What are the reasons for the rise in medical costs in our health insurance?

1 Reason China is gradually becoming an aging country, the rapid growth of the elderly population, the elderly population consumes an increased proportion of the total medical costs. With the development of the market economy, people's pace of life accelerated, competition intensified, coupled with industrialization, urbanization process occurred in the environmental pollution, so that occupational hazards and nutritional imbalance of the disease rise, resulting in a sharp increase in demand for medical services, medical costs rise [1]. The widespread use of highly sophisticated instruments and equipment in clinical settings due to technological advances, the popularization of disposable sanitary materials, and the rising prices of other consumer goods drive up the total cost of medical care. With the rise of medical costs and the imperfect compensation mechanism of medical services, hospitals derive irregular medical behaviors: (1) Hospitals, from the perspective of their own survival and development, go into the misguided area of large prescriptions, misuse of: high-grade antibiotics, expensive medicines, duplicate inspections, and overuse of high-tech equipments, which results in the excessive growth of medical costs. (2) hospitals can not make ends meet, prompting the hospitals within the layers of economic indicators, the implementation of various forms of economic responsibility system, the hospital's economic income and medical staff personal interests linked to this impetus to promote the substantial increase in medical costs. (3) The value of the technical services of medical personnel has not been fully realized, forming the irregular phenomenon of medical institutions "making up for losses within the price and outside the price", which has led to the emergence of decomposition charges, duplication of charges, and indiscriminate charges under different names, resulting in an abnormal rise in medical costs. The mismatch of macro policies has led to contradictions in the mechanism of various interests: (1) the contradiction between the two-line management of drug revenues and expenditures and the implementation of financial subsidy policies. Due to the unbalanced economic development, in the less developed areas, the government's financial subsidy policy is difficult to implement, while the hospitals are required to implement the "approved rate, over the rate of payment" and the proportion of community health services and preventive health care funds management approach, the hospital's need for survival and the pursuit of interests, the purpose of reducing medical costs is difficult to achieve. (2) medical institutions centralized bidding procurement of drugs, drug prices, the implementation of the Shunga price, leading to drug suppliers and hospitals in the economic interests of the consistency of the same quality of drugs, hospitals are willing to high into the high, as much as possible to get the difference in price, so that a part of the drugs appeared in the centralized bidding procurement of drugs after the purchase of the price of the strange phenomenon of a substantial increase in the desire to reduce health care costs is difficult to achieve. (3) disposable materials according to the price of the purchase price plus price, the hospital has a certain profit margin, but also due to the requirements of the hospital's internal departmental accounting, department to complete a certain amount of profit, resulting in the proliferation of disposable materials for clinical use, prompting the rise in medical costs.

2 Countermeasures

2.1 Standardize the medical market, promote the competition of medical institutions Health administrative departments to rectify a reasonable layout, standardized and orderly, fair competition in the medical market. Medical institutions to carry out property rights system reform, the state from a part of the public hospitals to withdraw, the formation of a variety of ownership of medical institutions coexist in the pattern, to play the role of the market mechanism, reduce the rise in medical costs.

2.2 Establishment of the hospital management committee as the main body of the corporate governance structure Hospital management committee as the main body of the hospital corporate governance structure, on behalf of the government and social public **** interests, to determine the hospital development strategy and development planning, the exercise of the hospital's major decision-making, the dean of the implementation of the management committee's decision-making, with the right to operate and manage the hospital, the hospital's day-to-day work of the overall responsibility for the unified leadership, and periodically report to the management committee on the status of operation and management, and accept the supervision of the management committee [2]. Make non-profit hospitals become low-priced, commonly used drugs, routine treatment, ordinary conditions, humanitarian, efficient operation, two-way referral (with community hospitals to establish a two-way referral system and the establishment of home hospital beds) hospital [3].

2.3 Establishment of a new type of medical fee system Establishment of a new type of medical fee system suitable for the level of economic development and meet the requirements of people at different levels, improve the compensation mechanism of medical institutions, and promote the healthy development of health undertakings: (1) Reasonable adjustment of fees for medical services, and gradually make the medical fees close to the cost of medical services, increase the price of technical labor services, reduce the price of medical equipment and inspection services, and reasonably determine the price of special-needs services. prices. (2) To widen the gap in medical service prices between medical institutions of different levels and doctors of different levels, to guide the reasonable diversion of patients, so that the treatment of general illnesses can be resolved in grassroots hospitals, to alleviate the pressure on large, high-grade hospitals, and to promote an increase in the utilization rate of medical resources. (3) Reasonably determining the prices charged for disposable materials, and determining prices with due consideration of the costs of materials such as wastage, transportation, and management, can reduce the excessive use of disposable materials in clinical practice. (4) Standardize drug pricing policies. Price authorities can use social intermediaries (certified public accountants) to audit drug production costs, verify production costs based on reports issued, set and adjust drug prices, and address inflated pricing of drugs. (5) Increase investment in health care, earnestly implement the policy of financial subsidies to government-organized non-profit medical institutions, and increase transfer payments to poor areas.

2.4 Accelerate the pace of reform of the internal operation mechanism of medical institutions Reform the distribution system and employment system, implement staff reduction and efficiency, and actively promote the socialization of hospital logistics services, and strive to reduce the cost of medical care, and reduce the economic burden on the government and the public. Adhere to non-profit hospitals is to maintain public health for the purpose of protecting social labor productivity as the goal, in pursuit of social benefits as the highest guidelines.