The medical security system adheres to both hands.
The core idea of India's medical security system is to make use of economic and administrative levers to formulate a series of effective public policies, so that the rich can enjoy high-standard medical services and advanced medical equipment with lush outdoor and elegant indoor environment, and at the same time let ordinary people enjoy basic medical security.
In India's view, if the medical and health system is completely commercialized and market-oriented, it will violate the basic laws of medical and health undertakings, undermine social equity and be detrimental to social stability. Therefore, India's medical security system insists on both hands, which not only supports the stable operation of government hospitals, but also encourages the healthy development of private hospitals. This coexistence of public and private hospitals allows India's rich and poor to coexist peacefully.
Although Indian government hospitals have some problems such as insufficient funds, poor management and poor conditions, they play an important role in social stability, so the government would rather bear a huge financial burden to maintain the operation of these hospitals.
Indian government hospitals inherited the free help behavior of church hospitals during the British colonial period. Free help from the church began in the 1930s. 1947 after India's independence, it expanded the scope of free services for all and established a free medical network in rural areas, which basically guaranteed the basic medical care for the poor. India is a developing country with 260 million people living below the poverty line. Poverty accounts for about 1/4 of the total population, and most of them live in rural areas. Once the free medical care system is abolished, the Indian government will lose the support of a large number of bottom voters, and government hospitals will reduce their psychological pressure and economic burden when they see a doctor, which is also an important reason why India can maintain social stability for a long time.
Gradually establish a three-level medical and health care network in rural areas
India's government medical system is divided into five levels: national hospitals, state (provincial) hospitals, regional hospitals, county hospitals and township hospitals. However, the number of government hospitals at all levels is far less than that of private hospitals. General hospitals, especially rural hospitals, are also facing many problems, such as drug shortage, less varieties of antibiotics, poor hospital conditions, narrow wards and so on, and the resulting disadvantages, such as excessive financial burden on the government and great pressure on doctors to accept patients. However, the patients who visit Indian government hospitals are basically low-income people. They don't have high requirements for medical conditions, as long as they can spend less money to treat diseases. Therefore, government hospitals can really play a "stabilizer" role in social equity and poverty alleviation.
In recent years, in order to ensure the health and safety of the vast rural population, trade associations and non-governmental organizations in some parts of India began to take action, actively participated in rural medical insurance for the risk of serious illness with low incidence rate but high medical expenses, and took the lead in helping farmers insure medical care, thus embarking on a new path of rural medical care in developing countries. At the same time, various private hospitals are competing to develop and can provide corresponding medical services for people with different needs. Even patients from some European and American countries go to private hospitals in India for medical treatment, which has also created an international market-oriented road.
In the rural areas of China, as early as the early 1980s, the Indian government set the grand goal of gradually establishing a three-level medical and health network in rural areas of China. This network includes three parts: health stations, primary health care centers and community health care centers, which provide free medical services for the poor. All government hospitals are free, which is the same for any Indian, whether he is poor or rich. Free items include registration fees, examination fees, hospitalization fees, treatment fees, all expenses for emergency rescue, and even meals for hospitalized patients, but do not include medicine fees. The Indian government also announced that it will spend 900 billion rupees on the infrastructure of medical facilities and the purchase of medical and health equipment in the next 10 year to ensure that the number of doctors and beds in major hospitals in India will double and the number of nursing staff will triple in the next 10 year.
Limited government investment is fairly distributed to those who need medical services most.
In recent years, with the vigorous development of the software industry, many people have changed their views on poverty and backwardness in India, but there are still many tourists who have been to India and think that it is still synonymous with dirty, chaotic and poor. Little known is that although India's overall health status is not ideal, its medical level ranks among the best in developing countries and is sought after by many Europeans and Americans.
India's public expenditure only accounts for 17.9% of the total health expenditure. In 2005-2006, the government spent 1 02.8 billion rupees (about 2.4 billion US dollars) on rural public health, but the World Health Organization allocated1to the United Nations.
9 1 The ranking of health performance of member countries is shocking: China ranks fourth from the bottom in terms of "fairness of health financial burden", and ranks among the most unfair countries together with Brazil, Myanmar and Sierra Leone, while India, which has always been regarded as "extremely unfair in distribution", ranks 43rd. The reason is that the main beneficiaries of the Indian government's health subsidies and social security are poor and difficult groups, which can make the relatively limited public investment take care of fairness to the maximum extent and distribute the limited government investment fairly to the people who need medical services most. It can be seen that wealth is not an absolute standard to measure the medical system. What matters is social equity and balance of interests.
India's medical insurance system attaches great importance to covering low-income groups, and has established public health systems such as universal free immunization program and free treatment program in public hospitals to ensure that poor groups, especially farmers, can enjoy basic medical security.
In addition, the Indian pharmaceutical market is well supplied, and the health services provided by public health institutions, church hospitals and private clinics are not difficult to match in urban and rural areas. What is more noteworthy is that although the Indian government has not been classified as a strong government internationally, it has always taken a tough intervention attitude towards the financial and insurance markets. For example, the Indian government has issued industrial policy guidelines to regulate the behavior of banks and insurance companies, so that they can take adequate measures to take care of vulnerable groups. Among them, the government has special regulations on banks and insurance companies, which stipulate the minimum proportion of loans to the poor to the total loans of commercial banks and the minimum proportion of insurance products sold to employees in the informal economy to the total sales of insurance companies, and take this as the basic conditions for business license examination and registration. The material basis of supporting the Indian government's free medical network is its growing pharmaceutical industry and low drug prices.
Like China, which is also an ancient civilization, Indian herbs are very developed. In recent years, the Indian government has actively advocated the use of Indian medicines, established herbal centers in rural areas, and encouraged the use of herbal medicines instead of western medicines, greatly reducing the treatment costs of the poor. Because the quality of domestic western medicine is generally good, most Indians choose domestic medicine. For minor illnesses such as colds and fever, patients go to pharmacies with prescriptions and spend 20 or 30 rupees to buy medicines, which can be cured quickly. A drug like "Votaline" only costs 65438+ 0/3 of China's.
The road of social security in poor countries
From India's experience, the expensive social insurance and income security system in developed countries is not a universal model for all countries in the world, even the poorest countries,
We can also establish various forms of social security by providing public support to the vulnerable groups in our population. Developing countries adopting the market economy system can completely establish a unique public health system and medical security system according to their own social, political, economic and cultural characteristics, and help the poor people meet the most basic health needs by means of medical relief.
India's experience in this area may not be perfect, but it has become a classic example of medical security system in developing countries. —— (The author is the deputy director of the Crisis Management Countermeasures Research Center of the Institute of Contemporary International Relations)
Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.