Chapter 533

Soon after, Si Daiqiang arrived, and Ceng Ming and a few others greeted him, then voluntarily left the room.

Si Daiqiang said with a smile, "Your drinking capacity is no good; you still need to practice!"

Lu Fan replied, "I usually drink very little, unless I meet you and then I drink to my heart's content! Daiqiang, congratulations on taking a big step forward; from now on, the sea is wide for the fish to leap, the sky is high for the birds to fly!"

"A few days ago I went to Nanling to report work; I estimate you won't be staying in Nanyuan much longer—just a matter of a couple days. Secretary Hong Tao is especially paying attention to your work! Lu Fan, are you still going ahead with that medical reform?"

"Going ahead, I'm currently planning it, intending to implement it this month."

"Still referring to the elderly and minors? Nanyuan has a population of 10 million; can the finances handle it?"

Lu Fan thought for a moment and said: "Nanyuan has conducted a deep anti-corruption drive in the medical field, extracting several billion yuan of corrupt funds from those corrupt elements. Moreover, the Municipal Discipline Inspection Committee and the Municipal Health Commission have strengthened supervision over the city's medical institutions, reducing medical costs by one-third, which is the foundation for carrying out medical reform. I had the Health Commission calculate it, and the average medical expenditure per person in Nanyuan is about 3800 yuan, of which the personal burden accounts for no more than 30%, i. e., about 1100 yuan. The population under 18 in Nanyuan is around 3 million, and those aged 60 and above are about 1.87 million. I estimate that the finances will need to increase investment by roughly 5 billion yuan per year."

Nanyuan has developed well over the past two years; both the municipal finances and the finances of the counties and districts have shown clear growth. I have kept tight rein on image projects and performance projects, so they dare not mess around arbitrarily, thus we have accumulated some reserves and can still strive for higher-level funds; gritting our teeth, we can get it started. But I worry that if someone else becomes the Municipal Party Secretary, this policy might not be sustained—you understand!

Si Daiqiang said: "Starting anything is difficult; once this people-benefiting policy is implemented, no leader would dare to defy heaven and stop it, for they would be cursed by the entire city's populace—even if forced, they would have to carry it out. Nanyuan needs 5 billion; Yingjiang would need at most 1.5 billion, which is enough. I will strive for some funds from above, and gritting our teeth we can also get it started."

Lu Fan said with a smile: "That's not necessarily true; your per capita medical expenses are definitely over 4000 yuan. I suggest you first bring down the costs and establish the supervisory system; otherwise it becomes a bottomless pit—the more money poured in, the worse the corruption problem, and eventually it will drag down the finances."

Si Daiqiang nodded in agreement, saying: "This is indeed a major stubborn obstacle and a stumbling block, the 'chief culprit' behind persistently high medical costs! Lu Fan, get it done quickly; I will send people to observe and learn throughout the process."

"Alright, but I will collect some tuition. When I was in high school, I had a few close classmates who have been stuck in Zhengke-level positions for many years; please, Secretary Si, give them a leg up!"

Si Daiqiang smiled and said: "Who doesn't have a few close friends? It's a small matter; just give me the list, and it's convenient because we are recently adjusting personnel." For him, the Deputy Division Level is already insignificant—just a matter of saying hello to the Organization Department.

"Then thank you; I should be heading off as well. There's a lot going on in the city this afternoon, and the head of the Transportation Bureau is coming for an inspection, so I need to accompany him for a meal."

"Alright, then I won't keep you. Next time when you go to Jingcheng to get in touch, we'll have another hearty drinking session."

……

After bidding farewell to Si Daiqiang and his brothers, Lu Fan returned to Nanyuan.

On the way, he called Zhu Jianglin and briefly mentioned a few words about promotion.

This made several high school classmates overjoyed; they had discussed it several times, wanting to go to Nanyuan to seek help from old classmates, but they never expected that Lu Fan would silently resolve it for them, leaving several people feeling grateful and moved.

Upon returning to Nanyuan, Lu Fan immediately convened Mayor Su Xiang Hai, Deputy Secretary Wang Hong, Discipline Inspection Committee Secretary Du Wenlong, Vice Mayor Ma Caihong, Finance Bureau Director Han Shimin, Health Commission Director Lu Kun, Medical Insurance Bureau Director Zheng Fengyu, and Human Resources Bureau Director Fang Wen, holding a small-scale meeting to study Nanyuan's medical reform.

After everyone had gathered, Lu Fan said: "I've called you all here for one matter—to sum up the medical reform. Last year I already told you all that I wanted to implement free medical care for minors and those aged 60 and above; the Health Commission and the Medical Insurance Bureau have also done some related work, and the situation is clear to everyone."

A few days ago, the director of the Provincial Medical Insurance Bureau came to Nanyuan for an inspection and issued the 'Opinions' supporting Nanyuan in building a strong sub-center, clearly stating that from five aspects they would assist and promote the high-quality development of our medical security undertaking. Support Nanyuan's pilot development of the traditional Chinese medicine industry; support Nanyuan's smart medical insurance construction, exploring diversified composite medical insurance payment methods such as TCM specialty disease groups, day surgery, per-bed per diem payment, per-capita payment, etc.; support the pilot city construction of 'one-stop online handling' and 'one matter handled once' for medical insurance government services; support the pilot of Nanyuan's service-oriented rule-of-law medical insurance construction; support full coverage of medical security for low-income rural populations.

Moreover, the Provincial Health Commission also gave us strong support; these are favorable news for Nanyuan's medical undertakings development and medical reform. I have a suggestion: this medical reform must definitely bring in the Provincial Health Commission and the Provincial Medical Insurance Bureau, letting them participate fully, and turn them into pilot programs for the two bureaus, letting them take the credit—Nanyuan's people just need to reap the benefits!

Mayor Su Xiang Hai said with a smile: "Secretary, your insight is high; the provincial bureaus' support can make our medical reform twice as effective with half the effort. Moreover, when the Provincial Health Commission conducted its research, they showed strong interest in our medical reform, and Director Wang He had an in-depth exchange with me; bringing them on board is absolutely no problem!"

Lu Fan said: "Xianghai, you personally handle this matter and strive to obtain financial support from the Provincial Health Commission and the Medical Insurance Bureau. Before implementing the medical reform, we must do these things: first, let the Health Commission take the lead, increase work efforts, and press down medical costs! Optimize medical procedures, improve the utilization rate of medical equipment and reduce unnecessary operations by medical staff, reduce unnecessary inspections, tests, and surgeries, etc., to avoid over-medicalization and over-treatment, and comprehensively reduce inflated prices and unreasonable charges. Lu Kun, state your position—can you do it?"

The director of the Municipal Health Commission, Lu Kun, hurriedly said: "Please rest assured, Secretary; our city's medical environment has already undergone a fundamental transformation, and I am confident I can complete the task you assigned."

Lu Fan nodded and said: "Second, let the Medical Insurance Bureau take the lead to thoroughly press down drug prices! Our country has over 6700 drug manufacturers, and drug production is severely oversupplied. To sell their products, manufacturers can only choose to increase the profit or fees in the distribution links to incentivize pharmaceutical and drug wholesalers to achieve sales."

The current drug distribution channel proceeds from drug manufacturers, agents, wholesalers, retailers, or medical institutions to consumers, including multiple levels of agents and pharmaceutical representatives; drugs go from manufacturers through a series of distribution links before finally reaching consumers' hands, and the cost markups from the complex distribution links are one of the important reasons for inflated drug prices.

Nanyuan must certainly let the 'using drugs to support medical care' model exit the historical stage, completely sever the interest chain between hospitals and pharmaceutical enterprises/suppliers, comprehensively promote centralized tender procurement, directly connect with manufacturers, and implement controlled drug pricing. By squeezing out drug sales expenses and changing the 'kickback sales' model, we can purify the medical staff's practice environment and promote rational drug use.

Fengyu, state your position!

The director of the Municipal Medical Insurance Bureau, Zheng Fengyu, bluntly said: "Secretary, I have been studying this work recently; the Medical Insurance Bureau will surely fulfill the task perfectly!"

Lu Fan continued: "Third, the Municipal Finance Bureau should do well in fund estimation and allocation; let's discuss how the investment involved in the medical reform should be divided between the municipal and county levels."

Mayor, who controls the money, Su Xiang Hai spoke first: "Secretary, can we split it fifty-fifty? Each side bears 50%."

Lu Fan shook his head and said: "The pressure on the counties and districts is great, and their situation is not as good as in the city. If the city bears 50%, it will definitely still seek higher-level funds, whereas the counties would actually have to come up with real money; we cannot let their burden become too heavy. Xianghai, there is about 5 billion yuan in the integrity account; I have been holding onto this money without moving it, intending to invest it in the medical reform—hand it over to you for full use."

Su Xiang Hai said with a smile: "With the Secretary's support, I feel much lighter all of a sudden! How about the city bearing 70%?"

Deputy Secretary Wang Hong said: "The counties and districts also vary between rich and poor; Secretary, I feel we shouldn't practice egalitarianism—give less subsidy to the rich and more to the poor counties, otherwise some counties' financial pressure will be too great; this is like squeezing money straight out of their pockets!"

Wang Hong's words won partial approval from the leaders, indicating that some counties and districts indeed face financial difficulties and should be properly taken care of.

Lu Fan said with a smile: "Everyone's opinions are good; we won't practice egalitarianism, but will follow what you said—give less to the rich and more to the poor, just like a family living together will surely take care of the poorer child! Let's do this: according to fiscal revenue balance, the top four get a 60% subsidy, the middle four get 70%, and the bottom four get 80%. Xianghai, you explain this to the counties and districts, so that all the city's people can enjoy the people-benefiting policy; there's no way to split the water evenly, so let them raise their political stance and display their style. If anyone truly can't understand, let them come find me, and I'll explain it to them."

Su Xiang Hai replied: "Alright, I believe the comrades can understand the Secretary's painstaking efforts!"

Finally, Lu Fan said: "Comrades, the level of medical security is an important 'benchmark' of people's livelihood happiness, concerning the health and well-being of the broad masses of the people, and the public's concerns and expectations. We must certainly rise to the challenge, take proactive action, and completely eliminate the phenomenon in Nanyuan where 'when one person falls ill, the whole family is affected'."

I have an idea: to fully leverage Nanyuan's advantages in traditional Chinese medicine characteristics to aid Nanyuan's medical reform construction. Practice is the sole criterion for testing truth; the ancestral medical knowledge passed down for thousands of years has cured countless people.

The Zhang Zhongjing National University of Chinese Medicine is about to start enrollment; we must strongly support the development of traditional Chinese medicine, so that Nanyuan truly becomes a 'National Capital of Traditional Chinese Medicine'! We need to introduce supporting policies and measures, as well as reward schemes, to promote deep participation of traditional Chinese medicine in the medical reform and to support the development of the traditional Chinese medicine industry, thereby providing strong policy and institutional guarantees for Nanyuan's traditional Chinese medicine development.

The Health Commission and the Medical Insurance Bureau should first come up with a plan; this matter must be implemented by May.