It is the hospital that provides the service, the medical insurance that purchases the service, and the patients who receive the service. The relationship between the three parties is complicated, and the importance of medical insurance control fees is self-evident.
It is reported that the total income of the urban basic medical insurance fund in 2011 was 539.39 billion yuan, and the expenditure was 443.1 billion yuan, up 29% and 25% respectively over the previous year. The income was slightly higher than the expenditure. In 2012, the total income of the urban basic medical insurance fund was 693.9 billion yuan, and the expenditure was 554.4 billion yuan, up 25% and 25% respectively over the previous year. The two were basically the same. As of 2013, the total income of the urban basic medical insurance fund was 824.8 billion yuan, and the expenditure was 680.1 billion yuan, up 19% and 23% respectively over the previous year. The income growth began to fall below the increase in expenditure. According to the table below, according to the current increase in income and expenditure, it will not be offset by 2017.
People's demand for health is getting higher and higher, the demand for quality medical services is increasing, the trend of aging in China is intensifying, and the incidence of chronic diseases is “blowout†and other factors will increase the per capita medical insurance expenditures. In order to reduce unreasonable medical and medical expenses, the National Health and Family Planning Commission and other five departments jointly issued the "Several Opinions on Controlling Unreasonable Growth of Medical Expenses in Public Hospitals", requiring lowering the high price of drugs and the proportion of expenses, and promoting the payment of medical insurance. reform.
Among them, CFDA announced 289 basic drug varieties that need to be evaluated for consistency, and must be evaluated before the end of 2018, otherwise these drug approvals will be revoked. This batch of drugs involves about 2,000 pharmaceutical companies, and the influence is huge. The same species will pass, and other manufacturers will also need to pass the evaluation within 3 years, otherwise the approval will be revoked. In addition, in the bidding process, three of the same products passed the consistency evaluation, and the unqualified drugs will lose the bidding qualification. Pharmaceutical companies that are not expected to withstand severe regulatory crackdowns in the second half of 2016 will leave the market one after another.
On February 28 last year, after the issuance of Document No. 7 of the Drug Purchase Policy of the General Office of the State Council, the Health Planning Commission requested all localities to focus on bid opening in November last year. However, two-thirds of the provinces did not open the bid, and some provinces are still waiting to see. Even if the bid opening, most of them are fragmented non-mainstream projects, and mainstream drug bidding has not yet officially started.
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