Medicine for the sick is everyone's most basic wish and need.
People's expectation is that every doctor can help the world and cure all diseases. Instead, clinical medicine has circulated the famous saying, To Cure Sometimes, To Relieve Often, To Comfort Always.
Not only are doctors limited in their ability to deal with complex medical conditions, but high medical bills are not something everyone can afford. One person gets a serious illness, and the family can all go back to poverty overnight. I read a study today that even in the United States, which is a global leader in medical care, the number one reason people go bankrupt is surprisingly the inability to pay for medical care.
The United States, with its advanced medical technology, should logically make it easier for the people to see a doctor, so why is it surprising to see bankruptcy when you see a doctor?
How much does American health care cost?
According to estimates, in 2018, the U.S. per capita GDP is about $62,500, but the per capita medical expenditure of $10,000 a year; while China's per capita GDP is about $9,900, and the per capita medical expenditure is $500. This means that the Chinese don't make enough money in a year for Americans to spend on medical care in a year. Even on a proportional basis, the U.S. per capita health care spending is as high as 16% of GDP, five times that of China, which is equivalent to creating 20,000 yuan of GDP each month, and getting 10,000 yuan of monthly income, but you have to spend 1,600 yuan each month to see a doctor, and you'll have to spend nearly 20,000 yuan a year.
And in our country, according to everyone's common sense can feel wrong, because for a person who does not have a major disease, it is almost impossible to spend an average of tens of thousands of dollars a year to see a doctor, usually a small disease prescribed a few dozen dollars of medicine, plus the cost of examination, but also a few hundred dollars. Assuming that a Chinese person spends an average of 300 yuan on each minor illness, 20,000 dollars would be enough for 67 visits to the doctor, and it would take an average of one visit in five days in a year to spend that much money.
The astronomical medical bills we can't afford to pay even if we don't eat or drink for a year are just as unaffordable to ordinary Americans.
The foreign media have reported on a number of super-high U.S. health care costs, such as a girl who broke her hand, went to the emergency room of a San Francisco public hospital, and later received a bill for 24,000 U.S. dollars. Although she had commercial insurance, it only reimbursed her $3,800. Then she went around to the media for help, and the hospital was pressured to change its mind and charge her only $200.
Once this story was reported, more than 2,000 readers subsequently sent this media outlet sky-high medical bills, with jaw-dropping complaints. Someone went to the hospital for abdominal pain, and the doctor suggested a natural treatment (that is, go back to normal life without medical intervention), but backhandedly sent him a bill for $8,000; parents took their little baby to the emergency room, and the doctor's treatment consisted of letting the baby take a nap and then drink a bottle of milk, and then ended up charging 18,000 U.S. dollars ......
This is not the behavior of individual unscrupulous hospitals, because in the United States to see the emergency room, call an ambulance itself is very expensive, and the United States of America on the pricing of medicines is not fixed and not transparent, different states, different hospitals, different treatments will have different prices, and the gap is very large. It is not uncommon for doctors to charge you thousands of dollars for medicines that cost a few dollars at the drugstore. As for surgery, a treatment with little reference, it's even harder to compare prices.
I went to a tertiary care hospital some time ago to see an ophthalmologist, and found signs on the wall stating the pricing for myopia correction surgery, laser treatment, full femtosecond treatment, etc., with the price for a single eye clearly stated. It's impossible to see signs stating how much a xxx surgery costs at a hospital in the U.S., the cost is based on the bill the patient receives at the end of the day.
What's worse, in the United States, there is a difference between the high and low levels of medical care, with a high price of commercial insurance, you can first appointment to the doctor, and no commercial insurance for the poor, often have to wait a few months to make an appointment with a doctor, a small illness dragged into a serious illness, not to mention the injuries, and ultimately, you have to bear the burden of more medical expenses.
Difference between Chinese and American health care systems
We emphasize morality in our culture and always say that doctors are kind and caring; while developed countries rely on selecting elites to become doctors and give them 4-5 times the average salary, how do you look at it, the doctor's own ability and morality will not be a big problem in general, so the doctor is not the key to the difficulty of getting to the doctor or the high cost of medical care.
The key to the problem, in fact, lies in the medical system.
The healthcare system is simply the relationship between the patient, the healthcare provider, and the payer, the three parties. In China, the payers are social security and out-of-pocket expenses; in the United States, the payers are mainly commercial insurance.
The U.S. designed an insurance model based on commercial insurance, leaving only a relatively small percentage for out-of-pocket costs, which is actually well-intentioned. But the system itself is fatally flawed, and all it takes is for insurance companies and healthcare organizations to join forces and coax patients into a frenzy.
It's easy to exploit the loopholes, because all an insurer has to do is convince a provider to issue a bill for a $1,000 treatment that costs $20,000, and then the patient pays $900 out of pocket and the insurer pays $100, and the cost of the medical care is perfectly passed on to the patient, and most of the premium is turned into a profit.
Some people are going to ask, "Wouldn't it be better to eliminate out-of-pocket expenses?
No. If all the costs of a visit to the doctor are paid for by insurance, the result will be that patients will overuse medical services, resulting in a waste of medical resources. The approach that the US is taking to prevent the price system from getting out of control is to try to split up the insurance companies and the payers who end up footing the bill, but at the same time it inevitably results in a longer, less efficient process, and ultimately higher costs.
But Obamacare has been working hard for four years, and was pushed back by Trump as soon as he came on board, so it is clear that the United States wants to implement universal health care is difficult, and involves a large and wide range of interest groups.
Then how did our country achieve social security as the main payer?
In the early years of China's medical resources are very backward, first of all, to make the majority of the people sick is the focus, so the nationalization of the unified regulation reasonably implemented. After the reform and opening up, in order to social stability, medical care also dare not arbitrarily market prices, individual parts of the market became we now criticize the Putian system. At the same time, the implementation of commercial insurance is more strenuous, because the Chinese people are generally reluctant to buy insurance for unknown needs, and no insurance, pure out-of-pocket expenses many people can not stand, if there is no social security, the impact of the group will be millions of people.
While social security is a big plus, China's healthcare system is not without its problems. A focus on price limits makes labor costs too low a proportion of medical costs, and a registration fee of a few dollars a time is too meager for a doctor, giving rise to the phenomenon of "medicines for doctors," commonly known as kickbacks.
The whole world wants to see a doctor, the same difficult, from the point of view of economics, health care prices and quality of care is always a contradiction in terms, just like playing mahjong, there is always someone who loses and someone who wins, or everyone does not make money, but it is not possible for all of them to make money. Cherish the relatively cheap and accessible medical resources now, and of course the most important thing is to take care of your health and try not to get sick.