Key Healthcare Priorities Highlighted by Premier Li Keqiang at the Closing of the Two Sessions

On the morning of March 16, following the closing session of the Fourth Session of the 12th National People's Congress, Premier Li Keqiang met with Chinese and foreign journalists at the Great Hall of the People and answered their questions. Among them, which issues are related to the pharmaceutical industry?

Advancing Nationwide Health Insurance Network Integration: Achieving Cross-Provincial Settlement Within Two Years

Premier Li Keqiang stated: The government is determined to advance the nationwide interconnection of medical insurance systems. This year, on the basis of basically resolving direct settlement for cross-province medical treatment within provinces, we will strive to achieve, within two years, direct settlement of hospitalization expenses for elderly people living away from their home regions. This will ensure that reasonable and legitimate issues regarding cross-region settlement no longer remain a pain point for the public. Of course, this requires substantial efforts from all relevant departments. What is the purpose of our governance? The ultimate goal remains improving people’s livelihoods. We must allow the public’s appeals and demands concerning livelihood issues to drive our development, and to promote and test our reforms.

According to statistics, the three basic medical insurance schemes—the New Rural Cooperative Medical Scheme, Basic Medical Insurance for Urban Residents, and Basic Medical Insurance for Urban Employees—have covered more than 95% of urban and rural residents in China.

However, an invisible barrier between different regions hinders the fulfillment of people’s basic healthcare security needs. Although some provinces have launched point-to-point inter-provincial instant settlement collaborations, most patients seeking medical care across provincial boundaries still have to carry various receipts and invoices, with the issues of “running errands” and “out-of-pocket advances” remaining prominent.

The main difficulties in cross-provincial settlement of medical insurance for off-site care are threefold:

1. Issues with the Level of Pooling. In many regions, basic medical insurance is still pooled at the county level, resulting in variations in contribution standards, reimbursement rates, and reimbursement caps; even the medical insurance catalogs differ. Interconnectivity of medical insurance information has not yet been achieved across provinces. To enable cross-regional "portability," both informational and policy barriers must be removed.

2. Disparities in the financial capacity of medical insurance funds across regions. Medical insurance funds operate independently in each locality, with contributions determined by local healthcare standards, resulting in significant discrepancies among regional funds. Medical resources generally flow from less developed to more developed areas, with Beijing, Shanghai, and provincial capitals concentrating a large share of high-quality medical resources. Under the current model, providing immediate reimbursement for all out-of-town medical treatments would pose a risk of overdrafts to medical insurance fund accounts. To enable cross-provincial "portability" of medical insurance, it is essential to address the potential deficits in medical insurance funds that may arise from imbalances in regional medical resource distribution.

3. Transition Between Different Systems. Currently, China implements three major medical insurance systems: the Urban Employee Basic Medical Insurance for enterprise employees, the Urban Resident Basic Medical Insurance for non-working urban residents, and the New Rural Cooperative Medical Scheme (NRCMS) for farmers. The employee and resident medical insurance programs are administered by the human resources and social security departments, while the NRCMS is managed by the health authorities. In some regions, pilot programs have consolidated the administration of these three policies as part of healthcare system reforms. Nevertheless, a significant challenge remains regarding how to ensure seamless coordination and transition between different administrative departments after cross-provincial transfer of medical insurance coverage.

Pension disbursement is guaranteed to be problem-free.

Premier Li Keqiang stated that everyone will eventually retire and require elderly care. Here, I wish to provide a public assurance: from a comprehensive and long-term perspective, the Chinese government is fully capable of ensuring the disbursement of pensions to Chinese citizens. Last year, the surplus of pension insurance revenues over expenditures exceeded RMB 340 billion, with accumulated surpluses surpassing RMB 3.4 trillion. Additionally, we have RMB 1.6 trillion in the National Social Security Fund reserve that remains untouched, and state-owned assets can also be transferred to bolster the pension fund. Therefore, it can be affirmed with certainty that the principle of “providing for the elderly” will not, and must not, remain an empty promise.

The disbursement of pensions also serves as a significant boost to the development of enterprises in the broader health sector. Previously, the “Guiding Opinions on Promoting the Healthy Development of the Pharmaceutical Industry,” issued by the General Office of the State Council, pointed out that regions with appropriate conditions should be guided to coordinate and leverage local advantageous resources in healthcare, traditional Chinese medicine, and eco-tourism; harness the role of the tourism market; and develop and establish a batch of demonstration bases for pharmaceutical and health tourism that integrate elderly care, medical services, rehabilitation, and tourism, thereby further improving the comprehensive system of social services for elderly care, healthcare, rehabilitation, and tourism.

(Source: 39 Medicine, WeChat ID: yiyao-39)