context: Healthcare insurance reforms have garnered much high-level attention, and NHSA has again been given the power to push through new reforms, this time joined by other healthcare authorities.
Although CCP Central Committee and State Council’s 5 Mar 2020 measures are branded as insurance reforms, they touch on all aspects of healthcare reform and will set the tone for the next decade, observes 8am Health Insight. It is partly a recognition of the work of NHSA (National Healthcare Security Administration) since its establishment in 2018. The four major areas of future measures include welfare, financing, payment and supervision. These will be supported by healthcare services and drug reforms, overseen by National Health Commission and National Medical Products Administration.
There are several notable innovations. Outpatient expenses will be gradually covered by coordinating BMI (Basic Medical Insurance) personal accounts, 8am Health Insight points out. BMI funds will also be coordinated at higher levels, and there have been calls for a central adjustment system.
Zhu Minglai 朱铭来 Nankai University Research Centre for Health Economics and Medical Insurance director notes that ‘healthcare mutual assistance’ has been mentioned for the first time. It is expected many existing programs will be absorbed into the social insurance system, National Business Daily reports. Zhu also lauds the move to unify BMI contribution policies, which will ensure full coverage and equality.
‘Internet + healthcare’ has also received central support, notes Yicai. But several problems remain. For example, it is unclear how BMI spending by online platforms will be budgeted. Varying local policies will also make reimbursements and supervision of national platforms difficult.
Some traditional themes remain unchanged, such as continuing centralised drug procurement, promoting high quality generic drugs and Reimbursable Drug List adjustments. Drug price reductions will be followed by increasing doctors' pay, says 8am Health Insight.