Read in Chinese

Speakers:

Mr. Hu Jinglin, administrator of the National Healthcare Security Administration (NHSA)

Mr. Shi Zihai, vice administrator of the NHSA

Ms. Li Tao, vice administrator of the NHSA

Mr. Huang Huabo, vice administrator of the NHSA

Chairperson:

Ms. Xing Huina, deputy director general of the Press Bureau of the State Council Information Office (SCIO) and spokesperson of the SCIO

Date:

May 18, 2023

Xing Huina:

Ladies and gentlemen, good afternoon. Welcome to this press conference held by the State Council Information Office (SCIO). This is the 16th briefing in the series "Embarking on the New Journey — A Government Perspective." Today, we have invited Mr. Hu Jinglin, administrator of the National Healthcare Security Administration (NHSA), to brief you on implementing the major decisions of the 20th National Congress of the Communist Party of China (CPC) and promoting the high-quality development of healthcare security. He will also take your questions. Also joining us today are three vice administrators of the NHSA, Mr. Shi Zihai, Ms. Li Tao, and Mr. Huang Huabo.

Now, I'll give the floor to Mr. Hu Jinglin for a brief introduction.

Hu Jinglin:

Ladies and gentlemen, friends from the media, good morning. It is my pleasure to meet you here. To begin with, on behalf of the NHSA, I would like to express my heartfelt gratitude to our journalist friends for their long-term support for the healthcare sector's development as well as their work to communicate and explain related policies.

In 2018, the CPC Central Committee with Comrade Xi Jinping at its core strategically decided to establish the NHSA. Since the institute's establishment, China's healthcare security system has focused on the major political task put forward by General Secretary Xi Jinping of "relieving people of worries about diseases and healthcare services." It has remained committed to the people-centered approach, overcome difficulties to promote systemic and institutional reforms, and made historic breakthrough in the domestic healthcare security sector. It has also played a vital role in resolving the problem of difficult and expensive access to medical treatment. Moreover, it has supported the development of the healthcare sector, safeguarding social harmony and stability, and helping to achieve the goal of common prosperity.

Over the past five years, the NHSA has made stability our top priority and established the world's largest basic healthcare security network. From 2018 to 2022, medical insurance coverage was maintained at around 95%. Meanwhile, the reimbursement rate for hospitalization expenses covered by related policies for urban workers reached 80% and around 70% for rural and non-working urban residents. The level of basic medical insurance coverage for low-income rural residents and people no longer in poverty has been maintained at over 99%, and medical insurance has successfully helped nearly 10 million poor households shake off poverty. The annual revenue of basic medical insurance funds, including maternity insurance, increased from 2.14 trillion ($302.56 billion) to 3.09 trillion yuan, and annual expenses rose from 1.78 trillion to 2.46 trillion yuan. The fund operates in a stable manner with a surplus. The annual per capita government subsidy for insured residents rose from 490 yuan to 610 yuan. In 2022 alone, government subsidies in this regard reached 600 billion yuan.

Over the past five years, the NHSA has been committed to bringing benefits to the public and strived to reduce people's burden on seeking medical treatment. The NHSA has expedited negotiations on insured medicines. Many exclusive varieties of anti-cancer and rare disease drugs, such as carrelizumab and nusinersen, have been included in the national medical insurance system at reasonable prices. This has reduced patients' medical expenses by more than 500 billion yuan after reimbursement and helped tens of millions of people suffering from serious illness and their families regain hope for life. The NHSA has worked to make bulk government purchases of medicines and medical consumables. Under the bulk government purchase scheme, the price of 333 medicines has declined by 50% on average. In addition, eight high-value medical consumables, such as heart stents and artificial joints, dropped by over 80% on average. Meanwhile, the NHSA has collaborated with local regions on drug-procurement programs, which has reduced related expenses by nearly 500 billion yuan. The NHSA has reformed insurance measures for people suffering from chronic diseases by including outpatient medicine expenses for hypertension and diabetes in national medical insurance, which has benefitted 140 million people with chronic diseases. The NHSA has continued to streamline procedures for settling healthcare costs directly where incurred. The scale of interprovincial on-the-spot settlement of medical bills has surged from 1.32 million applications in 2018 to 38.12 million in 2022, a 28-fold increase. In the face of the COVID-19 pandemic, the NHSA decisively implemented the policy of ensuring that patients will not be denied timely treatment due to medical costs and that the medical treatment at designated medical institutions is not affected due to healthcare insurance budget concerns. The NHSA also guaranteed the affordability of COVID-19 vaccines and vaccination services, contributing to the decisive victory of pandemic prevention and control. Additionally, the NHSA has kept extending pilot long-term care insurance schemes. Today, the schemes have covered 169 million people in 49 cities and benefitted 1.95 million people with disabilities, bringing quality and dignity to their lives.

Over the past five years, the NHSA has adhered to an innovation-driven approach and promoted the high-quality development of the pharmaceutical industry. The NHSA has encouraged research and development (R&D) and innovation in the sector and established a medical insurance access and negotiation renewal mechanism focusing on new drugs. Nowadays, it only takes two years on average for new drugs to be included in the medical insurance catalog, which is much shorter than the five-year time on average in the past. Some new drugs were included in the catalog after only six months on the market. Medical insurance expenditure on new drugs has increased from 5.95 billion yuan in 2019 to 48.19 billion yuan in 2022, a 7.1-fold increase. The NHSA has expanded the sales channels of insured drugs after medical insurance negotiations. Through a dual-channel management mechanism, some of these drugs that were mainly available in large hospitals are now also available in 155,000 designated medical insurance pharmacies and reimbursed by the health insurance fund. The NHSA has worked to ensure a clean environment for the pharmaceutical industry. By launching bulk government purchases institutionally and regularly, the NHSA has worked continuously to address the inflated price of medicines and medical consumables and avoid sales activities that take kickbacks from pharmaceutical companies. The innovation momentum of pharmaceutical companies keeps growing. The total R&D investment of the top 10 pharmaceutical companies in the A-share market by market value is 2.48 times that of 2018.

Over the past five years, the NHSA has followed a systemic and integrated philosophy and worked for the coordinated development and management of healthcare services, medical insurance, and medicine. The NHSA has supported the work to improve the wage compensation mechanism for medical workers and to clarify the fund surplus of public medical institutions due to bulk government purchases and medical insurance payment reforms, which can be used for staff salary expenses. The NHSA has worked to reform the mechanism of medical insurance fund allocation. Most regions under unified management have established a medical insurance fund flow system. Under the system, medical insurance funds are prepaid to medical institutions at the beginning of each year, which has reduced the pressure on hospitals to make advance payments. The NHSA has comprehensively established a dynamic adjustment mechanism for medical service prices. In addition to significantly reducing the price of medicines and medical consumables, the NHSA has also adjusted the prices of hospital service items, such as surgeries and traditional Chinese treatments, which reflect the value and capability of technical labor. The NHSA has supported the high-quality development of public hospitals. The NHSA has also supported the development of primary-level medical institutions. By increasing the medical insurance reimbursement rate and lowering the deductible line of medical treatment expenses at primary-level hospitals, the NHSA has worked to guide patients to purchase medicines and take healthcare services in these hospitals. The NHSA has established a medical insurance fund supervision system with proactive measures and a human touch. The NHSA has dealt with 1.54 million illegal medical insurance-related cases, and institutions recovered 77.13 billion yuan of medical insurance funds and exposed 245,000 typical cases. For medical institutions that take the initiative to conduct self-examination and self-correction, the NHSA has offered them leniency in accordance with the law. The NHSA has also made every effort to promote the standardization of diagnosis and treatment behaviors.

In summary, over the past five years, significant progress has been made in the coordinated development and governance of medical insurance, medical services, and pharmaceuticals. This has led to a win-win situation where the public benefits, the funds are more secure, hospitals are experiencing development, and enterprises are witnessing growth.

Ladies and gentlemen, friends from the media, these achievements are fundamentally attributed to the leadership of General Secretary Xi Jinping at the core of the Party and its Central Committee and the science-based guidance of Xi Jinping Thought on Socialism with Chinese Characteristics for a New Era. As we embark on the first year of fully implementing the guiding principles of the 20th CPC National Congress, the NHSA will adhere to the guidance of Xi Jinping Thought on Socialism with Chinese Characteristics for a New Era. We will seize the themed education campaign as an opportunity to comprehend the tasks and requirements put forward during the 20th CPC National Congress on healthcare security and strive to create a new era in which healthcare security brings more benefits and convenience to the general public.

Next, my colleagues and I are ready to answer your questions. We look forward to exchanging ideas with you. Thank you.

Xing Huina:

Thank you, Mr. Hu, for your opening remarks. The floor is now open to questions. Please identify the media outlet you represent before raising your questions.