As a basic medical service that all citizens should enjoy, the cost of medical insurance mainly comes from the government and social contributions from the working class. However, in recent years, with the growth of social security funds year by year, whether the management of medical insurance funds has grown rodently, people can't help but speculate whether there are deliberate gaps and capital flows.
According to the news, on April 18, Zhang Ming, head of the price procurement expert group of the National Health Insurance Bureau, was investigated on suspicion of bribery and corruption in the process of centralized medical procurement.
We all know that the purpose of centralized medical procurement is to save costs, reduce the unit price of drug procurement through large-scale procurement, and save expenses for the social security fund and patients' pockets. However, it is unbelievable that this insider of the Health Insurance Bureau actually put the purchase price four times higher than the retail market price.
According to a medical industry insider, in a pharmaceutical centralized procurement led by Zhang Ming, the quotation charged for the purchase of Fuyuan Pharmaceutical was nearly 4 times higher than the retail price, and the purchase price of Salubris Group was also 2 times higher than the retail price.
In this way, the purchase of a high price will cost an additional 600 million yuan for medical insurance in a centralized procurement. This money should have been used to provide medical assistance to more poor patients. But now it's corrupt money in someone's pocket inside the Health Insurance Bureau.
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In normal procurement operations, the centralized procurement price should be lower than the retail price, so that the purchasing unit and the end user can benefit. However, Zhang Ming actually overstated the price several times, which is undoubtedly taking advantage of his position for personal gain, harming the interests of the medical insurance fund and patients.
According to his procurement pricing standard, patients not only do not enjoy the preferential procurement of the same drugs, but need to pay a higher cost. If this vicious loophole is not plugged in time, it will lead to the loss of more medical insurance funds.
Remarkable achievements have been made in medical reform in recent years, but the problem of corruption in the interest link is still very prominent. As an important part of the medical safety net, if there are shortcomings in the operation of the medical insurance mechanism, it will inevitably have a negative impact on the masses. This case also proves that corrupt practitioners are not isolated in the medical sector, and internal collusion is difficult to detect.
The Health Insurance Bureau should immediately carry out a comprehensive audit of the procurement process of relevant personnel to prevent the recurrence of similar incidents again, so that the medical insurance funds can be used where they should be, so that the people can benefit the people.
The policy of highly centralized pharmaceutical procurement is well-intentioned, but if the important links are not strictly supervised in the implementation, it can easily become a hotbed for corrupt elements to seek rent and grow. The Zhang Ming case is a typical example.
As the decision-maker and executor within the medical insurance institution, he made full use of the convenience of information and operational gaps to collect kickbacks in the price setting process, and kept the medical insurance funds in his pocket. And judging from the amount of kickbacks, he has carried out such acts many times before, and it is very systematic.
There is obviously a major gap in the supervision of the medical insurance department in the implementation of the centralized procurement policy. The supervision of budget declaration and actual settlement is not effective, and the price remains high for a long time.
While enforcing discipline internally, there is no sound fraud reporting mechanism and punishment system to prevent the spread of such incidents from the source. Information communication and third-party monitoring and evaluation are not in place, making it difficult to detect and control major risks in a timely manner.
In order to make the supervision of the medical insurance system comprehensive and effective, the medical insurance department should focus on improving from many aspects: improve the multi-supervision mechanism, strengthen the synchronization of budget review and internal and external audits, establish reporting and blowing urn channels, and deal with internal fraud in a timely manner, regularly disclose the centralized procurement process and settlement data, strengthen social supervision, and widely attract third-party experts to participate in supervision and improve regulatory standards.
Only by exploring a set of scientific and efficient regulatory systems can medical insurance funds be truly locked at the end of the use of Huimin medical care and avoid a large amount of loss, which is the top priority of deepening medical reform.
We hope that the medical insurance department will deeply absorb this lesson and pay more attention to the construction of the regulatory system, so that medical insurance can get back on track and benefit more citizens.