ESRD Covered in the Pilot Program of Serious Illness Treatment
Date：2013-08-27
On March 17, the national conference on grassroots healthcare and new rural cooperative medical care was held and the Ministry of Health announced this year’s medical reform tasks of grassroots healthcare and new rural cooperative medical care. According to Mr. Chen Zhu, Minister of the Ministry of Health, the funding of basic public healthcare service per person will be raised from RMB15 to RMB22 this year, and the reimbursement proportion of five illnesses such as ESRD, breast cancer and cervical cancer in the new rural cooperative medical care system will be increased on a trial basis this year.
Mr. Chen Zhu said, the funding of basic public healthcare service per person will be raised from RMB15 to RMB22 this year, and the increased funding will mainly be used to expand the coverage of people, improve service quality and increase service items.
Newly increased service items include medical services provided for everyone under six that used to only cover children under three and dental healthcare; more examination for vulnerable groups such as the people above the age of 65 and pregnant women, healthcare education, and the services will be provided on a more frequent basis; the number of patients suffering from high blood pressure, diabetes and serious mental illnesses covered by the pilot program will be increased, and such services as public health emergency response plans and healthcare supervision and co-management.
Mr. Chen Zhu said, according to the Guidelines on the Twelfth Five-year Plan, we will achieve the objective of raising the average life expectancy by one year in 2015, and the main battlefield lies in the improvement of the management of high blood pressure and diabetes. According to Mr. Chen, we will increase the standard filing rate of medical health record in China to 50% this year, place 45 million high blood pressure patients and 15 million diabetes patients under standard management, and put all the identified serious mental illness patients into the scope of standard management.
The beneficiary groups of the new rural cooperative program will be expanded this year. In the previous year, the Ministry of Health improved the medical insurance coverage of leukemia and congenital heart disease of rural children across whole the country on a trial basis and enlarged medical care coverage through the new rural cooperative program and medical assistance. In principle, the reimbursement ratio of the new rural cooperative program of the illnesses covered in the pilot program should reach 70% of the total expenses of the corresponding provinces (districts and cities), medical assistance will reimburse the eligible patients and the reimbursement ratio will not be less than 20% of the total expenses. At the end of January this year, 4,859 children suffering from the illnesses had received medical treatment.
According to Mr. Chen Zhu, we will roll out the pilot program in all provinces this year and gradually expand the treatment coverage of serious illnesses with focus on including breast cancer, cervical cancer, ESRD and opportunistic infection of AIDS into the pilot program to expand beneficiary groups. Besides, the beneficiary coverage of the new rural cooperative program will be further enlarged this year and the oral medicine commonly used for serious mental illnesses and nine rehabilitation items for disabled people will be covered in the imbursement scope of outpatient treatment.
According to Mr. Chen Zhu, the State Council has decided this year to raise the new rural cooperative subsidies to RMB200 per person every year and moderately increase the amount paid by individuals, which is the fourth time of increasing the fund-raising standard since the new rural cooperative program was initiated; as the fund-raising standard is increased, the healthcare departments of different regions should adjust the new rural cooperative reimburse plan as soon as possible, increase the reimbursement ratio of inpatient expenses to around 70% so far as the policy permits, and increase the maximum payment limit to no less than RMB50,000.
(Chen Qiao)
