"Tooth implantation is equivalent to buying a house" The National Medical Security Administration launched a special treatment for the price of oral implants
Price-limited centralized procurement regulates the oral implant market
□ Our reporter Zhao Chenxi
"Toothache is not a disease. It hurts really badly." Some time ago, Yang Heping, a retired worker who lives in Xicheng District, Beijing, came to a nearby dental hospital for a dental problem because of a problem with his teeth. The cost of about 10,000 yuan was really difficult for him to accept, so he could only choose to give up.
As a missing tooth restoration technology, oral implants have the advantages of better tooth function recovery and similar appearance to real teeth, but the high cost is prohibitive for many people.
Recently, the National Medical Security Administration issued the "Notice on Carrying out the Special Treatment of Oral Implantation Medical Service Charges and Consumables Prices" (hereinafter referred to as the "Notice"), requiring the implementation of the special treatment of oral implantation prices covering public and private medical institutions. It is clarified that the total price of the medical service part of a single conventional dental implant in a tertiary public hospital shall not exceed 4,500 yuan in principle.
Sun Yuhua, an associate researcher at the China Rule of Law Strategy Research Center of East China University of Political Science and Law, said in an interview with a reporter from the "Rules of Law Daily" that the "Notice" clearly stated in the name that special governance should be carried out for "medical service charges and consumable prices", which can be described as a direct attack on the high price of oral implants. Measures such as centralized procurement of consumables and standardized charges will help reduce the price of dental implants.
The price of dental implants is very deep
"Implanting a full mouth of teeth is equivalent to buying a house in the county seat." This phrase used by many people to describe the high price of dental implants comes from Li Xiaoli, a deputy to the National People's Congress and part-time vice chairman of the Feidong County Federation of Trade Unions in Hefei City, Anhui Province.
In January 2021, Li Xiaoli went to a dental clinic for treatment because of a toothache. The doctor recommended dental implants after diagnosis, but the high price surprised her.
Since then, Li Xiaoli has conducted a survey on the dental implant market in Feidong County, and found that the quality of various dental implant materials is uneven, the price is generally high, and various medical institutions charge different charges for dental implants of the same material.
In a hospital below the county level, the average cost of a dental implant treatment ranges from about 6,000 yuan to 20,000 yuan. If a full mouth is implanted, the cost is equivalent to buying a suite in the county seat.
"Oral implant services involve multiple charging links, including medical service prices, implant prices, crown product prices, processing service fees, etc. Therefore, compared with other dental medical services, the price is higher." A dental office in Xicheng District, Beijing Zhao Qiyang, a doctor at the clinic, told reporters that dental implants are more comfortable, firm and durable than traditional porcelain teeth after being implanted in the mouth, and do not need to wear other teeth. Therefore, despite the high price, there are still many demanders, most of them are in Mainly elderly patients.
After searching the Internet for the keyword "dental implant", the reporter found that there are many advertisements for oral implants, and the price difference is huge. ” slogan.
"Even if you only consider the cost, the prices that claim that a tooth can be implanted for more than 2,000 yuan are unreliable." Zhao Qiyang said that in addition to the price of consumables, the main problem is the high cost of medical services, because dental implants It belongs to a type of oral surgery. Not just any dentist can do it. It must undergo relevant training, and have the national oral implant assessment certification and legal authorization to perform the surgery. Some small-scale dental hospitals simply do not have the conditions and skills for surgery.
Therefore, there is often deep water behind these low prices.
Chen Shaohua, who lives in Fengtai District, Beijing, has a deep understanding of this.
He found a clinic on the Internet that claimed to be able to plant a tooth for 2,500 yuan, but during the actual treatment, the clinic said that 2,500 yuan was only the cost of the first-stage implant, excluding other additional surgical expenses such as restoration of the abutment and subsequent crown restoration.
Since the treatment had already started, Chen Shaohua finally had no choice but to spend more than 3,000 yuan to complete a tooth.
Special treatment to help reduce fees
High fees, coupled with the increasing demand with the aging of the population, more and more medical institutions are eyeing the big cake of oral implantation.
In Sun Yuhua's view, this has also exacerbated the chaos in the oral implantation market. The National Medical Insurance Bureau launched a special treatment, which is necessary and timely.
In August this year, the National Medical Insurance Bureau issued the "Notice on Carrying out Special Treatment of Oral Implantation Medical Service Charges and Consumables Prices (Draft for Comment)" to solicit public opinions.
According to the situation notice released by the National Medical Insurance Administration, about 60% of the feedback supports the development of special governance.
One of the highlights of the special governance is the implementation of "separation of technology and consumption", that is, public medical institutions provide dental implant medical services, mainly adopting a separate pricing method of "service items + special consumables", implant placement fee and implant consumables system price Separate pricing; dental crown placement fee and dental crown product price are priced separately; bone graft surgery fee is priced separately from bone meal and periosteum prices.
Sun Yuhua believes that separate pricing is not only conducive to regulating the price of "technology" and "consumption" separately, but also facilitates supervision.
According to the results of a nationwide registration survey, taking the routine implantation of a single tooth in public medical institutions in various provinces as an example, the average cost of medical services exceeds 6,000 yuan, and even more than 9,000 yuan in some provinces and cities.
By synthesizing the opinions of the masses, medical institutions, professionals and other parties, the "Notice" finally sets the price control target for the medical service part of a single conventional dental implant in a tertiary public hospital at 4,500 yuan, and provides a set of regulations for regions or medical institutions that meet specific conditions. The conditions for allowing appropriate relaxations are clarified.
The relevant person in charge of the National Medical Insurance Bureau stated that the setting of the regulation target of 4,500 yuan is to guide medical institutions to strengthen self-discipline, and also remind patients to be vigilant and supervise for obvious over-the-line charges.
In order to reduce the overall price of dental implants, in addition to limiting the price of medical service fees, the "Notice" also clarifies that the prices of consumables such as implants and dental crowns will be squeezed out through centralized procurement and bidding and hanging on the net, reducing the price. .
In accordance with the requirements of the "Notice", after the results of the centralized implant procurement and crown bidding are produced, each provincial medical security department will further formulate and publish the price control targets for the whole process of dental implants in the region (including implants, crowns, and medical services). ), and reduce the cost of dental implants through comprehensive measures for the three components that constitute the cost of dental implants.
Strengthening Supervision and Promoting Integrity
When it comes to the high cost of dental implant medical services, the relevant person in charge of the National Medical Insurance Bureau said that there are not only unreasonable project settings, excessive decomposition, but also high pricing and arbitrary charges.
The situation announcement released by the National Medical Insurance Bureau also shows that the public has strongly expressed a strong response to the promotion of false subsidies in the field of oral implantation, deceiving patients with low-priced advertisements, and buying and selling customers with "benefits" and "referral fees".
In this regard, the "Notice" requires the establishment of an abnormal price warning system for dental implants, reporting more price complaints, pricing significantly higher than the local average, refusing or passively participating in the centralized procurement of dental implants, and falsifying facts to degrade the units participating in the centralized procurement and the winning candidates. Products and various medical institutions at all levels that do not cooperate with regulation and control to maintain falsely high prices are included in the price abnormality warning list, and comprehensive use of monitoring and early warning, letter inquiries, interviews, public exposure and other supervision methods to achieve closed-loop governance.
The "Notice" also requires the province as a unit to carry out special investigations and inspections, strengthen tracking and monitoring, find clues about violations of laws and regulations, and report typical cases to form a long-term governance effect.
The special governance work intends to reduce the price of dental implants in many ways, but it is worth noting that the direct target of this regulation is public medical institutions, and private medical institutions still implement independent pricing.
Sun Yuhua believes that among the oral medical institutions currently carrying out oral implants, the proportion of private institutions is much higher than that of public hospitals, accounting for about two-thirds of the total market. How to stimulate the enthusiasm of private medical institutions is also the key to the smooth development of governance work.
In this regard, the "Notice" puts forward specific requirements. In terms of centralized procurement, it is required that the number of medical institutions (including private individuals) participating in this centralized procurement in each overall planning area should account for more than 40% of the medical institutions that provide dental implant services.
Medical security departments at all levels should fully mobilize private medical institutions to actively participate in the centralized procurement of dental implant consumables.
At the same time, strengthen the price supervision and guidance for private medical institutions to carry out oral implants, and require private medical institutions to set prices for dental implants and other services in accordance with the principles of fairness, lawfulness, good faith, and quality and price. The law of market competition and the reasonable price expected by the masses, take the initiative to publicize the price according to regulations in obvious areas, and ensure the authenticity, timeliness and integrity of the public information.
In response to the exaggerated propaganda and vicious competition of individual institutions, the "Notice" clearly requires that private medical institutions should strictly regulate their own price behavior, and shall not use false or misleading "subsidy" and "low price" and other price means to induce Fraud patients.
Those with high prices and those who use "introduction fees" and "benefits fees" to sell and sell customers will be publicly exposed.
Sun Yuhua believes that although special governance is not "mandatory" for private medical institutions, by regulating the price of dental implant medical services provided by public medical institutions, patients will choose medical institutions with higher cost performance and more standardized services in the future, which can also force private medical institutions. Medical institutions reduce the price of dental implants, and the "high price myth" in the oral implant market will be broken.