[Study and implement Xi Jinping’s thoughts on socialism with Chinese characteristics in a new era]

　　Reform is the source of motivation to promote the development of medical, health, and health undertakings.

Deepening the reform of the medical and health system is an important part of reform and opening up. It is a major measure to protect and improve people's livelihood. It has a bearing on the health and well-being of the people and the future of the nation.

Since the founding of New China, especially since the 18th National Congress of the Communist Party of China, we have persisted in using Chinese-style methods to solve the worldwide problem of medical and health system reform, and achieved world-renowned achievements.

On the occasion of the 100th anniversary of the founding of the party, reviewing the history of the reform of the medical and health system will help us grasp the historical logic, strengthen our confidence in reform, and add momentum to reform.

Promote a strategic shift from disease treatment as the center to people's health as the center

　　The party and government have always attached great importance to health work.

At the beginning of the founding of the People’s Republic of China, a hundred wastes were waiting to be developed. The health work was faced with the severe situation of epidemics, parasitic and endemic diseases, shortage of medical and health resources, and low standards.

In accordance with the health work policy of “oriented to workers, peasants and soldiers, focusing on prevention, uniting Chinese and Western medicine, combining health work with mass movement”, after unremitting efforts, before the reform and opening up, my country has established provincial, municipal, and county-level public hospitals in cities. Network, established county, township, and village medical and health service networks in rural areas, initially formed a medical and health service system covering urban and rural areas, basically established a medical and health system suitable for the level of socialist economic development, and rapidly improved national health.

　　After the reform and opening up, in the context of the party and the country vigorously promoting economic construction and developing a socialist market economy, my country has continued to explore medical and health system reforms to expand the autonomy of medical institutions in response to the shortage of medical and health resources and the unequal distribution of resources. , Let go and invigorate, improve the operating mechanism of medical institutions, fully mobilize the enthusiasm of all parties, and increase the supply of medical and health resources.

After reforms, the vitality of medical and health institutions has increased significantly.

The outbreak of the SARS epidemic in 2003 exposed the uncoordinated economic and social development of our country, the development of health services lags behind economic and other social undertakings, and the weak public health system, prompting all sectors of society to attach great importance to deepening the reform of the medical and health system.

　　Since 2009, especially since the Eighteenth National Congress of the Communist Party of China, the new round of deepening medical reform has adhered to the basic concept of providing the basic medical and health system as a public product to all people, adhered to the basic principles of preserving the basics, strengthening the grassroots, and building mechanisms, and insisted on overall arrangements. , The basic path of highlighting the key points and gradual and orderly progress, the reform of the system and mechanism has continuously made new breakthroughs, and promoted the formation of a strategic shift from treatment-centered to people's health-centered, and strived to solve the problem of "difficult and expensive medical treatment".

　　In August 2016, the National Health and Health Conference adopted "reform and innovation as the driving force" as an important content of the new era of health and health work policy.

Focusing on deepening medical reform, General Secretary Xi Jinping has presided over the meetings of the Central Comprehensive Deepening Reform Leading Group and the Central Comprehensive Deepening Reform Committee to review major policy documents for medical reform, make decisions and deployments on major reforms, and provide follow-up for the deepening of medical reform.

The main health indicators of residents are generally better than the average level of high-income countries

　　After continuous and deepening reforms, the construction of a basic medical and health system with Chinese characteristics covering urban and rural residents has completed the task of supporting the pillars and beams. The results of the reform have widely benefited the people, and have withstood the test of the new crown pneumonia epidemic, laying a solid foundation for promoting the construction of a healthy China.

　　One is the continuous improvement of people's health.

The average life expectancy has increased year by year, from 74.4 years in 2012 to 77.3 years in 2019; the maternal mortality rate has dropped from 24.5 per 100,000 in 2012 to 16.9 per 100,000 in 2020, and the infant mortality rate has dropped from 10.3 in 2012 ‰ fell to 5.4‰ in 2020, achieving the United Nations Sustainable Development Goals ahead of schedule.

The main health indicators of Chinese residents are generally better than the average level of middle- and high-income countries, close to the level of developed countries, and have achieved higher health performance with less investment in health.

　　Second, the burden of medical care for residents has been continuously reduced.

Since the 18th National Congress of the Communist Party of China, the income structure of hospitals has continued to be optimized, and the trend of excessive growth in medical expenses has been effectively curbed. The growth rate of medical expenses in public hospitals across the country has dropped from 23.3% in 2012 to 13.6% in 2019.

The proportion of residents' personal health expenditure continued to decline, from 34.34% in 2012 to 28.36% in 2019, the lowest level in the past 20 years.

The prices of the 25 selected drugs in the national drug centralized procurement and use pilot program have dropped by an average of 52%, significantly reducing the cost of treatment of related diseases.

　　The third is the continuous improvement of health equity and accessibility.

Basically, villages have clinics, townships have health centers, and counties have standard county hospitals. Nearly 95% of residents can reach the nearest medical point within 15 minutes, and the medical and health service system has been further improved.

Continue to improve the capacity of primary medical and health services, increase transfer payments to the central and western regions, and continuously improve the fairness of the provision and utilization of basic medical and health services, and the difference in the health status of urban and rural residents has been further reduced.

Complete the task of integrating the medical insurance system for urban and rural residents, and promote the enjoyment of fair protection for urban and rural residents.

Intensify the implementation of the health poverty alleviation project, establish a medical insurance system for the poor, and ensure that the poor are treated for their illnesses.

　　Fourth, the service satisfaction of residents has been continuously improved.

Implement a series of measures to facilitate the people and benefit the people, optimize the service process, improve the medical experience, and make it easier for the people to see a doctor.

The quality and efficiency of medical services have greatly improved, the overall mortality rate of inpatients in my country has gradually decreased and stabilized at a relatively low level, and the level of reasonable clinical use of drugs has been continuously improved.

Promote the national network of basic medical insurance, realize the immediate settlement of medical treatment across provinces, and the direct settlement of hospital medical expenses for retirees placed in different places across provinces.

　　Fifth, the global influence of health continues to increase.

Give full play to the unique role of health in serving the overall situation of diplomacy, strengthen the international exchange of my country's medical and health policy experience and concepts, promote traditional Chinese medicine culture, actively participate in global health governance, and maintain international health security, and play an increasingly important role in the development of global health The role of.

In particular, the efforts and results in preventing the spread of the new crown pneumonia epidemic have fully demonstrated my country's sense of responsibility and mission in maintaining global public health security, and demonstrated to the world the responsibility of a major country.

Setting a model for global health governance

　　my country's deepening of the reform of the medical and health system is based on reality, drawing on international experience, and accumulating rich experience for the construction of a healthy China and comprehensively deepening the reform, and setting a model for global health governance.

　　The first is to uphold the party's leadership.

The leadership of the party is the fundamental guarantee for the victory of our various undertakings.

Since the founding of New China, the party and government have attached great importance to medical and health services and have always placed health and health work in an important position in the overall economic and social development.

Especially since the 18th National Congress of the Communist Party of China, under the strong leadership of the Party Central Committee with Comrade Xi Jinping at its core, the health of the people has been given a strategic priority for development, the reform of the medical and health system has been included in the overall situation of deepening the reform, and the party’s politics has been brought into full play. Advantages and organizational advantages, overall planning, comprehensive advancement, implementation of the new era of hygiene and health work policy, inject strong impetus into the construction of a healthy China.

　　The second is to insist on putting people's health as the center.

Unswervingly write the public welfare on the banner of medical and health undertakings, focus on the people’s urgent and worrying issues, continue to work from the supply side and the demand side, and through reforms to ensure that the masses "see the disease, can afford to see the disease, and can see it." Good sickness", and continuously enhance the people's sense of gain, happiness and security in seeing a doctor.

　　The third is to persist in reform and innovation.

Deepening the work of medical reform is arduous and complicated. It is necessary to emancipate the mind and dare to take responsibility. The more you enter the deep water zone, the more you have reached the stage of tackling hard bones. The more you need to strengthen your reform skills, break ideological barriers and institutional barriers, and continue to deepen supply-side structural reforms. .

At the same time, it is necessary to continuously deepen the understanding of the medical reform work, advance with the times, seek truth and be pragmatic, and make every effort to promote theoretical innovation, institutional innovation, management innovation, and technological innovation.

　　The fourth is to adhere to the linkage reform.

Deepening the medical reform work involves complex social subjects and interest patterns, always adhere to the system concept, pay equal attention to reform, improvement and development, make overall arrangements, highlight key points, divide stages, and make progress in an orderly manner.

Correctly handle the relationship between the government, the market, and the society, and realize the coordination between the central and local governments, the top-level design and the exploration at the grassroots level.

Take the joint action of healthcare, medical insurance and medicine as key measures, pay attention to the mutual promotion and benign interaction of various reforms, strengthen the system, integrity, and synergy of reforms, and ensure that reforms are promoted as a whole, policies are connected with each other, and measures are effective, and form a common promotion The powerful synergy of deepening the work of medical reform.

(Author: Liang Wannian, Deputy Dean of School of Public Health and Health, Vanke School of Public Health, Tsinghua University)