China's Government Work Reports Over the Past Five Years Emphasize Healthcare Reform and Digital Health Development; Zhenjiankang Medical Submits IPO Prospectus

In March, the much-anticipated Two Sessions were grandly convened in Beijing. The Premier stated that while governance should follow the principle of simplicity and power must not be exercised arbitrarily, the healthcare sector appeared remarkably capricious during the Two Sessions. Not only did the total number of delegates and committee members from the pharmaceutical and medical industries reach 74, but “Internet healthcare” also emerged as a buzzword at the event. Delegates and committee members expressed strong optimism about the prospects of Internet healthcare. Internet industry leaders such as Robin Li and Ma Huateng submitted formal proposals on healthcare reform and the development of Internet healthcare.

In this year’s Government Work Report, content related to healthcare and pharmaceutical reforms and the promotion of China’s medical and health services naturally became a focal point for all stakeholders. The report pointed out that with the further advancement of healthcare and pharmaceutical system reforms, China will promote direct intra-provincial settlement of residents’ medical expenses and direct inter-provincial settlement of medical expenses for retirees. It will also strengthen the general practitioner system, improve the tiered diagnosis and treatment system, continue to encourage physicians to practice at multiple primary-care institutions, and foster the development of privately run medical institutions.

VCBeat has compiled healthcare-related content from the government work reports of the past five years for readers’ reference.

2011 Government Work Report

2010 Work Summary:
Actively and prudently advance the reform of the medical and health care system, comprehensively establish the basic medical insurance system for urban residents and the new rural cooperative medical system, benefiting 1.267 billion urban and rural residents. ... Vigorously strengthen the capacity building of primary-level medical and health services. The national finance has allocated special funds to renovate and build 23,000 township health centers, 1,500 county hospitals, 500 county traditional Chinese medicine hospitals, and 1,000 county maternal and child health hospitals, and established 2,400 community health service centers.

2011 Work Deployment:
Advance the reform and development of healthcare and medicine. This year marks the critical phase of the three-year implementation plan for healthcare reform, and we must ensure that all targets and tasks are fully accomplished.

First, fully implement the National Essential Medicines System at the primary care level. Establish and improve the supply guarantee system for essential medicines, strengthen drug regulation, ensure medication safety, and effectively reduce drug prices.

Second, effectively advance pilot reforms of public hospitals. Encourage localities to boldly explore innovations in hospital management systems, mechanisms for forming medical service prices, and regulatory frameworks. Improve mechanisms for mediating medical disputes and enhance doctor-patient relationships.

Third, improve the level of basic medical security. Stabilize and increase the enrollment rates for urban employee basic medical insurance, urban resident basic medical insurance, and the New Rural Cooperative Medical Scheme (NRCMS). This year, raise the fiscal subsidy standards for both the NRCMS and the urban resident basic medical insurance to 200 yuan.

Fourth, we have completed the task of establishing a three-tier rural healthcare service network and urban community health service institutions. This year, the per capita funding standard for basic public health services nationwide has been raised to 25 yuan. We will strengthen the prevention, control, and standardized management of major infectious diseases, chronic diseases, occupational diseases, endemic diseases, and mental disorders. We will enhance maternal and child healthcare services and continue to advance pilot programs providing free screening and treatment coverage for cervical cancer and breast cancer among women. We will diligently carry out HIV/AIDS prevention and control efforts. We will vigorously promote the development of Traditional Chinese Medicine (TCM) and ethnic medicine, and implement various supportive policies.

Fifth, encourage social capital to establish medical institutions. Relax market access restrictions for domestic private capital and foreign investment in setting up medical institutions. Improve and promote the multi-site practice system for physicians, encourage the rational mobility of doctors among various types of medical institutions, and support them in opening clinics at the primary care level, so as to provide convenient healthcare services to the public.

2012 Government Work Report

2011 Work Summary:
Actively and steadily advance the reform and development of the medical and health sector. The coverage of basic medical insurance has continued to expand, with 1.3 billion urban and rural residents enrolled, marking the initial formation of a universal health insurance system. The reimbursement rate for inpatient expenses within the policy scope has increased, and the range of diseases covered under critical illness medical security has been further expanded. Fiscal subsidies from governments at all levels for basic medical insurance for urban residents and the New Rural Cooperative Medical Scheme (NRCMS) have risen from RMB 120 to RMB 200 per person annually. The national essential medicines system has achieved full coverage in government-run primary healthcare institutions, resulting in improved safety and reduced prices of essential medicines. Pilot reforms of public hospitals are proceeding in an orderly manner. The primary healthcare service system has been basically established. New progress has been made in equalizing access to basic public health services.

2012 Work Deployment:
Vigorously advance the reform and development of the medical and health sectors. Accelerate the improvement of a universal health insurance system, consolidate and expand coverage of basic medical insurance, and enhance the level of basic medical security as well as management and service standards. Raise the subsidy standards for urban resident basic medical insurance and the New Rural Cooperative Medical Scheme to 240 yuan per person per year. Comprehensively implement coverage guarantees for eight major diseases, including uremia, and include twelve major diseases, such as lung cancer, in the pilot programs for coverage and assistance. Consolidate and improve the essential medicine system, and strengthen the development of primary-level medical and health service systems. Advance public hospital reforms by separating prescribing from dispensing and separating administration from operation, thereby abolishing the mechanism of subsidizing healthcare with drug profits. Encourage and guide social capital to invest in healthcare, accelerating the formation of a diversified, open healthcare delivery landscape. Fully mobilize the enthusiasm of medical professionals and foster harmonious doctor-patient relationships. Strengthen public health services to prevent and control major infectious diseases, chronic diseases, and occupational diseases that pose serious threats to public health. Enhance drug safety oversight. Support and promote the development of traditional Chinese medicine and ethnic minority medicines.

2013 Government Work Report

2012 Work Summary:
Deepening the reform of the medical and health care system, establishing the New Rural Cooperative Medical System and the Basic Medical Insurance System for Urban Residents, initially forming a universal basic medical insurance system, with enrollment in various medical insurance programs exceeding 1.3 billion people, strengthening the construction of urban and rural grassroots medical and health service systems, establishing the National Essential Medicines System and implementing it in grassroots medical institutions, and steadily advancing pilot reforms of public hospitals.

Work Deployment for 2013:
Deepen the reform and development of the medical and health sector. Consolidate and improve the essential medicine system and the new operational mechanisms for primary healthcare institutions, accelerate the reform of public hospitals, and encourage private investment in healthcare. Support the development of traditional Chinese medicine and ethnic minority medicine. Improve the universal medical insurance system, establish mechanisms for security and assistance against catastrophic illnesses, and comprehensively launch pilot programs for the coverage of 20 major diseases, including childhood leukemia. This year, the fiscal subsidy standards for the New Rural Cooperative Medical Scheme and basic medical insurance for urban residents have been increased from RMB 240 to RMB 280 per person per year, and the per capita funding standard for basic public health services has been raised from RMB 25 to RMB 30.

2014 Government Work Report

2013 Work Summary:
Basic medical insurance has achieved near-universal coverage, with fiscal subsidies for basic medical insurance for urban and rural residents increased to RMB 280 per capita. The National Essential Medicines System now covers more than 80% of village clinics. Pilot programs for critical illness insurance have been launched in 28 provinces, and pilot initiatives for emergency medical assistance have been initiated. The National Basic Public Health Services Program has been fully implemented, and free pre-conception checkups in rural areas have benefited 6 million families.

2014 Work Deployment:
Promote the deepening of healthcare reform. Consolidate universal basic medical insurance and integrate the basic medical insurance systems for urban and non-working rural residents through reform. Improve the financing mechanism for basic medical insurance with reasonable cost-sharing among the government, employers, and individuals, raising the per capita fiscal subsidy for basic medical insurance for urban and non-working rural residents to 320 yuan. Implement critical illness insurance for urban and non-working rural residents nationwide. Strengthen medical assistance in both urban and rural areas, as well as emergency medical aid for diseases. Expand the pilot comprehensive reforms of county-level public hospitals to 1,000 counties, covering a rural population of 500 million. Broaden the pilot programs for comprehensive reforms of urban public hospitals. Eliminate the practice of subsidizing hospitals through drug markups, rationalize pharmaceutical pricing, and innovate mechanisms for social capital investment in healthcare. Consolidate and improve the essential medicines system and the new operational mechanisms for primary healthcare institutions. Establish a tiered diagnosis and treatment system, strengthen the training of general practitioners, promote multi-site practice by physicians, and enable the public to access high-quality medical services locally. Enhance capabilities for the prevention and control of major infectious diseases, chronic diseases, occupational diseases, and endemic diseases, increasing the per capita subsidy for basic public health services to 35 yuan. Support the development of traditional Chinese medicine and ethnic minority medicine. Unswervingly adhere to the basic national policy on family planning and implement the policy allowing couples where one spouse is an only child to have two children. For the physical and mental health of the people and the happiness of families, we must firmly advance healthcare reform and address this global challenge with Chinese solutions.

2015 Government Work Report

2014 Work Summary:
Deepen the reform and development of the medical and health sectors. Pilot programs for critical illness insurance for urban and rural residents have been expanded to all provinces, a system for emergency medical assistance has been basically established, and universal health insurance coverage exceeds 95%. Comprehensive reforms at primary healthcare institutions have been deepened, and the county-township-village service network has been progressively improved. The number of counties and cities participating in pilot public hospital reforms has exceeded 1,300.

2015 Work Deployment:
Accelerate the improvement of the basic medical and health system. Enhance the basic medical insurance for urban and rural residents, raising the fiscal subsidy standard from 320 yuan to 380 yuan per person annually. Basically achieve direct settlement of residents’ medical expenses within provinces, and steadily promote the cross-provincial direct settlement of medical expenses for retirees. Fully implement the critical illness insurance system for urban and rural residents. Deepen the comprehensive reform of primary healthcare institutions, strengthen the general practitioner system, and improve the tiered diagnosis and treatment system. Comprehensively launch the comprehensive reform of county-level public hospitals, conduct pilot reforms of public hospitals in 100 cities at or above the prefecture level, eliminate the practice of subsidizing medical services with drug profits, reduce artificially inflated drug prices, reasonably adjust medical service prices, balance costs through mechanisms such as medical insurance payments, and strive to alleviate the financial burden on the public.

Encourage physicians to practice at multiple sites, particularly in primary care settings, and promote the development of privately run medical institutions. Launch provincial-level comprehensive pilot programs for deepening healthcare reform. Accelerate the establishment of mechanisms for the prevention and mediation of medical disputes. Raise the per capita subsidy standard for basic public health services from 35 yuan to 40 yuan, with the entire increase allocated to compensating village doctors for providing basic public health services, thereby enabling hundreds of millions of rural residents to access medical care locally. Strengthen the prevention and control of major diseases. Actively promote the development of Traditional Chinese Medicine (TCM) and ethnic medicine. Advance reforms in family planning service management. Health is a fundamental need of the people; we must continuously improve the level of medical and healthcare services to build a Healthy China.

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