We know that the United States has a high level of health care, health care system, but the United States has only more than 300 million people, and their high level of health care is for the payment of U.S. health insurance for a portion of the middle- and high-income populations, even if so the U.S. government each year to come up with a 17% of the GDP invested in the country's health care system to go. Similarly, in our country, this aspect of the investment accounted for about 6% of GDP, but our population is 1.4 billion, and we are universal health insurance, this 6% is far from enough to support the normal operation of public hospitals, a three hospitals on the staff of a few thousand people, different titles of doctors and nurses, and a huge number of logistics staff are required to labor remuneration to support their families, in addition you talk about a lot of hospitals tens of millions of dollars of equipment, that is not iron, the need for professional and technical personnel to support the family, in addition to hospitals. That's not iron, need professional technicians to maintain and repair, and expensive, bad a little "strike", sometimes have to go far away to hire engineers to repair, these are not money? You only see the income of the hospital, but did not see the huge expenditure of the hospital.
Moreover, doctors nowadays have a very long growth cycle, and in public hospitals, they may not be able to earn enough to give their wives and children a decent living for a very long time. For example, one of my ENT classmates resigned from a public hospital to work in a private hospital last year, all the salary bonuses in public hospitals are just over 7,000 per month, but to the private hospitals will be able to open 2w more, to their wives and children a better life, which is still in the northeast, in fact, if you go to the south may open higher.
What's the point of giving doctors a raise? To retain doctors? To retain skills? I prefer to think of it as respecting knowledge. When your classmates have the same education as you, do the same job, have an easier working environment than you, but earn a lot more than you do, how many of them can stick to their positions in public hospitals? Doesn't your family need you?
You talk about the role of health care as a service provider, but health care is not an ordinary service, but a professional and technical service, and the patient is not the God who receives the service, but the person who receives guidance in the treatment of the disease. I don't support full marketization, just like the current outbreak, if all of it is marketized, where will the 4w+ healthcare workers who supported Wuhan come out? Of course there will be some support from private hospitals, but what percentage? The first thing you need to do is to get your hands on some of the most popular products and services in the world, and you'll be able to do that.
Another example, in our local area, one of the largest public tertiary hospitals, the state's annual appropriation is only enough for all staff to open a month's salary, and then all the operating costs and the 11 months of wages and bonuses, the hospital has to earn their own money, from where to earn? Not market-oriented hospitals can still open down? Now all the drugs in the hospital have abolished the price increase, how much money, how much money to sell drugs, drugs do not make money, but also to take the labor, that the cost of medical services do not rise, the hospital's operating costs from where?
First of all, we have to make sure that healthcare and education are public goods of the country. If you deny its nature, then privatization, capitalization, marketization, too, just call it a different way, the core purpose is a word ″money! Because the involvement of capital is inevitably for profit, it is a joke to talk about public welfare with capitalist groups. There is no kind-hearted capitalist, only more ruthless capitalists! The marketization of medical care will only increase the burden of the people. In the special industry of medical care, the people are an extremely disadvantaged group, it is not like other, I can choose to use or not to use. Sick to be treated, how to be treated to listen to the hospital, marketization just need such an excuse, to get the maximum benefit. The result will be the second real estate, another mountain on the shoulders of the people!
Before answering this question, we first need to know what marketization is? Marketization is the supply and demand sides in the equal voluntary full competition under the premise of the transaction occurred in the purchase and sale behavior.
One is a clinic, the patient's family to hire a sedan chair to bring the doctor to the doctor to see the prescription after the preparation of food and wine hospitality, and then send a red envelope, the number of depending on the family;
another is sitting, the patient door to door to ask the doctor to see the prescription, and then consciously put a red envelope on the table, the same number of unlimited.
Payment of consultation fees is the most thought-provoking way, it is non-market-oriented, charges are not standardized, how much to pay all depends on the patient's respect for the embodiment of the price, rather than explicitly purchased medical services, the doctor is a professional aura, which the economic relationship with a layer of warmth and affection of the veil wrapped up.
All medical services are clearly marked prices, fees are unified, doctors and patients are equal sellers and buyers, doctor-patient relationship is simplified to the exchange of money, so the original economic relationship between doctors and patients wrapped in the economic relationship between the veil of morality was lifted, medical ethics is no longer a place to hide, in addition to the doctor's head of the "sacred halo! "The first time I've seen this, I've seen it.
From now on, in order to make a living, doctors will have to earn money from patients; patients want to spend money to buy medical services, they will ask for quality of service, and require doctors to pay full responsibility for the treatment.
Even if the doctor is responsible and doesn't abuse his power, he can't allay the patient's concerns, which is the root cause of the tension between doctor and patient and the reason for today's question.
So in the end, marketization is right or wrong, there is no criterion for judging this, putting doctors into the market will cause serious problems is not a new discovery, Foucault said, the doctor's services should be free, so as to be able to match the sacred attributes of his profession. The fact that there should be no fees for medical services should not be interpreted to mean that doctors should not be able to earn an income, but rather that the income of doctors should not be directly linked to the amount of money spent by patients on medical treatment.
Like the patients who are overwhelmed by the difficulty and expense of seeing a doctor, healthcare workers are also victims of the marketized system of healthcare. We should face up to the anti-marketization nature of healthcare and let the moral aura of doctors return to the essence of doctors.
What else can we do without marketization?
In the early years of full funding, the state finally could not afford to do it and introduced market mechanisms!
Now is the difference in funding, the state can not afford the signs, only in the market to find a way out!
Because the matter of treatment is a bottomless pit.
In 2018, the total national health expenditure amounted to 5,799.83 billion yuan, of which: government health expenditure 28.3%, social health expenditure accounted for 43%, and personal health expenditure accounted for 28.7%. Per capita total health expenditure was 4,148.1 yuan, and total health expenditure as a percentage of GDP was 6.4%.
The total national education expenditure in 2018 was 4613.5 billion yuan, an increase of 8.39% over the previous year.
The hospital is a special unit that saves lives and has a stake in people's life and death, and his vocation is to save lives and fight with the gods of death, paying a price that can not be measured in money. In the past, Warren, magpie, Ye Tianshi and other famous doctors to save countless people, and money is not on the half of the relationship.... In the thirty years after the liberation, the doctor in people's mind high, everyone envy, everyone respect, called the white angel.
Nowadays, the privatization of hospitals has turned them into tools for earning a living, causing dissatisfaction among the people, and turning hospitals into slot machines that swallow money, which is hated by the people.
The key to healthcare reform! The key to healthcare reform is to turn private into public, serve the people, strengthen supervision, and put an end to arbitrary fees.
Medical is the nature of the service, but because it is a national livelihood, but with the nature of government services, not equivalent to market-oriented services, can not follow the market. The establishment of medical and health facilities, from the taxpayers, that is, taken from the people, used in the people. The channel of medical expenses mainly comes from medical insurance, the government should monitor and supervise the management, not less beds bed fee will be raised, the drug shortage will come to a sky-high price! Therefore, health care is a government service, not a market-oriented service!
I heard the medical industry mentioned as a service industry I'm angry, if the medical industry is really a service industry, then the doctor should be like a restaurant, just a normal IQ of people, can be a waiter, can provide services, there is no need for years and years of continuing education, all kinds of training, two years of a regular assessment, and from the primary, to the intermediate, to the senior national examination, the same sense of view, the teacher is also for the home town, the teacher is also a good choice, the teacher is also a good choice for the home town. The teacher is also for the service for the hometown and students, that is also a service industry.
Within the profession, doctors and nurses are professional and technical personnel, with a national examination and qualification issued by a variety of documents, he and the hospital inside the collection logistics is not the same, they are to provide services to make money to live, and doctors and nurses are holding their own hands of technology, like maintenance workers, technicians, and missile forces assemblers, with the ability to eat, not just a smile, ha medication, shout a The patient's pain can be removed by the grandparents, and he or she will be able to return home alive and well.
Some people have repeatedly emphasized the hospital's service, do not see the doctors and nurses behind the decades of lifelong training, assessment, purely as a standard of service, those hospital leaders in order to improve the competition with other health care units, but also the service mentioned in the mouth, and the hotel service, and a smile service, a patient in pain, you do not have to use their own skills to remove the pain, but also a smile, can remove the pain, but also a smile. Simply smile, can remove the pain, like a machine broke down, not quickly repaired, simply shouting grandparents, will be able to achieve satisfaction for the patient, the world I do not know how many countries to the medical industry into the service industry, that way, all the professional and technical personnel certificates, are the service industry, that can be pushed to the market, can let the people spend money to consume!
It is good to read the comments of the masters. Today's society can live without money? How much does a doctor in a public hospital pay in a month, of course, is a big hospital doctor's monthly salary of tens of thousands, right? How much do specialists in hospitals pay for registration now? In the past, there was no specialist number. You could also get well. Now there are specialists in the townships. Let's talk about two kinds of illnesses. Herniated lumbar discs, bone grafting, large and small hospitals are surgery, in order to get the patient's money empty. The folk herbal medicine with more than a thousand points can be cured. A lot of folk herbal medicine can cure the disease are helped to cure. Because the patient does not original to you, folk herbal medicine lost is normal. In addition, the country does not develop Chinese herbal medicine. I have a bone prescription, pull bone stretcher jump bone stretcher and so on. I have a prescription for a bone-setting medication, which is a week's worth of topical medication for a lumbar bulge. The public hospital is so troublesome. Now are not for the old man surnamed, are for money for money.
I agree with the attitude, housing, health care, education, these three are the people's lives live the basic security, and people's lives are closely related to the people's lives are closely related to the people's lives. But it is the people most need to be guaranteed aspects of the national policy is indeed allowed to engage in market-oriented, education, although there is a 9-year compulsory policy, but the status quo is to make up for the cost of material costs and other costs have become a great burden, the white angels and teaching vocation has been the market money interests thrown into the clouds. Our education is worrying! The housing is unattainable for most people, the sky-high price of medical care for many families is also prohibitive, can not afford a serious illness can only be at the mercy of God.
So the relevant departments of the state should study the reform as soon as possible, so that the people can enjoy the national development of the dividends of the rich businessmen, the majority of the people really appreciate the superiority of the socialist society, so that the people's life without worries, to improve the people's life happiness index!
Some hospitals have deteriorated into a fearful and scary place, especially, when the doctor asked what kind of medical book you use, you are no longer a patient, medical treatment and the value of life is not the same, which has violated the hospital's morality and the Holy Spirit loyal will. Is it hard to believe that hospitals make less money and have fewer benefits than other professions? Obviously not! In the face of income generation and benefits, even doctors will become greedy and even violate the law by losing their medical ethics and faithfulness. However, the serious social problems caused will also be even more horrible, and we all do not want to see such a result. Because the hospital is a special place to save lives and help the injured, once it becomes a patient's pain to make money, with the patient's life to make money, the hospital is no longer a hospital, must be a place of right and wrong, this special contradiction between doctors and patients to aggravate may evolve into the price of blood, and now who do not want to live a good and healthy. Occurrence of doctor-patient disputes, the main reason is still out of the high hospital and doctors, in addition to the level of medical care, service consciousness and attitude needs to be fully improved, as the patient to seek hospitals can not wait, who is stupid enough to go to the doctor, not to be pissed off forced to rush, or really can not see, who will go to the medical drama for no reason, of course, medical drama is not right, but the doctor should not receive a red packet. To completely solve the doctor-patient relationship and conflicts, the country should still implement free medical care for all as soon as possible, even if it is difficult to implement, many of the world's poorest countries have implemented free medical care for all, because not being able to afford to see a doctor is worse than having no money, after all, everyone's life is only once ......