We know that the medical level in the United States is high and the medical system is good, but there are only more than 300 million people in the United States, and their high medical level is aimed at some middle-and high-income people who pay American medical insurance. Even so, the US government will invest 17% of GDP into its own medical system every year. Similarly, China's investment in this area accounts for about 6% of GDP, but China's population is 65.438+0.4 billion, and we have universal health insurance. This 6% is far from enough to support the normal operation of public hospitals. A 3A hospital has thousands of employees, doctors and nurses with different professional titles, and a large number of logistics personnel who need labor remuneration to support their families. In addition, you said that the hospital has a lot of tens of millions of equipment, which is not made of iron and needs professional technicians to maintain it. You only see the income of the hospital, but you don't see the huge expenditure of the hospital.
Moreover, the growth cycle of doctors is very long now, and the income in public hospitals may not be enough to give his wife and children a decent life for a long time. For example, one of my otolaryngology students resigned from a public hospital last year and went to work in a private hospital. In public hospitals, all salary bonuses are more than 7,000 yuan per month, but when you go to private hospitals, you can open for two more weeks to give your wife and children a better life. This is still in the northeast. In fact, if I go to the south, I may make a higher salary.
What is the reason for giving the doctor a raise? To keep the doctor? Keep the technology? I prefer to think of it as respecting knowledge. When your classmates have the same education and do the same job, the working environment is more relaxed than yours, but the income is much higher than yours. How many people can stick to their posts in public hospitals? Don't your family need you?
You talked about the role of medical service as a service provider, but medical service is not an ordinary service, but a professional technical service, and patients are not the God who receives services, but the people who receive guidance to treat diseases. I don't support complete marketization, just like this epidemic. If it is completely market-oriented, where will more than 4w medical staff go to feed Wuhan? Of course, some people will support private hospitals, but what is the proportion? Who didn't take the lead in public hospitals?
For another example, in one of the largest public 3A hospitals in our local area, the annual state grant is only enough to pay all employees one month's salary, and then all the operating expenses and 1 1 month's salary bonus have to be earned by the hospital itself. Where can I earn it? Can non-market hospitals continue to operate? At present, all drugs in the hospital have been cancelled. How much is the purchase price, how much is the medicine sold, and the medicine does not make money, and it depends on labor. So if the cost of medical services does not rise, where will the operating expenses of hospitals come from?
First of all, we must make sure that medical care and education are the public welfare nature of the country. If we deny its essence, then privatization, capitalization and marketization are all good, but their names are different, and their core purpose is the word "money"! Because Zigan's intervention is bound to come for the benefit, it is a joke to talk about public welfare with Zigan Group. There are no good capitalists, only more ruthless capitalists! Marketization of medical care will only increase the burden on the people. In this special industry of medical treatment, people are extremely vulnerable groups. Unlike others, I can choose to use it or not. If you are sick, you need to see a doctor. How to see a doctor depends on the hospital. Marketization just needs such an excuse to get the maximum benefit. The result will be the second real estate, and there will be another mountain on the shoulders of the people!
Before answering this question, we must first know what marketization is. Marketization is the trading behavior of the supply and demand sides on the premise of equality, voluntariness and full competition.
First, the patient's family should hire a sedan chair to pick up the doctor, open wine for the doctor to eat, and then send red envelopes, the number depends on the family situation;
The other is sitting in the consulting room, where the patient comes to the doctor for a prescription, and then consciously puts a red envelope on the table, the same number is unlimited.
The payment method of consulting fee is the most worth pondering. It is non-market-oriented and there is no standard for charging. How much to pay depends on the respect of patients, not the price tag for medical services. Doctors have a professional aura, which puts a gentle veil on economic relations.
All medical services are clearly priced, the charging standard is unified, both doctors and patients are equal sellers and buyers, and the doctor-patient relationship is simplified as a money exchange relationship, so the moral veil originally wrapped in the doctor-patient economic relationship is lifted, and medical ethics no longer have a hiding place, taking off the "sacred aura" on the doctor's head.
Since then, doctors have to earn money from patients to make a living; Patients think that since they spend money on medical services, they will demand the quality of services and ask doctors to take full responsibility for treatment.
Even if doctors have a sense of responsibility and don't abuse their powers, they can't dispel patients' concerns, which is also the root cause of the tension between doctors and patients and the reason why this problem is raised today.
Therefore, there is no standard to judge whether marketization is right or not. Putting doctors on the market will cause serious problems, which is not a new discovery. Foucault said that doctors' services should be free, so as to match the sanctity of their profession. Medical services should not be charged, nor should it be understood that doctors cannot have income, but that doctors' income should not be directly linked to patients' medical expenses.
Like patients who are overwhelmed by the difficulty and high cost of seeing a doctor, medical staff are also victims of the medical market-oriented system. We should face up to the anti-market characteristics of medical treatment and let the moral aura of doctors return to the essence of doctors.
What can I do without marketization?
In the early years, it was fully funded, and finally the country could not afford it, and the market mechanism was introduced!
Now it is balance distribution, and there are signs that the country can't afford it. We must find a way out in the market!
Because treatment is a bottomless pit.
In 20 18, the total national health expenditure reached 5,799.83 billion yuan, of which government health expenditure accounted for 28.3%, social health expenditure accounted for 43% and personal health expenditure accounted for 28.7%. The per capita total health expenditure is 4 148. 1 yuan, accounting for 6.4% of GDP.
In 20 18, the total investment in national education funds was 4613.5 billion yuan, an increase of 8.39% over the previous year.
Hospital is a special unit to heal the wounded and rescue the dying, which is related to the life and death of the people. His bounden duty is to heal the wounded and rescue the dying, and the price he paid cannot be measured by money. In the past, Warren, Bian Que, Ye and other famous doctors have saved countless lives, which has nothing to do with money. In the 30 years after liberation, doctors were tall in people's minds, admired and respected by everyone, and were called angels in white.
Nowadays, the privatization of hospitals has become a tool to make money, which has aroused people's dissatisfaction. The hospital has become a slot machine for swallowing money, which makes people hate it.
The key to medical reform! Turn private into public, serve the people, strengthen supervision and put an end to arbitrary charges.
Medical care is a kind of service, but because it is the national economy and people's livelihood, it has the nature of government service, which is not the same as market-oriented service and cannot follow the market. The establishment of medical and health facilities comes from taxpayers, that is, from the people and for the people. The channel of medical expenses mainly comes from medical insurance, and the government should supervise and manage it well. It's not that the bed fee will go up if there are fewer beds, but the price will be sky-high if there are fewer medicines! Therefore, medical care is a government service, not a market-oriented service!
As soon as I heard that the medical industry is a service industry, I got angry. If the medical industry is really a service industry, then doctors should be like restaurants. Anyone with normal IQ can be a waiter and provide services, so there is no need for long-term continuing education, various trainings, biennial regular examinations and national examinations from elementary to intermediate to advanced. In the same sense, teachers are also serving their hometown and students.
Internally, doctors and nurses are professional and technical personnel, who pass the national examination and issue various certificates. They are different from the collection logistics in hospitals. They provide services to make a living, while doctors and nurses master their skills like maintenance workers, technicians and missile force assemblers. They eat by ability, not just by smiling. They can get rid of the patient's illness by calling their grandparents.
Some people repeatedly emphasize hospital services, but they have not seen the lifelong training and assessment of doctors and nurses for decades. They just regard service as a standard. In order to improve the competitiveness with other medical units, hospital leaders also mentioned service. That's hotel service and smile service. A patient is in terrible pain. You don't need your own skills to get rid of his pain. Can you get rid of the machine with a smile like it is broken? Can patients be satisfied by simply calling grandparents long live if they don't fix it quickly? I don't know how many countries in the world entrust the medical industry as a service industry. In that case, those who get professional and technical personnel certificates are all service industries, which can be pushed to the market and let ordinary people spend money!
It's good to read the comments of the masters. Can today's society live without money? . How much is a doctor in a public hospital in January? Of course, doctors in big hospitals earn tens of thousands of dollars a month, right? There are more than 5,000 doctors in villages and towns, right? How much does it cost to register experts in hospitals now? There was no expert number before? It can also cure diseases. Now there are also some expert numbers in towns and villages. Let's talk about two diseases first. Lumbar disc herniation and bone setting are all done in the hospital, which makes the patient's money empty. Folk Chinese herbal medicine 1000 can be cured. Many diseases that can be cured by folk Chinese herbal medicines have been helped. Because the patient didn't give it to you, the loss of folk Chinese herbal medicine is normal. In addition, the country does not develop Chinese herbal medicines. I have prescriptions for setting bones, pulling bones and jumping bones. A week's external use of medicine for lumbar process is enough. As troublesome as a public hospital. It's not the old man's surname anymore. It's all about money.
I agree. Housing, medical care and education are the basic guarantees of people's lives and are closely related to people's lives. However, it is the aspect that people need to protect most. National policies do allow marketization. Although there is a policy of nine-year compulsory education in education, the current situation is that tuition and information fees have become a great burden, and angels in white's vocation of teaching and educating people has been thrown out of the clouds by market money interests. Our education is worrying! Housing is beyond the reach of most people, and the sky-high medical care has also discouraged many families. If they are seriously ill, they can only look down on their own fate.
Therefore, the relevant state departments should study and reform this as soon as possible, so that the people can enjoy the dividend of the country's development of wealthy businessmen, truly let the broad masses of the people realize the superiority of socialist society, and let the people live a carefree life, thus improving the happiness index of people's lives!
Some hospitals have deteriorated into a frightening and terrible place, especially when the doctor asks you what kind of medical books you use, you are no longer a patient, and the value of medical care and life is different, which has violated the morality of the hospital and the loyalty of the Holy Spirit. Is the hospital's income and welfare less than other industries? Obviously not! In the face of income and interests, even doctors will become greedy and even lose their medical ethics and loyalty. However, serious social problems will be even more terrible, and we don't want to see such a result. Because the hospital is a special place to heal the wounded and rescue the dying, once it becomes a place to take money from patients' pain and make money from patients' lives, the hospital will no longer be a hospital, but must be a place of right and wrong. The intensification of this special contradiction between doctors and patients may translate into the price of blood. Who doesn't want to live a healthy life now? The main reason of doctor-patient disputes lies in the high level of hospitals and doctors. In addition to the medical level, service awareness and attitude also need to be comprehensively improved. As a patient, it is too late to ask the hospital. Anyone who is stupid enough to offend the doctor is either angry or really can't stand it. Who goes to the hospital for no reason? Of course, it's wrong to make medical trouble, but doctors shouldn't accept red envelopes. To completely solve the doctor-patient relationship and contradiction, the state should implement free medical care for all as soon as possible, even if it is difficult. Many poor countries in the world have implemented free medical care for all, because it is better to have no money than to look down on the disease. After all, everyone has only one life. ...