China Youth Daily·China Youth Daily reporter Wang Lin
Editor's note
A new journey has begun!
In October of this year, the "Proposals of the Central Committee of the Communist Party of China on Formulating the Fourteenth Five-Year Plan for National Economic and Social Development and the Long-term Goals for 2035", which was reviewed and approved by the Fifth Plenary Session of the 19th Central Committee of the Party, outlined a step towards socialist modernization The country’s road map.
What changes will happen in the future? How to solve the many troubles in our reality-high housing prices, expensive medical care, and difficulty in going to school?
Today, we are launching the column "The 14th Five-Year Plan for Youth Questions" to look at the expectations of the youth and look forward to the next 5 or 15 years...
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27-year-old Zhang Xiao is a patient with a rare disease. She suffers from Mucopolysaccharidosis type I. Since the onset of her illness, she still maintains her childhood height, unable to wash her hair, wear socks, etc., and walk carefully. .
At present, the confusion she faces is that even if special drugs for rare diseases are approved for marketing in China, the huge medical expenses still make many patients sigh.
What she wants to know is that in the next 5 or 15 years, patients with rare diseases will be unsightly and expensive. How to solve it?
The Fifth Plenary Session of the 19th Central Committee of the Communist Party of China proposed to improve the multi-level social security system, comprehensively promote the construction of a healthy China, implement a national strategy to actively respond to the aging of the population, and strengthen and innovate social governance.
The "Proposal of the Central Committee of the Communist Party of China on Formulating the Fourteenth Five-Year Plan for National Economic and Social Development and Long-Term Goals for 2035" (hereinafter referred to as the "Proposals") proposes that the multi-level social security system should be improved in the next 5-15 years. Comprehensively promote the construction of a healthy China.
Looking to the future, a new round of medical reform with the "three-medicine linkage" (that is, linkage of medical care, medical insurance, and medical reform) as the fulcrum will release more benefits for people's livelihood.
The problem of unsightly and expensive medical treatment that has plagued everyone for a long time is expected to be solved.
More courage to persist
Although difficult, it is more of a positive change.
This year, the special drug for the treatment of mucopolysaccharidosis-Laronie Enzyme Concentrate Solution for Injection (trade name: Alzan) was approved for marketing.
Although the price of this special medicine is "astronomical"-with Zhang Xiao's dosage, it will cost more than 3 million yuan a year, but Zhang Xiao still feels that he is one step closer to his goal.
Alzan's approval for listing will at least allow more patients to see new hope.
Recently, there have been two pieces of good news: related pharmaceutical companies have launched a "buy two, get one free" discount, and the price of Alzan medicine has been reduced by more than 1 million yuan a year; domestic pharmaceutical company Beihai Kangcheng also recently announced that, Start the commercialization of Idox Sulfatase β Injection, which is the first and only type II enzyme replacement therapy for mucopolysaccharidosis in China.
Zhang Xiao felt that he had more courage to persevere.
As far as the world is concerned, the treatment of patients with rare diseases is a difficult problem. On the one hand, the development cost of new drugs is high. Pharmaceutical companies need to recoup the cost and make profits by selling drugs, so as to invest in the new drug development cycle; on the other hand, because There are too few drug users, the cost of medication for a single patient remains high, and many "sky-priced drugs" have appeared.
However, “basic” medical insurance funds are often difficult to cover this group of people, and often fall into an embarrassing situation that is difficult to choose: should the basic medicine for the majority of people be protected or the life-saving medicine for a small number of people?
Over the years, Zhang Xiao and the others have been committed to promoting the inclusion of special drugs such as Alzan in the medical insurance list.
But it is obvious that medical insurance funds are limited, and it is not easy to include specific medicines for rare diseases into medical insurance.
And to reduce medical expenses and solve the problem of looking down on diseases, it is obvious that there is not only a path of "inclusion in medical insurance", but also a variety of mechanisms such as centralized drug procurement negotiations and social assistance.
In the next 5 and 15 years, with the development of China's economy and the improvement of the medical insurance system, more positive changes will be ushered in.
From 13,000 yuan to 700 yuan
From 13,000 yuan to 700 yuan, behind the change in numbers is the salvation of countless lives.
On November 5th, my country’s first centralized procurement of high-value medical consumables was opened in Tianjin. The object of centralized procurement was coronary stents.
This is a medical device commonly used in interventional heart surgery, which has the function of dredging arteries.
In our country, about 1 million patients have heart stents implanted each year, but most of the heart stents rely on imports, and the price remains high.
After centralized procurement, a total of 10 domestic and imported cardiac stent products were selected. The average price dropped from about 13,000 yuan to about 700 yuan, a decrease of about 93%.
It is expected that by January next year, patients will be able to use affordable heart stents.
Many such changes have occurred in recent years: accelerated approval of pharmaceuticals and equipment, expansion of volume purchases, and implementation of the reform of payment by disease...
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"In the next five years, the trend of separation of medicines will intensify. The moisture content of consumables and medicines in the circulation will continue to decline, and the income of medical institutions and medical staff will gradually become separated. They can rely on medical services to obtain reasonable remuneration. "Cai Jiangnan, director of the Health Management and Policy Center of China Europe International Business School and founder of Shanghai Chuangqi Health Development Research Institute, told a reporter from China Youth Daily and China Youth Daily.
According to Cai Jiangnan, the medical reform in the past five years has two outstanding manifestations: one is the further acceleration of the approval of drugs and devices, which has accelerated the development of innovative drugs and generic drugs; the other is a series of reforms such as mass procurement and drug payment methods. .
In the future, every citizen will benefit from these reform measures.
There is "system guarantee" for medical treatment and new hope for medication
Seeing the little granddaughter jumping around, Zhang Qingzhong, a farmer in Lanping County, Yunnan Province finally showed a long-lost smile.
Two years ago, Zhang Qingzhong's little granddaughter had symptoms such as fast heartbeat and pale face after she was born. She was sent to the hospital for examination until she found out that the child had congenital heart disease.
But this poor family really couldn't make up the money for the operation of the child, and the hospital in the small county was unable to treat it.
In times of crisis, the state reached out to them.
The Zhuhai Hospital of the Guangdong Provincial Hospital of Traditional Chinese Medicine with counterpart support not only admitted the children for free, but also reimbursed the transportation expenses to and from Zhuhai.
One day in September this year, Zhang Qingzhong took his little granddaughter to Lanping County Hospital of Traditional Chinese Medicine for a follow-up visit.
In his heart, there is a small wish: can he see the illness here in the future?
After all, the opportunity for free treatment is not always available.
"This idea will soon be realized." Li Chunheng, deputy dean of Lanping County Hospital of Traditional Chinese Medicine, told China Youth Daily and China Youth Daily reporter.
He pointed to a ten-story new building behind the hospital.
This is the new building of this county-level hospital with a total investment of more than 9 million yuan, of which a large part of the central financial support.
After completion, the equipment and beds here will be updated.
The new round of medical reform with the "three-medicine linkage" as the fulcrum is bringing opportunities for countless families who may be impoverished due to illness.
Fan Weidong, head of the Treatment Protection Department of the National Medical Insurance Administration, said at a press conference of the State Council Information Office that at present, on the whole, the "system guarantee" for medical treatment of the poor has basically been realized, and the problem of basic medical protection has basically been solved.
With the implementation of more medical reform measures, the number of people who look down on and look down on diseases will gradually decrease, and the situation of hard-to-find medicine will also usher in a change.
Young doctors take root, primary medical care "hematopoiesis"
As the head of the county hospital, Li Chunheng's expectations for the future do not just come from this new building.
In his heart, these young medical staff who have taken root in his hometown and are growing up are the "health guards" of the local people in the future.
Post-90s doctors and Li Mei are such "guardians."
Last year, this minority girl was selected to study in Zhuhai, Guangdong.
There, the doctors of Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine, which was supported by her counterpart, taught by hand. She also learned a complete set of painless gastroscopy techniques.
She said that before she went to Zhuhai, she had only one simple thought in her mind: "After learning this technique, the folks can do the inspection in Lanping."
Due to the spicy and salty eating habits, gastrointestinal diseases are common in Lanping County, but for many years, no hospital in the county can do painless gastrointestinal endoscopy.
Many patients have to travel to Dali, more than 100 kilometers away, to seek medical advice. Some patients may be delayed and become critically ill because they are not treated in time.
This year, Zhuhai City donated a complete set of electronic gastrointestinal endoscopy equipment to Lanping County Hospital of Traditional Chinese Medicine.
He and Li Mei also returned to their hometown, and almost every day, more than 10 patients undergo comprehensive gastrointestinal examinations.
What makes Li Chunheng more happy than this is that the help the hospital has received in recent years is "from blood transfusion to hematopoiesis", and young medical staff have gradually grown up.
The construction of primary medical institutions has always been a shortcoming of medical and health undertakings, and will also be the focus of investment in the future.
According to information released by the National Development and Reform Commission in July, of the central budget allocated by the central government to the national health sector in 2020, a total of 45.66 billion yuan will be used to strengthen the capacity building of public health prevention, control and treatment, including the comprehensive improvement of county medical and health services. Upgrade and transform major epidemic treatment bases and reserve a certain amount of treatment facilities and equipment.
In Cai Jiangnan’s view, the new crown pneumonia epidemic has sounded the alarm for the primary medical system. In the future, the construction of the primary medical system should focus on the improvement of the skills of medical staff and the compensation mechanism for medical services. Only in this way can real graded diagnosis and treatment be realized. Basic-level doctors play the role of "healthy gatekeeper".
In addition, he also believes that with the development of digital technology, telemedicine and Internet hospitals will also usher in rapid development in the next 5-15 years.
In recent years, "Internet+" has fully linked medical, pharmaceutical, and medical insurance services. Prescription drugs can be prescribed online and delivered by third parties.
In November this year, Internet medical institutions that clearly meet the conditions can voluntarily "sign up" into the scope of medical insurance through the physical medical institutions they rely on. "Internet +" medical insurance payment will adopt a consistent online and offline reimbursement policy.
"When these chains can be opened up, primary care can also develop." Cai Jiangnan said.
China Youth Daily and China Youth Daily reporter Wang Lin Source: China Youth Daily