Recently, the Liaoning Provincial Health and Family Planning Commission issued the "Notice on Improving and Implementing the Funding Compensation Policy for the Essential Drug System". The notice pointed out that the calculation of subsidies for the implementation of the essential drug system should be carried out in the province with the city as a unit, and the work requirements of the provincial government should be implemented. Promote the introduction of relevant measures and standards for the implementation of subsidies in the name of each city government.

For a long time, the compensation mechanism is not perfect and the fund allocation is not in place is a major problem that plagues public medical institutions. Primary medical institutions also face this problem when implementing the national basic medicine system. In many areas, serious problems have affected the enthusiasm of grassroots work and even encountered difficulties in their normal operations.

Due to these reasons, primary medical institutions directly or indirectly owe commercial distribution companies' payment, and distribution companies owe payment to manufacturers and suppliers. On the premise that the problem of arrears has not been resolved, the distribution company's enthusiasm for distribution has been greatly reduced, resulting in low profits. It will not be delivered far away. The above-mentioned problems are intertwined, and ultimately make the local medicine environment bad. High-priced medicines have replaced classic good medicines, and ordinary people cannot buy cheap good medicines.

Therefore, implementing government responsibilities and improving the compensation mechanism is an important proposition of the medical reform. This notice of the Liaoning Provincial Health and Family Planning Commission, regardless of whether the follow-up calculation and promotion work can be smooth, but after all, the government is also working hard to solve the problem, and it has brought us All-round thinking.

Notice on Improving and Implementing the Fund Compensation Policy of the Essential Drug System

Cities, Suizhong County, Changtu County Health and Family Planning Commission (Health Bureau):

The 2016 "Provincial Government Work Report" proposed to "promote the full implementation of the basic drug system at the grassroots level." At the same time, the provincial government incorporated the full implementation of the basic drug system into the provincial and municipal government performance appraisal system, requiring each township and community to have a grassroots medical and health institution , Each administrative village has 1 village clinic to implement the national essential medicine system; implement the compensation policy with the city and county as the main body, and issue relevant documents on the implementation of subsidies in the name of the government.

The non-implementation of the fund compensation policy is the fundamental reason and the key link that restricts our province to promote the full implementation of the essential drug system. In order to ensure the implementation of the provincial government's work tasks; after research, it was decided to carry out the calculation of subsidies for the implementation of the basic drug system in the whole province with the city as a unit, while implementing the provincial government's work requirements, and promoting the introduction of relevant measures to implement subsidies in the name of each city government And standards, further improve and implement the fund compensation policy for the implementation of the essential drug system.

1. Work goals

Give full play to the important role of the essential medicine system in the "three medical" linkages, and focus on fully implementing the compensation policy of the essential medicine system with cities and counties as the main body and increasing the proportion of essential medicines used by primary medical and health institutions, and effectively improve the supervision and management capabilities and The ability to use essential medicines rationally, strictly perform performance assessment, and strive to implement the essential medicine system in all townships and administrative villages by the end of the year.

2. Work basis

(1) Implementing the main responsibility for the implementation of the special subsidy funds for the essential medicine system "Implementation Opinions of the People's Government of Liaoning Province on the Implementation of the National Essential Medicine System to Promote the Pilot Work of the Comprehensive Reform of the Primary Medical and Health System" (Liao Zhengfa No. 35) stipulates: Counties (Cities) ) The district government assumes the main responsibility for the funds required for the comprehensive reform of primary medical and health institutions, and the municipal government should help solve the funds required for the comprehensive reform of primary medical and health institutions within its jurisdiction.

The "Opinions of the General Office of the State Council on Consolidating and Improving the Basic Drug System and the New Mechanism of Basic-level Operation" (Guobanfa No. 14) requires that localities are encouraged to explore the implementation of subsidies based on the number of services or the fixed compensation for the population served. Regions with conditions can explore to promote the integrated management of rural health services and implement two lines of revenue and expenditure. The income of primary medical and health institutions shall be turned in in full, and the current expenditures required for the development of basic medical and public health services shall be approved by the government and arranged in full .

(2) Implementation of the management and use of special subsidy funds for the essential drug system

In accordance with the requirements of the “Notice on Printing and Distributing the Measures for the Administration of Funds for the National Essential Medicine System Subsidy for Primary Medical and Health Institutions” (Liao Caishe No. 807) jointly issued by the Department of Finance of Liaoning Province and the Health and Family Planning Commission, the government-run community health service center (station ) And township health centers, the subsidy funds are mainly used to subsidize the current balance of income and expenditure after verification of income and expenditure, and to promote the overall reform of the personnel diversion and placement that meets the government's health investment policy. For rural doctors who practice in village clinics that implement the basic drug system, the subsidy funds are mainly used for income subsidies for rural doctors.

3. Basic job requirements

(1) Fully implement the compensation policy for the implementation of the essential drug system with cities and counties as the main body

It is necessary to further strengthen the responsibilities of the municipal and county governments, implement unified leadership across the province, and local levels of responsibility. The county (city) and district-level governments bear the main responsibility for the special subsidies for the implementation of the essential medicine system at the grassroots level, and the city-level government should help solve the funds required for the implementation of the essential medicine system at the grassroots level within its jurisdiction. Governments at or above the provincial level, in accordance with the requirements for equalization of basic public services, have increased subsidies to difficult areas.

(2) Solidly organize and carry out the calculation of special subsidy funds for the implementation of the essential medicine system in primary medical and health institutions and village clinics

Health and family planning administrative departments at all levels should actively cooperate with relevant departments of finance, development and reform, human resources and social security, and carry out implementation on the basis of the initial implementation of the basic drug system in primary medical and health institutions and village clinics on the basis of real-name system confirmation and thorough investigation. Calculation of special subsidy funds for the essential medicine system. It is recommended to include at least the following items:

1. For government-run community health service centers (stations) and township health centers, the subsidy funds required are the regular income and expenditure difference subsidy after the approved income and expenditure, the diversion and placement of personnel involved in the promotion of comprehensive reforms, etc. that meet the government's health investment policy regulations amount of payout.

2. The calculation of the income subsidy for village doctors practicing in village clinics that implement the basic medicine system is recommended to be slightly higher than the income level of doctors or village cadres in primary medical and health institutions in the same area.

3. Implement the basic medicine system for non-government-run community health service centers (stations) and township health centers, adopting the method of government purchase of services, and the scope and content of government purchases of services shall be determined by each city based on actual conditions.

All cities, Suizhong County, and Changtu County shall report to the Provincial Health and Family Planning Commission the paper version and the electronic version of the basic medicine system subsidy funds calculation statistics for the basic medical institutions and village clinics in their jurisdictions before May 10 .

(3) Improve and implement the basic drug system compensation policy

On the basis of calculations, the government must formulate and issue a compensation policy for the implementation of the essential medicine system funds by the end of June. On the basis of scientifically defining the intergovernmental primary medical and health powers, the investment responsibilities of the municipal and county-level governments shall be rationally divided. Develop a fund compensation policy for the implementation of the essential drug system with clear responsibilities, hierarchical burdens, and matching financial and administrative powers, and complete and perfect a long-term mechanism for the implementation of the essential drug system