"Charge first, then charge", the reform temperature of life first

(Combating New Coronary Pneumonia) "First pay after treatment", the reform temperature of life first

China News Service, Beijing, March 8th: "Rescue first and charge later", the reform temperature of life first

Author Guo Chaokai Zhang Ziyang Ma Haiyan

The "Opinions on Deepening the Reform of the Medical Security System" (hereinafter referred to as "Opinions") recently issued by the CPC Central Committee and the State Council proposes that in emergency situations such as emergencies, medical institutions should be treated first and fees charged later. Observing under the window of "life first", the interviewed experts believe that this move more shows "a respect for human rights".

Government pockets help curb epidemic

Since the outbreak of the new crown pneumonia outbreak, the issue of treatment costs has attracted much attention from all walks of life. On January 21, the National Medical Security Administration of China announced that it would adopt a special reimbursement policy for patients diagnosed with New Coronary Pneumonia, and all the drugs and medical service items covered by the New Coronary Pneumonia Diagnosis and Treatment Plan would be temporarily included in the payment scope of the medical insurance fund. In other words, the relevant medical expenses of patients with newly diagnosed new coronary pneumonia are the responsibility of the government, and treatment is settled first.

In the early days of the outbreak, there were reports on social platforms that suspected patients were hesitant to go to the hospital for fear of excessive costs. In the "Opinions" released on March 5, the principle of "first treatment and settlement of sudden outbreaks" was once again clarified, which will effectively promote the timely treatment of patients with new coronary pneumonia, and help the country to prepare for the epidemic in the next game of chess. Prevention and control work.

Yang Yansui, director of the Tsinghua University Medical Service Governance Research Center and a professor of the School of Public Management, told China News Agency that the "first treatment, then charge" policy has a positive impact on patient treatment and epidemic prevention and control. Compared with the SARS epidemic in 2003, the new crown pneumonia epidemic, the government's rescue policy is more timely and comprehensive.

Chang Jian, a professor at Zhou Enlai School of Government Management, Nankai University, said that the principle of "first charge after treatment" ensures that patients with new coronary pneumonia do not delay treatment due to cost issues. In addition, the income of some special groups is not high. Although there are medical insurance reimbursement ratios, they may still not be able to pay the expenses. Therefore, some exemption systems for medical expenses need to be established.

Practical considerations of "zero pay"

In fact, it is a common practice in the world to cover the cost of treating infectious diseases at public expense. In 2013, Japan identified H7N9 avian influenza as a "designated infectious disease", and its treatment costs were borne by public funds. After the outbreak of new crown pneumonia, Japan, Thailand, Singapore and other countries also implemented public expense treatment for patients with new crown pneumonia in the country.

In addition to ensuring that medical institutions "receive treatment first and then charge", China has successively introduced policies to provide patients with free treatment during this outbreak. The reporter learned that if the cost is self-care, if some severely ill patients use the ventilator in the ICU, the first day cost is about 1500 yuan (RMB, the same below), and the daily cost is about 800 yuan thereafter. If the "artificial lung" ECMO treatment is used, the cost will be about 60,000 yuan on the first day, and about 1,000 yuan per day after that; plus the comprehensive treatment, the cost will be about 100,000 to 200,000 yuan.

The outside world noticed that in the early stage of the outbreak, the Ministry of Finance of China issued an announcement saying that the medical expenses of patients diagnosed with new coronary pneumonia were paid in accordance with regulations after basic insurance, critical illness insurance, medical assistance, etc., and the central financial subsidy was 60%. For medical treatment expenses, subsidies shall be formulated and funded by the medical institution, and the central government shall provide subsidies as appropriate. This means that patients with new coronary pneumonia receive free treatment and achieve "zero payout".

"The free treatment not only benefits patients with new crown pneumonia, but also benefits more Chinese people," said Zhuo Jiatong, chief physician of the Guangxi Center for Disease Control and Prevention. "New crown pneumonia is an infectious disease. If the patient cannot afford the cost of treatment, Without going to the hospital for treatment, a wider range of infections will result.

"First charge after treatment" returns to life first

The new crown pneumonia epidemic was a major public health emergency with the fastest spread, the widest range of infections, and the most difficult prevention and control in China since the founding of New China. Faced with a wide-ranging outbreak, it is inevitable that the medical system that has been followed step by step will be out of date. "Pay for treatment first and pay later" will help isolate patients early and curb the epidemic.

Some experts pointed out that the "Opinions" once again clearly stated that "the first treatment and then charge" is actually to adjust the patient's interests to the "first place", which is a kind of life-oriented tenderness. Regarding the practice of "receiving treatment first and charging afterwards", Chang Jian fully affirmed: "This is the protection of the basic right to life and a respect for human rights."

At the press conference of the Joint Prevention and Control Mechanism of the State Council of China held on March 3, Fu Jinling, director of the Social Security Department of the Ministry of Finance of the People's Republic of China, stated that as of March 2, the financial authorities at all levels had arranged 108.75 billion yuan for epidemic prevention and control funds and medical expenses The protection is relatively sufficient, and the people will not delay treatment due to medical expenses.

There are comments here that the "Opinions" stipulates that the medical institution's response to patients' payment in the event of an outbreak is a normal measure to upgrade the temporary policy during the "epidemic" period to the reform of the medical insurance system. This is a kind of policy design innovation after experiencing actual combat. It is also a perfect system that adheres to the principle of seeking truth and demonstrates humane care. (Finish)