每经记者｜赵李南 每经编辑｜文多 图片来源：圆点直播官网截图 "二是医疗服务价格形成的机制有待完善，价格水平总体是偏低的，重物资消耗，轻技术劳务，定调价缺乏医院和医务人员的有效参与，动态调整机制还没 有建立起来。此外，医保支付方式改革目前从进展看还需要加速。"许树强表示。 "三是符合行业特点的人事薪酬制度改革还需要加大力度。公立医院编制标准严重滞后且没有落实，编外人员占比较高，目前占到了51%。医务人员、技术 劳务价值尚没有充分体现，多数公立医院可支配收入不足，提高薪酬水平缺乏资金来源。"许树强说道。 7月6日，国务院医改领导小组秘书处、国家卫生健康委在福建省三明市召开新闻发布会。 国家卫生健康委体改司司长许树强、国家卫生健康委体改司一级巡视员朱洪彪、福建省卫生健康委党组书记黄如欣、三明市政府副市长张元明、三明市沙县 区总医院党委书记万小英参加了新闻发布会。 会上，媒体针对三明医改的成果和接下来全国如何进一步推广学习三明医改经验等问题进行了提问。 许树强在回答现场记者提问时分析称，目前全国推广三明医改经验仍然存在着难点和堵点，比如有些地方对"三医"联动改革存在畏难情绪。许树强认为，各 地需要在领导体制、三医联 ...

Core Viewpoint - The article emphasizes the importance of promoting the Sanming healthcare reform model across China, highlighting its unique features and the challenges faced in its implementation in other regions [1][4][10]. Group 1: Overview of Sanming Healthcare Reform - The Sanming healthcare reform, initiated in 2012, has significantly influenced China's healthcare reform trajectory, focusing on the establishment of a medical insurance bureau, centralized procurement of drugs and medical supplies, and a salary system for doctors [2][3][25]. - The reform was launched in response to the risk of the medical insurance fund running dry and prominent doctor-patient conflicts, aiming to enhance the public hospital system's efficiency and accountability [2][3][25]. Group 2: Key Experiences and Challenges - Four key experiences from the Sanming reform include adherence to party leadership, a focus on public welfare, a proactive reform attitude, and a tailored approach to local conditions [8]. - Challenges in replicating the Sanming model include the need for local leaders to recognize the importance of reform, breaking existing interest groups, and ensuring effective policy execution [10][14][15]. Group 3: Government's Role and Responsibilities - The Sanming model emphasizes the government's responsibility in healthcare provision, including hospital construction, management, and supervision, which contrasts with previous profit-driven models [27][28]. - The reform has shifted the focus from profit maximization to improving public health outcomes, with doctors incentivized to prioritize patient health over financial gain [28][30]. Group 4: Financial Structure and Incentives - The financial structure of hospitals in Sanming has been optimized, with a target of increasing medical service revenue while reducing reliance on drug sales, thus enhancing patient care quality [43]. - The implementation of a performance-based salary system for healthcare workers has led to a high satisfaction rate among medical staff, with over 80% expressing contentment with their income [31][29]. Group 5: Broader Implications and Future Directions - The Sanming healthcare reform serves as a benchmark for national healthcare reform, with ongoing efforts to promote its principles across various regions [3][25]. - The focus on health-centered policies aims to reduce disease incidence and improve overall public health, aligning with national strategic goals for healthcare development [27][38].

Core Viewpoint - The Chinese government emphasizes the promotion of the Fujian Sanming medical reform experience as a model for healthcare service development during the 14th Five-Year Plan period [1][2]. Summary by Sections Medical Reform Experience - The Sanming medical reform has achieved significant results in health security and reform through four key principles: adherence to party leadership, a public welfare focus, a proactive reform approach, and local adaptation of reforms [2][3]. Reform Logic - The Sanming medical reform prioritizes the people's perspective, aiming to enhance public satisfaction and ensure equitable access to healthcare services [3][4]. - The reform is characterized as a revolution in the healthcare sector, addressing issues like high medical costs and inefficient healthcare practices [3][4]. Reform Methods and Pathways - The reform adopts a systematic approach, integrating medical, insurance, and pharmaceutical reforms to enhance overall effectiveness [4][5]. - Key strategies include establishing efficient management systems, improving insurance fund utilization, and eliminating corrupt practices in drug pricing [5][6]. Reform Phases - The reform is divided into three phases: 1. Addressing profit-driven practices in healthcare [5][6] 2. Reorienting healthcare towards patient treatment [5][6] 3. Focusing on health promotion and prevention [5][6]. Reform Achievements - Significant reductions in patient costs have been observed, with hospitalization costs for urban employees increasing from 6,553 yuan in 2011 to 8,560 yuan in 2023, while personal burdens have only slightly increased [8]. - The total salary expenditure for hospitals rose from 382 million yuan in 2011 to 2.044 billion yuan in 2022, indicating improved compensation for healthcare workers [8][9]. - The structure of hospital revenue has shifted, with medical service income rising from 18.37% to 46.07% of total revenue from 2012 to 2023 [9]. Future Goals - The reform aims to establish a comprehensive health security system, emphasizing the government's role in providing public health services and ensuring effective management of healthcare institutions [11][12]. - The focus will be on enhancing the efficiency of insurance funds and promoting health management organizations to improve overall health outcomes [12][13].

Core Viewpoint - Anhui Province is implementing the "Sanming Medical Reform" experience to enhance public hospital services, focusing on improving healthcare accessibility and affordability for the local population [1][2]. Group 1: Financial Support and Policy Implementation - Anhui Province has allocated 820 million yuan for public hospital development and clinical specialty construction, marking a 13.6% increase in health investment compared to the previous year [2]. - The province has established a dynamic allocation system for public hospital staffing, optimizing resources across over 200 public medical institutions [2]. - In Fuyang City, the proportion of fiscal investment in public hospitals has increased to 15.2% in 2024, up by 6.3 percentage points since 2020 [2]. Group 2: Resource Allocation and Service Improvement - Over 5 billion yuan has been invested in the construction of healthcare facilities at county, township, and village levels in Shouxian County, addressing the healthcare needs of its population [3]. - The county has reduced the external transfer rate of cancer patients by 12.9% through the enhancement of clinical specialties and local healthcare capabilities [3]. - Collaborative efforts among hospitals have led to the establishment of regional specialty medical centers, improving local healthcare service quality [3][4]. Group 3: Technological Integration and Patient Services - The Anhui Provincial Hospital has connected with over 60 hospitals for remote consultations, completing over 3,000 online consultations and 500 remote pathology diagnoses in the past three years [4]. - A comprehensive medical imaging cloud has been established, linking 2,385 medical institutions for mutual recognition of medical examination results [5]. - Online services such as appointment scheduling and electronic health record access have been implemented, enhancing patient convenience and reducing the need for physical visits [6].

Core Insights - The article discusses the declining interest in studying clinical medicine in China, highlighting the low salaries and high pressures faced by doctors, which has led to a hesitance among students and parents regarding the medical profession [1][2][3] Group 1: Doctor's Salary and Work Conditions - The average annual salary for doctors in China varies significantly, with junior, intermediate, senior, and chief doctors earning average salaries of 143,000, 174,000, 218,000, and 265,000 yuan respectively [3] - In first-tier cities, senior doctors earn nearly double compared to their counterparts in county-level hospitals, with average clinical income for senior doctors in top-tier hospitals reaching 246,000 yuan [3][4] - The income disparity among different medical specialties is notable, with some specialties like orthopedics and plastic surgery offering significantly higher salaries compared to others like gastroenterology [5][6] Group 2: Medical Reform and Salary Structure - The "Sanming Medical Reform" initiative aims to stabilize doctors' incomes by increasing the proportion of fixed salaries, which has reportedly exceeded 50% of total compensation in some hospitals [1][10] - The implementation of a salary system for hospital directors is being promoted, with plans to extend this to doctors, aiming to improve overall compensation structures [10][13] - The average salary for hospital directors varies widely, with many earning less than 150,000 yuan annually, indicating a need for reform to ensure fair compensation [11][13] Group 3: Challenges Faced by Medical Professionals - Doctors face increasing pressures to publish research and achieve academic milestones to advance their careers, leading to a highly competitive environment [8][9] - The medical profession is experiencing a crisis of morale, with many young doctors feeling disillusioned due to low pay and high workloads, prompting some to leave the profession [5][7] - The ongoing crackdown on corruption in the medical field has created additional stress for senior doctors, who are often caught between ethical dilemmas and financial pressures [7][9]

Group 1 - The article highlights the advancement of medical services in China, particularly the implementation of a cloud-based system for sharing medical imaging data, which enhances convenience for patients and healthcare providers [1] - The "14th Five-Year Plan" emphasizes the construction of a robust healthcare system, aiming to improve public health and ensure that patients can access quality medical services close to home [2][3] - The establishment of a comprehensive medical insurance system is noted, with significant improvements in coverage and reimbursement rates, benefiting millions of patients across the country [3] Group 2 - The article discusses the integration of public health and medical services, with initiatives such as the appointment of dedicated disease control supervisors in hospitals to enhance disease prevention efforts [4] - Financial support for public health services has increased, with per capita fiscal subsidies reaching 99 yuan, contributing to improved health literacy among the population [4] - The promotion of a health-conscious society is evident, with a notable increase in health literacy from 17.06% in 2018 to 31.87% in 2024 [4]

Core Viewpoint - The National Healthcare Security Administration (NHSA) has emphasized the importance of deepening healthcare reform during the "14th Five-Year Plan" period, focusing on the integration of healthcare services with economic and social development [1][2]. Group 1: Healthcare Fund Management - The NHSA has managed a total healthcare fund expenditure of 12.13 trillion yuan, with an average annual growth rate of 9.1% since the beginning of the "14th Five-Year Plan" [2]. - The healthcare fund has significantly supported the pharmaceutical industry, with expenditures on innovative drugs projected to reach 3.9 times the 2020 level by 2024, reflecting an annual growth rate of 40% [2]. Group 2: Reforms and Innovations - The NHSA has implemented a prepayment system for healthcare funds and promoted real-time settlement reforms, covering 357 regions nationwide, with a total of 594.8 billion yuan disbursed since 2025 [1][2]. - The introduction of the "dual directory" reform, including a new commercial health insurance innovative drug directory, aims to support pharmaceutical innovation, with over 100 drugs currently under application [2][3]. Group 3: Integration with Commercial Insurance - The NHSA has facilitated the integration of healthcare insurance with commercial insurance, resulting in over 27 million claims in Shandong province alone benefiting from a "one-stop settlement" service in 2024, enhancing the competitiveness of related insurance products [1][2]. Group 4: Future Directions - The NHSA plans to continue managing healthcare funds effectively while injecting strong momentum into the pharmaceutical industry, aiming to provide more efficient, safe, and accessible medical products and services [3]. - The basic medical insurance coverage rate has remained stable at around 95%, with 1.327 billion people insured in 2024, and annual medical assistance benefiting approximately 8 million people [3].

Core Insights - The article discusses the implementation of the "Sanming Medical Reform" experience in Jinan, focusing on improving chronic disease management and enhancing trust in community healthcare [1][2][3] Group 1: Medical Reform Implementation - The Sanming Medical Reform experience is being promoted nationwide, with a focus on adapting it to local conditions, aiming for comprehensive implementation by 2025 [3] - The reform emphasizes the importance of integrating community healthcare with higher-level hospitals to build a reliable healthcare network for chronic disease management [1][2] Group 2: Patient Experience and Trust - A case study of an 86-year-old patient illustrates the effectiveness of the new healthcare model, where community doctors can directly manage patient care and facilitate timely referrals to specialized hospitals [1][2] - Patients are more willing to trust community hospitals due to the involvement of top-tier hospitals in creating treatment plans, which also improves the convenience and reimbursement rates for patients [2] Group 3: Goals and Future Directions - The overarching goal of the reform is to ensure that every chronic disease patient receives proper management and care, thereby shifting the focus from treatment to prevention [4] - The initiative aims to create a robust health protection network for residents, enhancing overall public health outcomes [4]