Research On Market Access Regulatory System Of The Medical-healthcare Combined Institutions

China is the country with the largest old population in the world,and the aging of the population is very severe.How to solve the problem of old-age care and medical care for a large number of elderly people is the focus of the current state and society.In order to overcome the difficulty in healthcare and medical treatment for the elderly,and to achieve the goal of “keeping aging population healthy and out of poverty”,we must re-examine the state of separation of medical care and support in our country’s traditional culture.The medical care and health care are provided separated by the medical institution and nursing institution for the aged,which causing the contradiction between the medical treatment and the long-term care.The combination of medical care and health care is an effective way to solve the problem of elderly care and medical care for the elderly.The combination of medical and health care institutions integrates “medical care” and “social care,” and it can provide elderly care services for the elderly as well as care services,medical services,and health consultations,health check-up services,rehabilitation training services,and hospice care allow elderly people to enjoy their old age without worry.The current law in our country does not clearly define the the Medical-healthcare combined institutions,neither distinguish it from ordinary retirement institutions.In addition,there are no exact rules for the conditions of their access,which might cause some speculators to defraud the country’s relevant preferential policies in the name of setting up a the Medical-healthcare combined institutions.Therefore,it is necessary to establish a system for admitting medical institutions,standardize the market for elderly care services,protect the legitimate rights and interests of the elderly,and perform the basic public service duties of the country.In the future,there will be four possible forms of Medical-healthcare combined institutions in China: the first is to provide old-age care services in the existing medical and health institutions,and the second is to add medical services to the old-age care institutions,and the third is the cooperation between medical institutions and old-age care institutions.The fourth is to integrate medical treatment and healthcare into communities and families.Based on the method of providing services and the closeness of medical and health care,only the first three categories can be referred to as the Medical-healthcare combined institutions.And they are still in the initial stage of implementation.There is no uniform provision for the access at the national legislative level.The relevant legal norms are mainly based on normative documents,which has relatively low legal rank.In addition,the conditions for alignment are mostly principle requirements and lack of detailed regulations.China’s current laws determine that the civil affairs department is the main supervisory authority for pension institutions.From the time of entry,operation,and withdrawal,the civil affairs department plays a major regulatory role.However,the Medical-healthcare combined institutions is a part of the old-age care institution that incorporates medical components.The supervision of the health and family planning department will inevitably be indispensable in the process.It will still require the approval of the Health and Family Planning Commission when it is approved by the civil affairs department.This is the biggest difference between the Medical-healthcare combined institutions and ordinary old-age care institutions.Multi-sector supervision,which may create unclear powers and responsibilities and duplicate supervision,it also leaves a lot of room for the seeking rent by power.In addition,the inability to include medical insurance is also an important reason to hinder the access of Medical-healthcare combined institutions.Because the reimbursement of medical expenses directly affects the occupancy rate of medical institutions,it also needs attention.In response to these problems,first,we should improve the legislation on the access of medical institutions,determine the issues that should be reviewed when the sponsors apply for establishment,and also clear up existing legal documents,abolish outdated,promote new and effective,while improving the corresponding supporting policies.Second,the responsibilities of various regulatory bodies should be clarified.For instance,the implementation of the power list system can not only limit the discretionary power of the regulators,but also clarify the responsibilities between the various regulatory agencies.Again,the procedures for approval and licensing should be improved.The Medical-healthcare combined institutions and the ordinary old-age care institutions should be distinguished firstly,and then the necessary conditions and procedures should be set according to the different types of the Medical-healthcare combined institutions.The market entry “negative list” system can be introduced experimentally for the approval of licenses,and gradually changes the admission method of permitting from " Strict access with Permissive supervision" to "Permissiveaccess with Strict supervision ",which could not only lower the threshold for entry,but also force the competent authorities to improve their supervision capabilities.Finally,it is necessary to improve the medical insurance application system and treat public and private medical institutions in a unified manner.The medical support institutions that meet the statutory requirements for medical insurance should not be rejected.Only in this way can we establish a reasonable and effective legal system for the the Medical-healthcare combined institutions,which will be the first step for the healthy development of China’s old-age care industry.