And community clinics are obviously private for profit! The purpose is to make a profit!
Heh but the reality is that all hospitals in China are for profit! Oh!
The State Council recently forwarded the "guiding opinions on the reform of the medical and health system in towns and cities", proposed to "establish a new classification and management system of medical institutions", the current medical institutions are divided into two categories of non-profit (i.e., public welfare) and for-profit (i.e., private). (i.e., public welfare) and for-profit (i.e., private). According to this idea, the reform of 15,277 hospitals in counties and above, 50,600 health centers and street hospitals in townships and cities, 229,300 clinics, infirmaries and outpatient clinics, and 503 sanatoriums in China has since entered the property rights reform-oriented level. This reform means that half of China's more than 60,000 existing publicly owned medical institutions will become for-profit private hospitals.
Why "public" and "private"
The medical institutions that have been treated as public welfare institutions for decades to make such a "classification", bring the medical profession and the private sector to a new level. But without the classification and management of medical institutions as a system established, many deep-seated problems in the reform of medical institutions can not be solved.
For example, the public medical institutions still account for the absolute main body, not only lagging far behind China's economic system from the monopoly of the public system into the public system as the main body of a variety of economic components *** with the development of the trend, but also, a single system of ownership of the lack of competition and vitality of the medical institutions, bloated, inefficient, urban and coastal economically developed areas of the health resources are relatively surplus, rural and economically less developed areas are relatively insufficient; at the same time can not solve the problem of the health care sector and the society as a whole. At the same time, there are other problems that cannot be solved, because the country's financial resources are no longer able to support the tens of thousands of public medical institutions that cover both urban and rural areas throughout the country, and the cries of "insufficient compensation" can be heard almost everywhere in the medical and health care community, and in the face of the "wailing and waiting to be fed," there is a lack of financial resources to support the development of medical institutions. A piece of that only a little bit of financial resources are often to be "crying child have milk to eat" and "eat more eat less" about the fairness of the problem confused.
In fact, in the dwindling financial compensation, in recent years, China's public hospitals have long been diversified in the main body of compensation and compensation channels. For example, in order to obtain more compensation for the purpose of departmental contract responsibility system, choose a specialist registration and other reforms, as well as "one hospital, two systems", "high quality and high price", in a hospital to open special special wards or wards, leasing or loans to buy large-scale advanced medical equipment and other reform measures. Reform measures such as "one hospital, two systems", "quality and price", the opening of special wards or wards within a hospital, the lease or loan purchase of large and advanced medical instruments and equipment, and so on, are essentially the opening of for-profit departments in non-profit hospitals, which has resulted in the diversification of property rights in medical institutions and the diversification of the main body of the investment in the mixed ownership system. The current public medical institutions, more or less or to some extent, are no longer purely non-profit organizations.
From the current private capital demand for the opening of the medical market more and more high, the medical institutions will be divided into for-profit and non-profit management, is also an imperative thing. On the one hand, the health care industry, which has a bearing on people's health and lives, should not be engaged in rashly, and should develop a strict, even harsh access system, but if even the door of access is not open, there is a lack of fairness; on the other hand, the state financial compensation for medical institutions is insufficient to mobilize the strength of all sectors of the community to mobilize multi-channel funding to start a health business is the way to go. The for-profit medical institutions to give way to private capital investment, non-profit medical institutions really do to protect the prevention and protection, put medical, scientific research, put the general, basic, put special, will help to form the state-owned capital and private capital to succeed each other and supplement the structure of running a medical, faster and better to enhance the comprehensive capacity of China's health care business.
The government from running hospitals to manage hospitals
After the introduction of the guidelines for the establishment of a classification and management system of medical institutions, it is imperative to establish as soon as possible with the supporting policies and regulations, the existing medical institutions, based on the regional health planning for the structure of property rights adjustments to the for-profit hospitals, the first clear property rights of the shareholding, auctions, asset reorganization and other for-profit transformation, so that it is completely In accordance with the laws of the market economy; for non-profit hospitals, according to the number of basic medical and preventive and protective tasks undertaken, the ability of the state financial subsidies, etc. for non-profit transformation. The restructuring of the more than 60,000 existing publicly owned medical institutions is obviously a very complex systematic project. But there is a principle has been very clear, that is, the government's future relationship with the medical institutions will be: only hospitals do not run hospitals, you license me for approval, you operate me to supervise, you violate my penalties, you make a profit, I collect taxes, and you close down my acceptance.
So, for the "management" of the hospital government, first of all, we have to identify which are non-profit medical institutions. That is, the existing medical institutions should be in accordance with the requirements of regional health planning to determine the location, function and size of the "three" adjustments to identify non-profit medical institutions. The first step is to determine the location: based on the population density of the residential area, the transportation situation, the age structure of the population and the incidence of infectious diseases, epidemics and chronic diseases, and other statistical indicators, the main solution to the problem of the number of medical institutions. The second step is to determine the function: based on the task of undertaking maternal and child health, preventive health care and community medical care, they are located in community medical stations, street outpatient clinics, township health centers, epidemic prevention stations, women's health insurance institutes and non-profit hospitals. The third step to determine the scale: to be able to complete the basic medical and preventive health care work as a prerequisite, set up to establish the scale of non-profit medical institutions.
After determining the "nature" of the medical institutions, the state health administrative department will be freed from the specific running of the medical, its functions will inevitably change to the purchase of labor from medical institutions, the development of overall health care planning, policy, on behalf of the state to exercise the owner of the quality control and management, and so on up.
According to preliminary estimates, China's demand for the above non-profit publicly owned medical institutions is only about 1/2 of the existing 60,000 or so. With reference to successful foreign experience, the state compensation for this "1/2", i.e., for the 30,000 or so non-profit medical institutions providing basic medical services, should be in place, and the state compensation for the 60,000 or so non-profit medical institutions providing basic medical services should be in place. For these "1/2", that is, the 30,000 or so non-profit medical institutions providing basic medical services, state compensation should be in place, and it should be changed from the state compensation which was distributed to the 60,000 or so institutions in the past and which could not feed anyone to ensuring that the 30,000 or so institutions which are characterized as non-profit-making institutions are fed. The rest should be converted into profit-oriented medical institutions and put on the market. Of course, there are many supporting policies and measures to follow, for example, some Western countries, all public medical school graduates, must be non-profit medical institutions to serve at least five years, to obtain a certain professional and technical titles before applying for individual practice, or apply for better treatment of for-profit private hospitals, so as to ensure that public hospitals, talents.
In addition to the more than 30,000 existing publicly owned medical institutions that should be established as non-profit medical institutions, it is widely believed that the public welfare charitable medical institutions run by social organizations, charities and celebrities who donate funds for free should also be recognized as complementary to the non-profit medical institutions.
To the two types of hospitals to determine the "sex"
From the property rights of the division and definition of for-profit and non-profit medical institutions, at this stage can be adjusted according to the country's financial capacity.
The first category is public non-profit medical institutions. This type of institution is mainly supported by the state finance in terms of investment; does not bear tax obligations in terms of taxation; continues to implement the necessary price control in terms of price to adapt to the basic medical needs of the general public; shall not dispose of and transfer their own assets, and the assets ultimately belong to the social public welfare; serves as a designated medical institution for the national basic medical insurance and receives this part of the investment; and must bear the burden of medical treatment for the poor, those who do not have medical insurance, and those with low living capacity. They must assume responsibility for the medical services of the poor, the uninsured, and those with low living standards. These institutions are monopolized by the State and private capital is not allowed to intervene. Based on the principles of regional health planning, statistics on population distribution and the incidence of infectious and chronic diseases, and transportation, cultural and economic backgrounds, first-, second- and third-tier non-profit hospitals are set up to provide basic medical services. With the exception of a very few national hospitals that are tasked with medical care, teaching and research, the vast majority of non-profit hospitals can only be equipped with instruments and equipment that are appropriate for basic medical care, that is to say, people can receive basic medical care at non-profit medical institutions, and they are not allowed to use them. In other words, when people visit non-profit medical institutions, they can only enjoy basic medical services that are compatible with the current level of economic development at the primary stage of socialism in China. The standards set for basic medical care can be based on the successful practices of many countries around the world, such as stipulating that only people below the minimum income line can visit non-profit medical institutions, and that there should be stricter restrictions on the medical items available to those who are entitled to basic medical care, and so on. In addition, the vast majority of community medical stations and preventive and protective organizations must also be included in the non-profit operation at present.
The finance of non-profit medical institutions must master the following points: the establishment of annual financial declaration system of income; once the balance exceeds or deviates from the non-profit regulations, the government will have to tax according to the law; the accumulation of capital can not be arbitrarily misappropriated and transferred, can only be used for the expansion of reproduction.
The second category is charitable welfare non-profit medical institutions. This type of institution is essentially a special non-profit medical institutions, the channels of financing mainly from social organizations, enterprises, individuals and other donations and sponsorship. The State exempts donated funds from income tax and other tax exemptions, and the value of the charitable services provided by such non-profit medical institutions is equal to the amount of the State's tax exemption. The content of the services should be limited to programs such as geriatric care and rehabilitation. At present should be established as soon as possible, individual donations, social organizations, foundations and charitable institutions and other contributions to tax-exempt policies and regulations, otherwise similar to the first category of non-profit medical institutions.
The third category is private for-profit medical institutions. Access to this type of medical institutions is entirely dependent on enterprises and individuals in terms of investment; profit is expected in terms of purpose; taxes are paid in accordance with the rules; price control is gradually liberalized; the disposal of assets is decided by the law itself; fair competition in terms of eligibility for admission is not discriminated against or excluded; sources of financing are permitted in terms of participation in commercial and supplemental insurance; and the price, quality, and efficiency of medical services are subject to the challenge of the market and the competition of non-profit medical institutions. competition from non-profit healthcare organizations. Private capital investors should be equal in front of the access system of such medical institutions; the responsibility of health administration departments at all levels of government is to strengthen supervision and law enforcement; the state treasury does not bear any responsibility for compensation, and on the contrary, tax revenues from private hospitals can also be used to subsidize public hospitals.
Benefit will be the people
It should be pointed out that whether the state finance to ensure that non-profit institutions or for-profit health care institutions to the market, are to make the development of health care institutions more healthy, the health care market more orderly. The property rights of medical institutions from attributed to all members of society and run as a social public welfare cause, the government assumes unlimited responsibility, categorized into non-profit medical institutions and for-profit medical institutions to manage, the government assumes limited responsibility; part of the members of the community or a single member of the community to assume the responsibility of the market risk; social groups and charitable organizations, etc., to assume part of the responsibility of the welfare of the development of the socialist market economy is an inevitable choice. In the property rights restructuring, attributing part of the for-profit medical institutions to some members of society or individual members will attract more private capital to flow in and be invested in the development of health undertakings, and the exclusivity and natural attributes of the property rights will inevitably produce a strong intrinsic motivation, and the benefits and risks will become binding and directly related to the immediate interests of property rights owners, which will not only alleviate the state's Financial burden, so that the medical service attitude and quality of medical services in a variety of ownership competition to improve and enhance; so that different medical needs of the population in a variety of ownership competition to get care and benefit, get the development of the medical institutions, and ultimately benefited from the majority of the people is undoubtedly. Zhang Bin, director of the Ministry of Health's news and publicity department
Reference:
National Research Network