《中國的醫(yī)療衛(wèi)生事業(yè)》白皮書(漢英對照版)

1、中國的醫(yī)療衛(wèi)生事業(yè)白皮書White Paper: Medical and Health Services in China中華人民共和國國務(wù)院新聞辦公室26日發(fā)表中國的醫(yī)療衛(wèi)生事業(yè)白皮書。全文如下：The State Council Information Office of the People's Republic of China on Wednesday published a white paper on the medical and health services in China. Following is the full text of the white pape

2、r:中國的醫(yī)療衛(wèi)生事業(yè)(2012 年 12 月)中華人民共和國國務(wù)院新聞辦公室Medical and Health Services in China(December 2012)Information Office of the State CouncilThe People's Republic of China目錄Contents前言Foreword一、衛(wèi)生基本狀況I. Basic Conditions二、醫(yī)藥衛(wèi)生體制改革II. Reform of Medical and Healthcare Systems三、傳染病防治與衛(wèi)生應(yīng)急III. Infectious Disease

3、Prevention and Treatment, and Health Emergency Management四、慢性非傳染性疾病防治IV. Prevention and Treatment of Chronic Non-communicable Disorders五、婦女兒童健康權(quán)益保護(hù)V. Protecting Women and Children's Right to Health六、中醫(yī)藥發(fā)展VI. Development of Traditional Chinese Medicine七、衛(wèi)生國際合作VII. International Medical and Health

4、care Cooperation結(jié)束語Conclusion前言 Foreword健康是促進(jìn)人的全面發(fā)展的必然要求。提高人民健康水平，實現(xiàn)病有所醫(yī)的理想，是人類社會的共同追求。在中國這個有著13 億多人口的發(fā)展中大國，醫(yī)療衛(wèi)生關(guān)系億萬人民健康，是一個重大民生問題。Good health is a prerequisite for promoting all-round development of the person. And it is a common pursuit of human societies to improve people's health and ensure

5、their right to medical care. For China, a large developing country, medical and healthcare is of vital importance to its population of over 1.3 billion, and is a major issue concerning its people's well being.中國高度重視保護(hù)和增進(jìn)人民健康。憲法規(guī)定，國家發(fā)展醫(yī)療衛(wèi)生事業(yè)，發(fā)展現(xiàn)代醫(yī)藥和傳統(tǒng)醫(yī)藥，保護(hù)人民健康。圍繞憲法，中國逐步形成了相對完善的衛(wèi)生法律法規(guī)體系。China pays

6、 great attention to protecting and improving its people's health. As the Constitution stipulates, "The state develops medical and health services, promotes modern medicine and traditional Chinese medicine., all for the protection of the people's health." Based on this constitutiona

7、l stipulation, China has put in place a complete system of laws and regulations concerning medical and health services.多年來，中國堅持“以農(nóng)村為重點(diǎn)，預(yù)防為主，中西醫(yī)并重，依靠科技與教育，動員全社會參與，為人民健康服務(wù)，為社會主義現(xiàn)代化建設(shè)服務(wù)”的衛(wèi)生工作方針， 努力發(fā)展具有中國特色的醫(yī)療衛(wèi)生事業(yè)。經(jīng)過不懈努力，覆蓋城鄉(xiāng)的醫(yī)療衛(wèi)生服務(wù)體系基本形成，疾病防治能力不斷增強(qiáng)，醫(yī)療保障覆蓋人口逐步擴(kuò)大，衛(wèi)生科技水平日益提高，居民健康水平明顯改善。Over the years, Chi

8、na has worked hard to develop its medical and health services with Chinese characteristics in accordance with the policy of "making rural areas the focus of our work, putting disease prevention first, supporting both traditional Chinese medicine and Western medicine, relying on science, technol

9、ogy and education, and mobilizing the whole of society to join the efforts, improving the people's health and serving socialist modernization." Thanks to unremitting efforts that have been made, medical and healthcare systems covering both urban and rural residents have taken shape, the cap

10、abilities of disease prevention and control have been enhanced, the coverage of medical insurance has expanded, continuous progress has been made in medical science and technology, and the people's health has been remarkably improved.為建立起覆蓋城鄉(xiāng)居民的基本醫(yī)療衛(wèi)生制度，保障每個居民都能享有安全、有效、方便、價廉的基本醫(yī)療衛(wèi)生服務(wù)，中國深入推進(jìn)醫(yī)藥衛(wèi)生體

11、制改革，取得了 重要階段性成效。To put into place basic medical and healthcare systems covering both urban and rural residents, and ensure that every resident has access to safe, effective, convenient and affordable basic medical and health services, China has kept advancing the reform of its medical and healthcare

12、 system, and made important achievementsin the current stage.一、衛(wèi)生基本狀況I. Basic Conditions居民健康狀況不斷改善。從反映國民健康狀況的重要指標(biāo)看，中國居民的健康水平已處于發(fā)展中國家前列。2010年人均期望壽命達(dá)到74.8歲， 其中男性72.4歲，女性 77.4歲。 孕產(chǎn)婦死亡率從2002年的 51.3/10萬下降到2011 年的 26.1/10萬。嬰兒死亡率及5歲以下兒童死亡率持續(xù)下降，嬰兒死亡率從 2002年的29.2%下 降到2011年的12.1 %0, 5歲以下兒童死亡率從2002年的34.9 %下降到2

13、011年 的15.6%,提前實現(xiàn)聯(lián)合國千年發(fā)展目標(biāo)。The people's health has been improved. Judging from important indicators that give expression to national health, the health of the Chinese people is now among the top in developing countries. In 2010, the life expectancy was 74.8 years - 72.4 years for males and 77.4 y

14、ears for females; the maternal mortality rate went down from 51.3 per 100,000 in 2002 to 26.1 per 100,000 in 2011; the infant mortality rate and the mortality rate of children under the age of five have kept dropping, with the former going down from 29.2 per thousand in 2002 to 12.1 per thousand in

15、2011, and the latter, from 34.9 per thousand to 15.6 per thousand, attaining ahead of schedule the UN Millennium Development Goal in this regard.建立起覆蓋城鄉(xiāng)的醫(yī)療衛(wèi)生體系。一是公共衛(wèi)生服務(wù)體系。包括疾病預(yù)防控制、健康教育、婦幼保健、精神衛(wèi)生、衛(wèi)生應(yīng)急、采供血、衛(wèi)生監(jiān)督和計劃生育等專業(yè)公共衛(wèi)生服務(wù)網(wǎng)絡(luò)，以及以基層醫(yī)療衛(wèi)生服務(wù)網(wǎng)絡(luò)為基礎(chǔ)、承擔(dān)公共衛(wèi)生服務(wù)功能的醫(yī)療衛(wèi)生服務(wù)體系。二是醫(yī)療服務(wù)體系。在農(nóng)村建立起以縣級醫(yī)院為龍頭、鄉(xiāng)鎮(zhèn)衛(wèi)生院和村衛(wèi)生室為基礎(chǔ)的

16、農(nóng)村三級醫(yī)療衛(wèi)生服務(wù)網(wǎng)絡(luò)，在城市建立起各級各類醫(yī)院與社區(qū)衛(wèi)生服務(wù)機(jī)構(gòu)分工協(xié)作的新型城市醫(yī)療衛(wèi)生服務(wù)體系。三是醫(yī)療保障體系。這個體系以基本醫(yī)療保障為主體、其他多種形式補(bǔ)充醫(yī)療保險和商業(yè)健康保險為補(bǔ)充?；踞t(yī)療保障體系包括城鎮(zhèn)職工基本醫(yī)療保險、城鎮(zhèn)居民基本醫(yī)療保險、新型農(nóng)村合作醫(yī)療和城鄉(xiāng)醫(yī)療救助，分別覆蓋城鎮(zhèn)就業(yè)人口、城鎮(zhèn)非就業(yè)人口、農(nóng)村人口和城鄉(xiāng)困難人群。四是藥品供應(yīng)保障體系。包括藥品的生產(chǎn)、流通、價格管理、采購、配送、使用。近期重點(diǎn)是建立國家基本藥物制度。Medical and healthcare systems covering both urban and rural residents

17、 have been put in place. Of these systems, the first is the public health service system, which covers disease prevention and control, health education, maternity and child care, mental health, health emergency response, blood collection and supply, health supervision, family planning and some other

18、 specialized public health services, and a medical and healthcare system based on community-level healthcare networks that provides public health services. The second is the medical care system. In the rural areas, it refers to a three-level medical service network that comprises the county hospital

19、, the township hospitals and village clinics, with the county hospital performing the leading role, and township hospitals and village clinics service at the base. And in the cities and towns, it refers to a new type of urban medical health service system that features division of responsibilities a

20、s well as cooperation among various types of hospitals at all levelsand community healthcare centers. The third is the medical security system. This system comprises mainly the basic medical security, supported by many forms of supplementary medical insurance and commercial health insurance. The bas

21、ic medical security system covers basic medical insurance for working urban residents, basic medical insurance for non-working urban residents, a new type of rural cooperative medical care and urban-rural medical aid, which cover, respectively, the employed urban population, unemployed urban populat

22、ion, rural population and people suffering from economic difficulties. And the fourth is the pharmaceutical supply system, which covers the production, circulation, price control, procurement, dispatching and use of pharmaceuticals. The recent work is focused on establishing a national system for ba

23、sic drugs.衛(wèi)生籌資結(jié)構(gòu)不斷優(yōu)化。衛(wèi)生籌資來源包括政府一般稅收、社會醫(yī)療保險、商業(yè)健康保險和居民自費(fèi)等多種渠道。2011 年，中國衛(wèi)生總費(fèi)用達(dá)24345.91 億元人民幣，同期人均衛(wèi)生總費(fèi)用為1806.95元人民幣，衛(wèi)生總費(fèi)用占國內(nèi)生產(chǎn)總值的比重為5.1%。按可比價格計算，1978 2011 年，中國衛(wèi)生總費(fèi)用年平均增長速度為11.32%。 個人現(xiàn)金衛(wèi)生支出由2002年的57.7%下降到2011 年的34.8%， 衛(wèi)生籌資系統(tǒng)的風(fēng)險保護(hù)水平和再分配作用不斷提高。2011 年，醫(yī)院、門診機(jī)構(gòu)費(fèi)用為18089.4億元人民幣，公共衛(wèi)生機(jī)構(gòu)費(fèi)用為2040.67億元人民幣，分別占衛(wèi)生總費(fèi)用的71

24、.74%和 8.09%。醫(yī)院費(fèi)用中，城市醫(yī)院、縣醫(yī)院、社區(qū)衛(wèi)生服務(wù)中心、鄉(xiāng)鎮(zhèn)衛(wèi)生院費(fèi)用分別占64.13%、 21.28%、 5.17%、 9.3%。The health financing structure has been constantly improved. China's health expenditure comes from the government's general tax revenue, social medical insurance, commercial health insurance, residents' out-of-pock

25、et spending, etc. In 2011, the total health expenditure in China reached 2,434.591 billion yuan, 1,806.95 yuan per capita. The total expenditure accounted for 5.1% of the country's GDP. In comparable prices, the health expenditure grew by an average annual rate of 11.32% from 1978 to 2011. Indiv

26、idual "out-of-pocket" spending declined from 57.7% in 2002 to 34.8% in 2011, showing that health financing is working better in the areas of risk protection and re-distribution. In 2011, the spending on hospitals and outpatient establishments was 1,808.94 billion yuan, and that on public h

27、ealth agencies, 204.067 billion yuan, comprising 71.74% and 8.09%, respectively, of the total health expenditure. Of the total spending on hospitals, those on urban hospitals, county hospitals, community health service centers and township health service centers stood at 64.13%, 21.28%, 5.17% and 9.

28、3%, respectively.衛(wèi)生資源持續(xù)發(fā)展。截至 2011 年底， 全國醫(yī)療衛(wèi)生機(jī)構(gòu)達(dá)95.4萬個（所 ）， 與 2003年比較，醫(yī)療衛(wèi)生機(jī)構(gòu)增加14.8 萬個（所 ）。執(zhí)業(yè)（助理）醫(yī)師246.6萬人，每千人口執(zhí)業(yè)（助理）醫(yī)師數(shù)由2002年的 1.5人增加到1.8人。注冊護(hù)士224.4萬人，每千人口注冊護(hù)士數(shù)由2002年的 1 人增加到1.7 人。醫(yī)療衛(wèi)生機(jī)構(gòu)床位數(shù)516 萬張，每千人口醫(yī)療衛(wèi)生機(jī)構(gòu)床位數(shù)由2002 年的 2.5張?zhí)岣叩?.8張。Health resources have been developing in a sustained way. By the end of

29、 2011, medical and healthcare institutions around the country totaled 954,000, an increase of 148,000 over 2003. Licensed doctors （assistants） reached 2,466,000, or 1.8 perthousand people, as compared with 1.5 per thousand people in 2002. Registered nurses totaled 2,244,000, or 1.7 per thousand peop

30、le, as compared with one per thousand people in 2002. The number of hospital beds reached 5160,000, or 3.8 per thousand people, as compared with 2.5 per thou-sand people in 2002.醫(yī)療衛(wèi)生服務(wù)利用狀況顯著改善。2011 年，全國醫(yī)療機(jī)構(gòu)診療人次由2002 年的21.5億人次增加到62.7億人次， 住院人數(shù)由2002年的 5991 萬人增加到1.5億人。中國居民到醫(yī)療衛(wèi)生機(jī)構(gòu)年均就診4.6次， 每百居民住院11.3人， 醫(yī)

31、院病床使用率為88.5%， 醫(yī)院出院者平均住院日為10.3天。 居民看病就醫(yī)更加方便，可及性顯著提高。15分鐘內(nèi)可到達(dá)醫(yī)療機(jī)構(gòu)住戶比例，由2003年的80.7%提高到2011年的83.3%，其中農(nóng)村地區(qū)為80.8%。醫(yī)療質(zhì)量管理和控制體系不斷完善。建立無償獻(xiàn)血制度，血液安全得到保障。Marked improvement has been seen in the utilization of medical and health services. In 2011, medical institutions throughout the country hosted 6.27 billion o

32、utpatients, as compared with 2.15 billion in 2002; and admitted 150 million inpatients, as compared with 59.91 million in 2002. That year, Chinese residents went to the medical institutions for medical treatment 4.6 times on average; 11.3 of every 100 people were hospitalized; the utilization rate o

33、f hospital beds reached 88.5%; and the hospital stay of the inpatients averaged 10.3 days. These figures show that it has become increasingly convenient to see a doctor and more easily accessible to get medical services. In 2011, 83.3% of all households (80.8% in rural areas) could reach medical ins

34、titutions within 15 minutes, as compared with 80.7% in 2002. Medical service quality management and control systems have been constantly improved. A system of blood donation without compensation has been established, so as to ensure blood supply and safety.二、醫(yī)藥衛(wèi)生體制改革II. Reform of Medical and Healthc

35、are Systems經(jīng)過多年努力，中國衛(wèi)生事業(yè)取得顯著發(fā)展成就，但與公眾健康需求和經(jīng)濟(jì)社會協(xié)調(diào)發(fā)展不適應(yīng)的矛盾還比較突出。特別是隨著中國從計劃經(jīng)濟(jì)體制向市場經(jīng)濟(jì)體制的轉(zhuǎn)型，原有醫(yī)療保障體系發(fā)生很大變化，如何使廣大公眾享有更好、更健全的醫(yī)療衛(wèi)生服務(wù)，成為中國政府面臨的一個重大問題。從 20 世紀(jì) 80 年代開始，中國啟動醫(yī)藥衛(wèi)生體制改革，并在2003 年抗擊傳染性非典型肺炎取得重大勝利后加快推進(jìn)。2009 年 3 月，中國公布關(guān)于深化醫(yī)藥衛(wèi)生體制改革的意見，全面啟動新一輪醫(yī)改。改革的基本理念，是把基本醫(yī)療衛(wèi)生制度作為公共產(chǎn)品向全民提供，實現(xiàn)人人享有基本醫(yī)療衛(wèi)生服務(wù)，從制度上保證每個居民不分地域

36、、民族、年齡、性別、職業(yè)、收入水平，都能公平獲得基本醫(yī)療衛(wèi)生服務(wù)。改革的基本原則是?；?、強(qiáng)基層、建機(jī)制。With years of effort, China has made remarkable achievements in the development of its healthcare undertakings, which, however, still fall far short of the public's demands for healthcare as well as the requirements of economic and social deve

37、lopment.Especially when China turned from a planned economy to a market economy, the old medical care system has undergone great changes. So it becamean issue of major importance for the Chinese government to provide better and more accessible medical and health services to the public. In the 1980s,

38、 the Chinese government initiated reform of the medical and healthcare systems, and speededup the reform in 2003 after a success was won in the fight against the SARS. In March 2009, the Chinese government promulgated the "Opinions on Deepening Reform of the Medical and Health Care Systems,&quo

39、t; setting off a new round of reform in this regard. The basic goal of this reform was to provide the whole nation with basic medical and health services as a public product, and ensure that everyone, regardless of location, nationality, age, gender, occupation and income, enjoys equal access to bas

40、ic medical and health services. And the basic principles to be followed in the reform were to ensure basic services, improving such services at the grass-roots level and establishing the effective mechanisms.醫(yī)改是一項涉及面廣、難度大的社會系統(tǒng)工程，在中國這樣一個人口多、人均收入水平低、城鄉(xiāng)區(qū)域差距大的發(fā)展中國家，深化醫(yī)改是一項十分艱巨復(fù)雜的任務(wù)。三年多來，中國政府大力推進(jìn)醫(yī)藥衛(wèi)生服務(wù)與經(jīng)

41、濟(jì)社會協(xié)調(diào)發(fā)展，積極破解醫(yī)改這一世界性難題。通過艱苦努力，中國的新一輪醫(yī)改取得積極進(jìn)展。Medical reform is a social program that covers a wide range and involves difficult tasks. And it is a hard and complicated task to deepen this reform in China, a developing country with a large population, low per-capita income and a wide gap between urban

42、 and rural areas. For over three years, the Chinese government has worked hard to strike a balance between improving medical and health services on one hand and economic and social development on the other, trying to find a solution to this worldwide problem. Thanks to the persistent efforts made, C

43、hina has made positive progress in this new round of medical reform. 基本醫(yī)療保障制度覆蓋城鄉(xiāng)居民。截至 2011 年，城鎮(zhèn)職工基本醫(yī)療保險、城鎮(zhèn)居民基本醫(yī)療保險、新型農(nóng)村合作醫(yī)療參保人數(shù)超過13 億，覆蓋面從2008年的 87%提高到 2011 年的95%以上，中國已構(gòu)建起世界上規(guī)模最大的基本醫(yī)療保障網(wǎng)。 籌資水平和報銷比例不斷提高，新型農(nóng)村合作醫(yī)療政府補(bǔ)助標(biāo)準(zhǔn)從最初的人均 20 元人民幣，提高到2011 年的 200 元人民幣，受益人次數(shù)從2008 年的5.85 億人次提高到2011 年的 13.15 億人次，政策范圍內(nèi)住

44、院費(fèi)用報銷比例提高到70%左右，保障范圍由住院延伸到門診。推行醫(yī)藥費(fèi)用即時結(jié)算報銷，居民就醫(yī)結(jié)算更為便捷。開展按人頭付費(fèi)、按病種付費(fèi)和總額預(yù)付等支付方式改革，醫(yī)保對醫(yī)療機(jī)構(gòu)的約束、控費(fèi)和促進(jìn)作用逐步顯現(xiàn)。實行新型農(nóng)村合作醫(yī)療大病保障，截至2011 年， 23 萬患有先天性心臟病、終末期腎病、乳腺癌、宮頸癌、耐多藥肺結(jié)核、兒童白血病等疾病的患者享受到重大疾病補(bǔ)償，實際補(bǔ)償水平約 65%。 2012 年，肺癌、食道癌、胃癌等12 種大病也被納入農(nóng)村重大疾病保障試點(diǎn)范圍， 費(fèi)用報銷比例最高可達(dá)90%。 實施城鄉(xiāng)居民大病保險，從城鎮(zhèn)居民醫(yī)?；稹?新型農(nóng)村合作醫(yī)療基金中劃出大病保險資金，采取向商業(yè)保險

45、機(jī)構(gòu)購買大病保險的方式，以力爭避免城鄉(xiāng)居民發(fā)生家庭災(zāi)難性醫(yī)療支出為目標(biāo)，實施大病保險補(bǔ)償政策，對基本醫(yī)療保障補(bǔ)償后需個人負(fù)擔(dān)的合規(guī)醫(yī)療費(fèi)用給予保障，實際支付比例不低于50%， 有效減輕個人醫(yī)療費(fèi)用負(fù)擔(dān)。建立健全城鄉(xiāng)醫(yī)療救助制度，救助對象覆蓋城鄉(xiāng)低保對象、五保對象，并逐步擴(kuò)大到低收入重病患者、重度殘疾人、低收入家庭老年人等特殊困難群體，2011 年全國城鄉(xiāng)醫(yī)療救助8090萬人次。The basic medical care systems cover both urban and rural residents. By 2011, more than 1.3 billion people had

46、 joined the three basic medical insurance schemes that cover both urban and rural residents, i.e., the basic medical insurance for working urban residents, the basic medical insurance for non-working urban residents, and the new type of rural cooperative medical care, with their total coverage being

47、 extended from 87% in 2008 to 95% in 2011. This signaled that China has built the world's largest network of basic medical security. Medical care financing and the reimbursable ratio of medical costs have been raised, and the government subsidy standards for the new rural cooperative medical car

48、e system were increased from 20 yuan at the beginning to 200 yuan per person per year in 2011, benefiting 1.315 person/times in 2011 as against 585 person/times in 2008. The reimbursement rate for hospitalization expenses covered by relevant policies has been raised to around 70%, and the range of r

49、eimbursable expenses has been expanded to include outpatient expenses. Real-time reimbursement has been adopted for medical expenses, making it more convenient for people to have their medical costs settled. Reform has been carried out in respect of the forms of payment to include payment by person,

50、 payment by disease and total amount pre-payment, enabling medical insurance to play a better restrictive role over medical institutions as well as to control expenses and compel the medical institutions to improve their efficiency. Critical illness insurance has been included in the new type of rur

51、al cooperative medical care system. By 2011, some 230,000 patients of congenital heart disease, advanced rental diseases, breast cancer, cervical cancer, multidrug-resistant tuberculosis and childhood leukemia had been granted subsidies for major and serious diseases, with the actual subsidies accou

52、nting for 65% of their total expenses. In 2012, lung cancer, esophagus cancer, gastric cancer and eight other major diseases were included in the rural pilot program of insurance for the treatment of major diseases,and the reimbursement rate reached as high as 90%. Critical illness insurance has bee

53、n introduced for both urban and rural residents, in which certain amounts of money are earmarked in the medical insurance fund for non-working urban residents and that of the new type of rural cooperative medical care to buy critical illness insurance policies from commercial insurance companies, ai

54、ming to relieve urban and rural families of the heavy burden of catastrophic medical spending. The policy of subsidy for critical illness insurance, which covers no less than 50% of the actual medical costs, provides a guarantee for the compliance costs to be shouldered by the individual after reimb

55、ursement from the basic medical insurance. This has effectively reduced the financial burden of individuals. An urban-rural medical assistance system has been established and improved, which at first covered urban and rural subsistence allowance recipients and childless and infirm rural residents wh

56、o receive the so-called "five guarantees," and is now extended to coverthose who are severely ill and have low comes, the severely disabled, senior citizens from low-income families, and some other groups with special difficulties. In 2011, the urban-rural medical assistance was granted to

57、 80.90 million cases across the country. 基本藥物制度從無到有。初步形成了基本藥物遴選、生產(chǎn)供應(yīng)、使用和醫(yī)療保險報銷的體系。2011 年，基本藥物制度實現(xiàn)基層全覆蓋，所有政府辦基層醫(yī)療衛(wèi)生機(jī)構(gòu)全部配備使用基本藥物，并實行零差率銷售，取消了以藥補(bǔ)醫(yī)機(jī)制。制定國家基本藥物臨床應(yīng)用指南和處方集，規(guī)范基層用藥行為，促進(jìn)合理用藥。建立基本藥物采購新機(jī)制，基本藥物實行以省為單位集中采購，基層醫(yī)療衛(wèi)生機(jī)構(gòu)基本藥物銷售價格比改革前平均下降了30%。 基本藥物全部納入基本醫(yī)療保障藥品報銷目錄。有序推進(jìn)基本藥物制度向村衛(wèi)生室和非政府辦基層醫(yī)療衛(wèi)生機(jī)構(gòu)延伸。藥品生產(chǎn)流通領(lǐng)域改

58、革步伐加快，藥品供應(yīng)保障水平進(jìn)一步提高。A basic system of drugs has been developed from scratch. A system for the selection, production, supply and use of basic drugs, and cover of them in medical insurance has been put into place. In 2011, the coverage of this system was extended to all grass-roots medical and health-care institutions run by the government, where these drugs were sold at zero profit, practically eliminating the practice of hospitals subsidizing their medical services with drug sales. A national guideline for the clinical applica