CCTV:

My question is for Mr. Ma. Earlier, you introduced the progress in health-related work in China during the past seven decades. And we know well from our own experience that the medical services have improved a lot in recent years. What measures will you take next to better resolve the problem of access to and affordability of medical services? Thank you.

Ma Xiaowei:

Resolving the problem of access to and affordability of medical services is a prolonged major issue in our health work. To deepen the reform of the medical and health care systems, and make medical services more accessible, we should optimize the distribution of medical resources and try to solve the problem from a developmental perspective. Here, we have four major considerations.

First, we will steadily progress in our efforts to develop national medical centers. We will improve the level of medical and health services of all provinces, nurture local doctors skilled in the relevant medical disciplines so that patients with difficult and complicated diseases can be treated and cured within their provinces, rather than rushing to hospitals in metropolises like Beijing, Shanghai and Guangzhou. Recently, the CPC Central Committee for Comprehensively Deepening Reforms has adopted a plan on the pilot construction of regional medical centers. Also, we have signed agreements with four provinces on jointly building regional medical centers.

Second, we will continue to enhance the medical capabilities of county-level hospitals. Together with the Ministry of Finance, we have launched the project "ten thousand doctors giving support in rural medical care" since 2004, consistently encouraging urban Grade-A tertiary hospitals to extend support to rural county-level hospitals. At present, 500 county hospitals have reached the level of tertiary hospitals. Next, we plan to help another 500 county hospitals and 500 county TCM hospitals reach the level of tertiary hospitals by 2020.

Third, we will consolidate regional medical resources. Nowadays, people are used to rushing into big hospitals to treat both minor and serious illnesses. We will improve medical services at the grass-roots level, develop healthcare consortiums in urban areas, with big hospitals guiding smaller hospitals. We will also develop medical communities in rural areas, linking township hospitals to county hospitals. By upgrading the overall level of grass-roots medical services, we hope to find a good solution where serious illnesses are treated at hospitals, while treatments for minor illnesses and rehabilitation are available within the communities. 

Fourth, we will advance the reform of health insurance payouts, which are very closely linked to the categorization and division of patients. The medical fees charged by a big hospital are different from that of a small hospital. A reform that will institute differentiated or tiered charges is now carried out to create different categories for reposition of patients.

By putting current medical resources to good use, we will promote the tiered diagnosis and treatment model to further categorize and divide patients into different groups. A major task in our medical reform is to carry out the standardized training of resident physicians. In China, medical students must finish a five-year undergraduate program before graduation. We then help graduates undergo clinical training at large hospitals for another three years. After training, the expertise level of village doctors, and doctors from big or small hospitals is relatively similar. 

As for the affordability of medical services, our focus is on the following three areas. First, we will develop our medical care system. China's current healthcare insurance system is based on a low-level model with widespread coverage but is now undergoing rapid and sustainable changes and development. However, the system is still somewhat weak in the areas of critical illnesses and offsetting high medical expenses in the event of emergencies or critical illness. In the meantime, we are also developing commercial insurance schemes.  

Second, we will upgrade policies related to medical supplies. We have cut the prices of some imported patent drugs. After negotiations, the prices of 17 cancer drugs were slashed and these drugs were included in the national medical insurance catalog. Also, we conducted a volume-based drug procurement scheme, which reduced transaction costs, especially costs incurred in the intermediary links of the production of drugs. 

Third, we will enhance the management of hospitals. We must strengthen the professional ethics and work practices of doctors and increase supervision in the healthcare industry.