Highly monopolized health care system, resulting in a high concentration of medical resources in large cities and large hospitals, formed over the years of the centralized monopolized medical model has changed hundreds of millions of people's habits and culture of medical care, it is a disease to run to the big hospitals, hanging expert number.
The key to the deep-water battle of healthcare reform is how to control the uncontrolled expansion of large public hospitals. In response to the highly monopolized health care system, Hu Daiyi said that doctors from large hospitals and community-based doctors work together to see outpatient clinics at the grassroots level and transfer to the community, and large hospitals only retain consulting organizations to receive patients referred up from grassroots hospitals as a way to change the traditional culture and habits of medical care.
The second is the health insurance payment mechanism.
Medical payment mechanism is "pay according to the amount" of medical expenses by the agricultural cooperative or urban residents, employee health insurance proportionally paid part of the individual proportionally paid part. This payment mechanism will inevitably lead to large giant specialized or general hospitals are not limited to see difficult and complex critical illnesses, to do research and innovation, but common diseases and diseases also grab, unlimited expansion scale.
Hu Daiyi said, a few minutes to see the common sense of the disease who all understand, but the family of large hospitals are the outpatient clinic volume as a hard economic indicators to assess the various departments, but also with the income of health care workers directly linked. The country continues to increase investment in health care, but also managed to put more common diseases and some basic surgery in the county and more grass-roots level to undertake, such as the grass-roots level to increase the proportion of reimbursement of health insurance, but it is not very effective.
There is a policy at the top and a plan at the bottom. Large hospitals have ample economic resources to cope with the national strong grass-roots initiatives, "health care consortium or, large hospitals to help the development of county hospitals or, the original intention may be good, but the result is a further siphoning phenomenon, the economic benefits of the examination, surgery, and more lead to large hospitals. A director of a large hospital has a theory that as long as there are patients continue to come, it means that there is a need to continue to expand the scale. This is actually continue to strengthen the monopoly fallacy."
Aiming at the irrational health insurance payment mechanism, Hu Daiyi proposed a fundamental change in the payment mechanism is more critical to abolish the "pay by volume" of the burning model, changed to the type of disease, preferably to the efficacy of the prognosis for the standard payment model, but not to change the certainly not.
Third, the distribution of health care workers income mechanism, the actual three parts: the first part of the lawful and reasonable basic salary, the social **** knowledge that this part is too low, and the responsibility of health care workers and the degree of hard work does not match.
The second part is performance pay, the amount of which is vital to the lives of the vast majority of health care workers, there is this part of the income is also in line with the more you work more you get, should be reasonable and legitimate. But now in the medical profession, Hu Daiyi think this distribution mechanism is legal and unreasonable, "it is bound to become excessive medical over-checking enabler, and even the same coronary heart disease patients, it will happen that cardiology, cardiac surgery rush to do, the stent of the beauty of the name of a small incision minimally invasive bypass bridge, of course, than should not be bypassed much more than bypassed by the bypass was more than one stent. " Hu Daiyi spoke of how it is not the incentives that are unreasonable, but how they are unreasonable.
The third part is gray income, neither legal nor reasonable, it is more excessive examination of over-treatment enabler, which is precisely this deepening of the reform need to eliminate the part of governance.
In response to this problem, Hu Daiyi suggests that the basic salary of doctors, technical skills content wages should be increased, but the increase certainly need to be balanced with other sectors of society. Performance pay should be from the standardization of medical practice, good follow-up preventive rehabilitation, thus saving medical funds in the commission.
At the same time, the government on the one hand to do away with the establishment, synchronized with supporting the simplification of the mechanism of multi-practice doctors, support for multi-practice doctors, so that the doctors return to conform to the laws of the industry freelance, such as many dental clinics. This will also prompt a generation of young doctors to choose the clinical work, the serious life to learn to learn to "grind tofu", and not be forced to spend a lot of time "coal mine", for SCI hard busy life.