Liao Xinbo

Liao Xinbo

Liao Xinbo, male, born in August 1956 in Taishan, Guangdong, Han nationality. He joined the Communist Party of China in July 1997 with bachelor's degree in medicine and master's degree in management. He once served as deputy director and member of the Party group of Guangdong health and Family Planning Commission. In April 2014, he was removed from the post of deputy director of the health and Family Planning Commission of Guangdong Province and changed to inspector of the health and Family Planning Commission of Guangdong Province.

Personal resume

From May 1974 to December 1975, he was a cadre of Shaoguan Administration for Industry and commerce. From December 1975 to March 1978, he worked in Shaoguan wireless electric appliance factory. He studied in the medical department of Guangzhou Medical College from March 1978 to March 1982. From December 1982 to February 2004, he worked in Guangdong Provincial People's Hospital, and successively served as a pathologist, attending physician, deputy chief physician, deputy director of the hospital office, assistant director of the hospital, director of the office, and deputy director of the hospital. Period: from July 1991 to June 1993, he went to George Washington University to study at his own expense. He graduated from China Europe International School of business administration from 2000 to 2003 and from Lingnan College of Sun Yat sen University in 2005. From June to August 2005, he participated in the CUHK Oxford Advanced Seminar on Public Administration for senior civil servants organized by the Organization Department of the provincial Party committee. He also served as visiting professor of Lingnan College of Sun Yat sen University and mph tutor of School of public administration of Sun Yat sen University. After February 2004, he served as deputy director of the Department of health of Guangdong Province and member of the Party group. On September 24, 2013, the general office of Guangdong provincial government announced that Guangdong Provincial Department of health and Guangdong Provincial Population and Family Planning Commission, the existing constituent departments of Guangdong provincial government, were merged to establish Guangdong Provincial Health and Family Planning Commission, and served as deputy director of Guangdong Provincial Health and Family Planning Commission.

Interpretation of the new plan of health care reform

brief introduction

Liao Xinbo's new health care reform plan is not exciting. The national development and Reform Commission released "opinions on deepening the reform of the medical and health system (Draft)" to solicit opinions from the public. The public opinions have different opinions on the scheme, and one obvious complaint is "not understanding".

In this regard, we interviewed Liao Xinbo, deputy director of the Department of health of Guangdong Province, and asked him to interpret the new plan.

Summarize the new plan

In the simplest words, what is the purpose of this consultation? What is your biggest puzzle?

Liao Xinbo: I just published the view that "there is no exciting point in the new scheme" on my blog. We can compare with the decision of the CPC Central Committee and the State Council on health reform and development in 1997. The goal of the old plan in 1997 is to "basically realize that everyone enjoys primary health care and further improve the national health level". The goal of the draft is "everyone enjoys basic medical and health services, basically meets the people's multi-level medical and health needs, and further improves the people's health level.". It can be seen that after 10 years, China's economy has undergone tremendous changes, but our goal of health care reform is still at the original level, or even retrogressive!

Both the old and the new "plans" clearly put forward the leading role of the government, and also mentioned the leading role of government investment. There are also "developing community health care", "implementing regional health planning", "preventing the tendency of one-sided pursuit of economic benefits while ignoring social benefits", etc., which have long been highlighted in the "old medical reform plan" in 1997. But what does it actually do?

From the perspective of data, the proportion of personal health expenditure in total expenditure in China increased from 35.7% in 1990 to 58.3% in 2002, while the proportion of government health expenditure decreased from 25.1% to 15.2% in the same period, and the proportion of social expenditure also decreased significantly from 39.2% to 26.5%.

China's health work has always adhered to the principle of "prevention first", but the expenditure structure of health service fee does not meet the national policy objectives of "prevention first" and "health care for all". The lack of national investment in public health will lead to the dislocation of the functions of public health institutions, excessive dependence on paid services, and insufficient provision of public health services.

programme

Therefore, no matter how good the medical reform plan is, if it is put on the shelf, it can only be an article on paper and can not be understood and realized. This is my biggest puzzle.

When it comes to "seeking public opinions" this time, why didn't the public understand the specific direction?

Liao Xinbo: there are multiple meanings for people not to understand. One is "professionalism" and the other is "feasibility". I have said for a long time that the problems we encountered in the past health care reform have not been well solved in the new plan, that is, there are no tools to solve the problems.

Some people say that "the new plan has many directional goals", but these goals have always been what we are exploring and pursuing. Because no matter how big and how many goals are, they are all for one goal: everyone has access to basic medical services. In fact, in the 10 years since the implementation of the old plan in 1997, our distance from the overall goal has not been significantly narrowed, and some sub goals have gone against the same direction.

For the common people, what they care about most is how much money I will pay to see a doctor in the future? If I'm sick, who will protect me? As a government, it needs an executable program and tools to implement it. I think if this plan is to be introduced in the short term, there may be very little chance to adopt your opinions and suggestions. In other words, there will not be much change in the plan unless it is delayed.

forecast

What are the details of the next step?

Liao Xinbo: to achieve this goal, we must formulate some implementation measures and supporting documents. Most of these supporting documents are the redistribution of departmental interests. Therefore, it depends on how our policy makers consider the overall situation of the whole country's medical and health development and the fundamental interests of the people to formulate feasible measures, rather than the narrow administrative concept of "defending one's own territory".

North South difference

China has a large population. There are huge differences between the East and the West and between the South and the north in terms of medical level and social resources. Will there be some acclimatization in a comprehensive medical reform plan?

Liao Xinbo: China has a vast territory, and the regional economic level varies greatly. It is unrealistic to formulate a nationwide plan in the short term. As a matter of fact, all localities are already making various attempts and have their own regional development programs. As a national level program, they only need to formulate a framework, and all localities will supplement it according to their own conditions and gradually move towards the direction of great harmony.

The metaphor of building a house is the most appropriate. The central government formulates a framework standard with a certain defensive ability, and all localities "decorate" it according to the actual situation, so as to provide all members of the society with suitable "living" standards. Of course, those who do not want to live in "collective apartments" can live in "villas" by themselves. The "framework" of the government must be able to withstand the wind and rain, not the "shelter" or "tent" that can not withstand the wind and rain.

This healthcare reform proposes to increase government investment while breaking government monopoly. How to understand these two seemingly contradictory efforts?

Liao Xinbo: it is necessary to establish a multi-level medical service system, which is the most effective means to achieve the unity of fairness and efficiency.

The government should understand its own responsibilities, accurately position its functions, not be absent, not misplaced, not offside. It should not do what it needs to do in the future ahead of time. It should do what it can, and it should also do what it should do, such as solving the problem of fairness and accessibility of medical services. We should also make clear what kind of medical services we can provide to the public, what the service content is and what it is. It should be increased and decreased year by year.

Therefore, at the present stage or in the future, we should encourage a variety of different ingredients to standardize the operation of medicine according to laws and regulations, rather than blindly. We should encourage non-public capital to provide comfortable and enjoyable medical services for the high-end class. That is to say, we should divide the basic attributes of medical services into pure public welfare, semi public welfare and non public welfare (private). Only in this way can we solve the public attribute of public goods fairly. As a matter of fact, the government will basically fulfill its responsibilities if it manages basic medical care well and attaches importance to medical scientific research, which is what some experts call "grasping both ends and putting the middle".

Any attempt by the government to monopolize "medical service products" is not beneficial to the society. However, many of our current policies hinder the investment of non-public capital in the medical market. Governments at all levels, including the operators of public hospitals, have the idea of "monopoly" for fear of impact on public hospitals.

Hospital system reform

The reform of hospital system is also a hot topic. At present, the best hospitals in China are all public hospitals. Will this situation change greatly in the next step?

Liao Xinbo: just according to the "guiding opinions", large hospitals may face severe difficulties. What we are worried about is how the government will compensate after the new deal, whether it will invest money or give policy? Big hospitals are different from grass-roots hospitals. They are not only specialized hospitals for solving "difficult and miscellaneous diseases", but also important bases for medical education. They are also the comprehensive embodiment of the medical level of a region and a country.

There are many contradictions in the new health care reform plan. On the one hand, it emphasizes the government's leading role, on the other hand, it doesn't want to invest more money, for example, to make up for the drug mark up through pharmaceutical expenses; on the other hand, it advocates the public welfare of government hospitals and relies on large hospitals to exercise government functions. Such as "city"

Chinese PinYin : Liao Xin Bo