Deepening The Reform Of Medical And Healthcare System:Depending On National Essential Medicines System In Sichuan Province

On August18,2009, China’s National Development and Reform Commission, as well as the Ministry of Health and other nine ministries together delivered Views on the Establishment of a National Essential Medicines System. It witnessed the official establishment of China’s National Essential Medicines System. National Essential Medicines System made its list, production and supply, procurement and distribution, rational use, price management, payment of reimbursement, quality supervision, monitoring and evaluation, and other aspects under the implementation of effective management. China plans to fulfill the National Essential Medicines System with full implementation of the specification in2020, covering both urban and rural areas. It is also going to develop the ambitious reform goals in basically establish a basic medical and healthcare system covering both urban and rural residents in2020so as to achieve universal access to basic health services. In2012, it is now a start for two new career start, which has a significance of connecting the past and the future in both the research on medical and healthcare system reform and the National Essential Medicines System.Essential Medicines System is one of the five key tasks of deepening medical and healthcare system reform for its connecting to the pharmaceutical industry and the healthcare system. It also has a dual function of protecting the supply of drugs and medical services, for which it becomes the most complex part of the medical and healthcare reform. Study of Essential Medicines System seems to bite a piece of "hard bone". However, it can effectively leverage the mechanism of medical institutions and deal with all hospitals under the system of "making a living by excessive sales of medicines" which led to excessive treatment to patients and artificially high drug prices. Essential Medicines System can also ensure that the masses buy safe, effective, inexpensive drugs to reduce their burden of medical costs and promote social equity and justice. Sichuan Province, as a western province, has a large population, vast hills, and plateaus in cold areas, the medical and healthcare system has been weak for a long time. Especially the three western states, ethnic minority areas, and remote areas had left far behind. Sichuan Province, in the process of full implementation of the new medicine and healthcare reform likewise suffered from the Wenchuan earthquake which added a huge challenge to the already grim form of medical reality. However, Sichuan Province, in the implementation of essential medicines system, fully integrated with the realities of the province and gained a lot of experience such as the focus on the village hospitals, the practical experience of a dollar prescription, low-cost but high-quality medicines. Sichuan has concentrated in essential medicines procurement and extended the implementation of the content of Essential Medicines System. All these made Sichuan rank in the forefront of the country.In this paper, the Essential Medicines System is applied as a research breakthrough of medical and healthcare reform. It will review the implementation of the policy framework of national Essential Medicines System in Sichuan Province and its progress. Examples in Santai County, Sichuan Province, Xinjin County and Mianzhu City come to be a case study to analyze Sichuan province’s Essential Medicines System from the point to the surface. This paper, moreover based on a combination of theory and practice, puts forwards "three existences" and "three unifications" to countermeasure against the four aspects of problems came across in Sichuan’s implementation of essential drug system. In addition, this paper further discusses the Essential Medicines System and grassroots administrative reform of the healthcare system under the background of medical and healthcare reform. Without a solid foundation, the ground will collapse! The base of grassroots medical and health administration are tightly related to the success of Essential Medicines System. This paper emphasizes that we start from four aspects such as the construction of primary health care, the personnel reform of the primary health care institutions, the reform of the distribution system in primary health care institutions, management mechanism reform in health administrative departments to reinforce the Essential Medicines System, as well as the medical and healthcare system.