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this article is reproduced from qiushi.com

the decision of the cpc central committee on further comprehensively deepening reform and promoting modernization with chinese characteristics (hereinafter referred to as the decision), adopted at the third plenary session of the 20th cpc central committee, has made deepening reform of the medical and health system an important task for further comprehensively deepening reform and promoting modernization with chinese characteristics, which fully reflects the firm determination of the cpc central committee with comrade xi jinping as the core to safeguard the health of the people. to thoroughly study and implement the spirit of the plenary session, we must adhere to the guidance of xi jinping thought on socialism with chinese characteristics for a new era, accurately understand and grasp the great significance, overall requirements and tasks and measures of deepening reform of the medical and health system, further improve the medical and health system with chinese characteristics, continuously improve the health level of the people, and provide healthy support for the great cause of building a strong country and national rejuvenation.

1. deeply understand the great significance of deepening the reform of the medical and health system

general secretary xi jinping pointed out that people's health is an important symbol of socialist modernization. in the new journey of promoting the construction of a strong country and the great cause of national rejuvenation with chinese-style modernization, the fundamental status and overall role of health work have been further highlighted. deepening the reform of the medical and health system will help solve the most direct and realistic interests of the people when they seek medical treatment, and will help solve the main contradiction of unbalanced and insufficient development of the health cause, and better serve the overall situation of people's health and economic and social development.

1. deepening reform of the medical and health care system is an inevitable requirement for realizing people’s aspirations for a better life.general secretary xi jinping pointed out that health is the most important indicator of a happy life. health is 1, and the rest are the 0s behind it. without 1, no matter how many 0s there are, they are meaningless. realizing people's yearning for a better life is the starting point and end point of china's modernization. we must deepen reforms to promote a more equitable, effective, mature and established basic medical and health system, use the system to protect people's health and well-being, and better meet people's expectations for high-quality and healthy life in the process of promoting common prosperity.

(2) deepening reform of the medical and health system is an important driving force for building a modern socialist country.general secretary xi jinping pointed out that people's health is an important symbol of national prosperity and national strength. we must deepen reforms, promote supply-side structural adjustments in the field of medicine and health, comprehensively improve the health quality of the population, make the physical and mental health of the people compatible with modernization, and enable all our people to enter a modern society with a strong attitude. at the same time, deepening the reform of the medical and health system is conducive to improving expectations and expanding domestic demand by promoting people's health, cultivating new economic growth points, and helping to adjust the structure, stabilize employment, and promote growth.

(3) deepening reform of the medical and health system is an important measure to coordinate high-quality development and high-level security.general secretary xi jinping pointed out that preventing and resolving major epidemics and public health emergencies is related to national security and development, as well as the stability of the overall social and political situation. we must deepen reforms, improve the early warning, assessment and response mechanism for major infectious diseases, comprehensively enhance our prevention, control and treatment capabilities, weave a dense protection network, build a solid isolation wall, and build a strong public health system to provide strong guarantees for the stable development of the economy and society.

(4) deepening the reform of the medical and health system is an important manifestation of the superiority of the socialist system with chinese characteristics.general secretary xi jinping emphasized that chinese-style modernization has shown another picture of modernization, expanded the path choices for developing countries to move towards modernization, and provided a chinese solution for mankind's exploration of a better social system. we must deepen reforms, continuously improve the level of equalization of basic public health services, continuously promote the balanced layout and sinking of high-quality medical resources to the grassroots, continuously improve the health development path that conforms to national conditions and the laws of human social development, use chinese methods to solve the world's difficult problems in medical reform, and show a new picture different from the western modernization model in continuously improving the health level of all people.

ii. firmly grasp the principles and requirements of deepening the reform of the medical and health system

since the 18th cpc national congress, the cpc central committee with comrade xi jinping as the core has integrated the deepening of reforms in the medical and health system into the overall planning and promotion of the overall deepening of reforms, and has successfully embarked on a path of health development with chinese characteristics, withstood the severe test of the covid-19 pandemic, achieved a major and decisive victory, and accumulated valuable theoretical and practical experience. we must thoroughly study and understand general secretary xi jinping's series of new ideas, new viewpoints, and new conclusions on comprehensively deepening reforms, and implement them in all aspects of the entire process of deepening reforms in the medical and health system.

the picture shows that on april 28, 2024, the department of obstetrics and gynecology, department of anesthesiology, etc. of peking union medical college hospital completed the "resection of giant pelvic intravenous leiomyoma, removal of inferior vena cava and bilateral iliac vein leiomyoma involving the heart" for a rare 15-week pregnant patient. after the operation, the patient continued to be pregnant and the pregnancy was smooth. national health commission

first, uphold and strengthen the leadership of the party.we must resolutely safeguard the authority and centralized, unified leadership of the party central committee with comrade xi jinping at its core, firmly advance in the correct political direction, and always rely on upholding the party's leadership to gather powerful forces to deepen reform of the medical and health system and safeguard people's health.

second, we must continue to give priority to the health of the people in their development.we must firmly stand on the people's side, implement the health-first development strategy, start from where the people most expect and make changes from where the people are most dissatisfied, and find the greatest common divisor and best balance point of reform based on the interests of the people, so as to make improving health and well-being and consolidating the party's ruling foundation the greatest political achievement.

third, we must uphold the public nature of health care.we will unswervingly write public welfare on the banner of medical and health care, adhere to the dominance of public welfare, adhere to the dominant position of public medical institutions in the service system, guide and standardize the development of private hospitals, adhere to doing our best and acting within our means, constantly improve the system, reform the mechanism, expand services, and improve quality, so that the people can share the dividends of reform.

fourth, adhere to the party’s health and health work guidelines in the new era.this is the basic requirement of the party for the health and wellness cause. we must focus on the grassroots, take reform and innovation as the driving force, give priority to prevention, attach equal importance to traditional chinese and western medicine, integrate health into all policies, and build and share with the people. through deepening reform, we will promote the shift from treating diseases to people's health, integrate health policies into the overall situation, provide health services throughout the whole process, and benefit all people with health and well-being.

in early october 2023, the five medical insurance government service sub-centers jointly built by the beibei district medical insurance bureau of chongqing and relevant towns and streets were officially put into use. they mainly handle 19 medical insurance businesses such as transfer and continuation of medical insurance relations, one-time withdrawals from personal accounts, and medical insurance supplementary payments, providing surrounding enterprises and the public with better quality, more efficient and convenient medical insurance public services. the picture shows citizens handling medical insurance-related matters at the medical insurance government service sub-center in jingguan town, beibei district on october 9. people's photo by qin tingfu

fifth, we must adhere to national conditions and coordinate and cooperate.we will adhere to the principle of starting from the basic national conditions, promote the coordination of basic medical and health service levels with economic and social development, and be in line with the expectations and affordability of the people, correctly handle important relationships such as those between the government and the market, and highlight the systematic nature of reforms and the coordination of policies.

iii. comprehensively implement key tasks for deepening reform of the medical and health system

we must fully implement the arrangements of the "decision", combine it with the actual situation of health work, continue to deepen and expand reforms in key areas, further highlight the structural reform and intensive development of the medical and health supply side, further highlight the system continuity of health services, pay more attention to the system integration of reforms, consolidate and improve the basic medical and health system with chinese characteristics, and ensure the effectiveness of reforms.

1. promote the coordinated development and governance of medical care, medical insurance, and pharmaceuticals.taking the improvement of people's health and well-being as the starting point and foothold, we will improve the mechanisms of unified goals, policy connection, information interconnection, and regulatory linkage, and enhance the coordination of medical, medical insurance, and pharmaceutical reforms. in terms of medical care, we must adhere to the public welfare orientation, deepen the supply-side structural reform, improve the high-quality, efficient, continuous and coordinated, and resilient integrated service system, enhance the fairness, accessibility, and continuity of medical and health services, and continuously improve the ability and level of serving people's health. in terms of medical insurance, we must strengthen the construction of the universal medical insurance system, promote the provincial-level coordination of basic medical insurance, reform the medical insurance payment method, and promote the standardized development of commercial health insurance; establish and improve a charging mechanism that reflects the value of medical service technology and labor, regularly evaluate and dynamically adjust the prices of medical services such as diagnosis, surgery, and nursing, orderly guide the masses to go to the grassroots for treatment, and stimulate the vitality of medical institutions and medical personnel. in terms of medicine, we must make efforts from the entire process of research and development, production, circulation, and use, improve the drug supply guarantee system, vigorously support innovative research and development and achievement transformation, continuously optimize the review and approval process, promote the expansion of centralized procurement of drugs and consumables, and strengthen quality and safety supervision.

(2) accelerate the construction of a tiered diagnosis and treatment system.we will vigorously promote the policy of "solving serious diseases in the province, solving common diseases in cities and counties, and solving headaches and fevers in towns and villages", promote the systematic reshaping of the medical and health system, and promote the expansion and balanced layout of high-quality medical resources. we will focus on the grassroots, strengthen the coordination and support of the service system, promote the sinking of urban medical resources to county-level hospitals and urban and rural grassroots, and carry out rounds of teaching and remote consultations at the grassroots level in central and western regions. we will promote the construction of close-knit medical alliances, with the core of promoting the sinking of personnel and services, and the simultaneous implementation of technology and management, consolidate and improve the management system and operation mechanism of various forms of medical alliances such as close-knit county medical communities and urban medical groups. we will promote full coverage of close-knit county medical communities and consolidate the three-level collaborative relationship between counties, towns and villages. we will strengthen grassroots medical and health services and strengthen disease prevention, treatment and health management capabilities. we will solidly promote referral continuous services and mutual recognition of inspection and test results, strengthen communication between doctors and patients, and adapt to the new expectations of the people. give full play to the role of performance appraisal and evaluation, guide the development of national medical centers, national and provincial regional medical centers, implement the functional positioning in critical referral consultation, emergency medical rescue for emergencies, reform and improve new operating mechanisms, scientific and technological innovation, talent training, grassroots assistance, and strengthening public welfare, so as to drive the overall improvement of regional medical and health service capabilities. grasp the value and growth rules of health and health talents, deepen the collaboration between medicine and education, cultivate medical talents guided by clinical needs, and develop and expand the medical and health team with a focus on the grassroots. expand general practice, pediatrics, mental health, infection, pathology, anesthesia and other medical and health resources to improve service levels.

august 19, 2024 is the seventh chinese doctors' day. enabling more people to see a doctor at their doorstep is an important goal of deepening the reform of the medical and health system. the latest data shows that there are 4.95 million primary health workers in my country, including 1.1 million rural doctors, who play an important role as "health gatekeepers". this collage photo shows rural doctors conducting health consultations and knowledge promotion during their visits. photo by xinhua news agency reporter cao yiming

(3) improve the public health system.we will thoroughly summarize the experience of fighting the covid-19 pandemic, transform mature practices through institutional construction, and focus on more accurate and effective prevention, make full preparations for new and sudden outbreaks of major infectious diseases, and better coordinate development and security. we will improve the national, provincial, municipal, and county-level major epidemic prevention and control systems, improve and optimize the joint prevention and control mechanism that combines peacetime and wartime, crosses departments and regions, and links up and down, strengthen monitoring and early warning, risk assessment, epidemiological investigation, inspection and testing, emergency response, and medical treatment capabilities, improve the ability to detect major epidemics early, and effectively curb the spread of major infectious diseases. we will adhere to prevention first, innovate medical and prevention coordination and medical and prevention integration mechanisms, implement the public health responsibilities of medical institutions, promote the communication of personnel, information, and resources between medical institutions and public health institutions, and vigorously cultivate compound talents with both prevention and treatment. we will carry out the healthy china action and the patriotic health campaign in depth, advocate a healthy lifestyle, strengthen the prevention and early intervention of major chronic diseases, and further control the main factors affecting residents' health.

(iv) deepen the reform of public hospitals oriented towards public welfare.improve the public hospital operation mechanism that takes people's health as the center, maintains public welfare, mobilizes enthusiasm, and ensures sustainability. implement government investment responsibilities, establish a stable fiscal investment policy, strengthen economic operation management, prevent and orderly classify and resolve operation risks. establish a dynamic adjustment mechanism for establishment, strengthen establishment guarantees based on the actual situation of the industry, and give preferential support to those who undertake national directive tasks. deepen the reform of the public hospital salary system, implement the "two permissions" (allow medical and health institutions to break through the current salary control level of public institutions, and allow medical service income to be deducted from costs and various funds to be withdrawn according to regulations and mainly used for personnel rewards), further improve the performance evaluation mechanism, optimize the salary structure, gradually increase the proportion of fixed income of medical personnel, promote more reasonable salaries for different departments and different positions in medical institutions, and accelerate the establishment of a salary system that reflects job responsibilities and technical labor value. carry out special medical services in public hospitals in a stable and orderly manner. guide and standardize the development of private hospitals, play an important supplementary role in improving the medical and health service system and meeting the diverse health needs of the people, and strengthen the connection with commercial health insurance. innovate comprehensive supervision methods for the medical and health industry, strengthen institutional supervision, behavioral supervision, functional supervision, penetrating supervision, and continuous supervision, and further improve supervision efficiency. strengthen the construction of clean government in the medical and health sector, and continue to rectify corruption and unhealthy practices among the people.

(v) promote innovation in medical science and technology.vigorously develop new productivity in the field of health and improve the health and health science and technology innovation system. focus on key technologies and equipment and improve the domestic standard and specification system around practical, effective, easy to use, and good use, support the development of clinical medical research, promote the integration of medicine and engineering, and promote the innovative research and development of cutting-edge technologies and future industries in the field of medical science and technology, and establish health standards and normative guidelines that meet the chinese physique. promote the transformation of innovative drugs, vaccines, medical equipment and other achievements into clinical applications, promote the in-depth application of information technologies such as artificial intelligence and the internet in the field of health and provide more tools and means to maintain people's health.

(6) improve the inheritance, innovation and development mechanism of traditional chinese medicine.we will promote the improvement of the quality, expansion and capacity of high-quality tcm medical resources, strengthen the capacity building of tcm specialty departments, optimize tcm medical service prices and payment policies, and give full play to the unique advantages and role of tcm in preventing and curing diseases. we will enhance the scientific and technological service capabilities and collaborative innovation capabilities of tcm, and strengthen the excavation, protection and development of the essence of tcm classical medical books. we will promote the implementation of the "new era shennong tasting hundreds of herbs" project, enrich tcm treatment methods, and develop more authentic medicinal resources. we will vigorously promote the cultural and spiritual connotations and contemporary values ​​of tcm, and continuously promote tcm to go global.

iv. gathering a strong synergy to deepen the reform of the medical and health system

deepening the reform of the medical and health system involves a wide range of areas and has a high level of social attention. it is necessary to build a work pattern of party committee leadership, government dominance, departmental coordination, social participation, and joint construction and sharing by all people. it is necessary to further improve the organizational leadership mechanism of unified leadership by the party committee and joint management by the party and the government, strengthen the leadership responsibilities of local party committees and governments at all levels, formulate specific implementation measures, and combine the research and formulation of the "15th five-year plan" to plan projects and action plans. regularly study and deploy major issues in the process of advancement to ensure the implementation of reform policies. it is necessary to strengthen departmental coordination and cooperation, think in one direction and work in one direction, jointly study and refine practical and operational supporting measures, and jointly push the deepening of the reform of the medical and health system to a deeper level. it is necessary to mobilize the enthusiasm, initiative, and creativity of the whole society to participate, encourage social forces to participate in medical and technological innovation, and enrich the supply of medical and health services. it is necessary to encourage local pilot projects and regional coordination and linkage, and boldly explore according to local conditions under the reform direction and principles determined by the party central committee to form more replicable and popularizable experiences and practices. it is necessary to strengthen publicity and guidance, make good use of the reform experience at the national, local, and institutional levels, and actively create a good atmosphere for the whole society to support, plan, and promote medical reform.