sanming healthcare reform 三明医改 sānmíng yīgǎi
A healthcare reform mode originating in 2012, when insurance funds in Fujian’s Sanming City province dealt with issues threatening localities nationwide such as
health insurance funds in deficit
state finances declining to cover the shortfall
the public hit by crippling medical costs
doctors paid low salaries
A leadership group coordinating the response was set up by Zhan Jifu 詹积富 then a Sanming vice mayor. It tackled pharmaceutical and medical supplies issues via
launching zero mark-up sales on medical supplies citywide
limiting pharmaceuticals within the ‘two-invoice system’
limiting purchase of a given pharmaceutical to a maximum of two receipts
centralised volume-based procurement
real-time monitoring of high-cost drugs with uncertain efficacy
controlling inflated prescriptions and trimming charges for major equipment tests
Medicine prices and healthcare costs fell citywide. Insurance fund deficits were curbed, with surpluses for years in a row. Service fees were raised, rewarding skills. Total salaries paid out in 2013 rose from C¥ 382 mn to 2.0 bn 2011–22.
State Council issued its ‘Key tasks for deepening healthcare system reform 2021’ in June 2021, urging ‘promoting Sanming reforms nationwide, speeding up coordinated reform of medical services, health insurance, and medicines’. With a growing elderly population straining healthcare insurance, State Council reiterated the need for Sanming-style reform on 6 June 2024.