspaper that the Ministry of Health and the provincial health department have set up a clinical expert team for major diseases to provide technical support and guidance, assist in medical quality management and control, and strengthen personnel training. Wait for work. At the same time, we have formulated the clinical pathways for 20 major diseases, refined the sub-paths for disease-related diseases, improved the diagnosis and treatment norms and guidelines for some diseases, and gradually established and improved a standardized standardized diagnosis and treatment system for major diseases.

Zhu Hongming believes that the key to the protection of 20 major illnesses is medicines and equipment and grassroots medical service capabilities.

Zhuang Ning, deputy director of the Planning and Pricing Department of the Planning and Finance Division of the Ministry of Health, said: "The main contributors are high-value consumables. At present, through unified procurement, the prices of high-value consumables have been reduced, and in particular, 20 major consumables have priority for centralized procurement. ”

For medicines, Yao Jianhong said that for drugs that are clinically low in price and cheap, the country will uniformly provide fixed-point production and supply throughout the country and will not participate in national drug bidding.

In addition, the biggest problem facing the new rural cooperative medical system is the inter-provincial reimbursement. Zhu Hongming stated that at present, two-thirds of the provinces in the country can be settled in the province. Cross-province is a difficult problem for medical insurance. Now it is working as a national medical insurance platform for the new rural cooperative medical system, piloted in Henan and Hainan, and the second batch of pilots. The provinces are Jiangsu and Hubei.