Today, the Beijing Municipal Commission of Health and Planning officially released monitoring data showing that the total number of outpatient and emergency room visits of the monitoring units (373 medical institutions in the city) after the implementation of the new health care reform is about 22,614,000, a decrease of 8.46% compared with the same period of last year, in which the total number of outpatient and emergency room visits of the second and third-tier hospitals has decreased by 12.58% and 4.54% year-on-year, and that of the first-tier hospitals and community health service institutions has increased by 7.6%. 7.6%, the effect of hierarchical diagnosis and treatment is gradually appearing. As of June 7, the total savings from the sunshine procurement of drugs amounted to 842 million yuan.
But that's not how some patients feel. Recently, on Zhihu, the question "Why is the doctor's prescription still so expensive now that the registration fee is 25 or 30 a piece?" The question aroused discussion, with more than 500,000 views.
The 388 responses were categorized into "professional practitioners" and "patients' personal experience", and the network filtered out two responses to explain the patient's concern about "expensive prescriptions".
Shang Fang Hui Clinic (Oncologist, Fudan University Cancer Hospital)
It is assumed that the price of medications prescribed by a doctor is determined by the doctor and/or the hospital - but it is not.
The fact that drugs are expensive has basically nothing to do with the hospital. Drugs are priced after centralized bidding, and how much they cost is largely irrelevant to doctors/hospitals. Hospitals and doctors have no influence on the vast majority of drug prices, if anything, it's the hospitals that choose to admit the drugs with the most bang for their buck (many of which are domestically produced and pretty crappy) over the cheapest or most efficacious or cost-effective drugs. Well, it's that dopey!
The price of drugs is expensive mainly:
1) China's poor production capacity for drug research and development, the better drugs are imported, not expensive, a lot of U.S. drugs and devices, the domestic sale than the U.S. are more expensive.
2) There are too many distribution links, too many hands wanting to dip their hands in the oil and water, and the doctors are just the weakest link you can see, being exposed as soon as something happens to be pushed out as a shield; it's the ones hidden in the back that are the big ones.
Well, that's just how dumb it is.
It's assumed that when drug prices are lowered, there are fewer kickbacks for doctors, so there's less incentive for them to overmedicate - but there isn't.
It depends on a number of factors, how competitive the drugs are, the profit margins of the manufacturers, etc. The impact on drug rebates in the long run is unknown, and the probable event is that there will be an overall reduction in drug rebates.
While outpatient prices have gone up, outpatient charges are not high and do not account for a large proportion of hospital revenue. After the abolition of drug markups and a drop in testing costs, overall hospital revenue is down, and the rise in outpatient revenue does not offset the decline in other revenue, and the state does not increase subsidies as a result.
The overall revenue of hospitals is not rising in the environment, the doctor will be because of the price increase in outpatient fees and the basic possibility of income unchanged or rising is very small. Of course the share of a single visit is certainly more than before, so it is really intoxicating to have a knowledgeable user say that some doctors have to make a single visit into several visits!
Of course, there are also departments with increased benefits, such as oncology radiotherapy departments, because the main medical services, price increases are medical services ah. At present, the departments that benefit from health care reform are very few.
Of course, after the price hike, our outpatient fees are still not expensive, and the outpatient experience is really bad. These are two issues that are hard to reconcile at the same time; it can't always be cheap and good, not in accordance with basic principles.
Assuming that doctors' incomes are largely based on drug rebates, then after doctors' incomes increase due to higher outpatient fees, doctors will suddenly exercise self-ethical restraint and not over-prescribe and over-medicate - but they won't.
China's drug-based medicine has its own background and motivation to begin with, but by now it has become a basic unspoken rule. Even if doctors' sunshine income rises dramatically, it won't necessarily change the habit of taking kickbacks. Changing this will take a systematic, long-term effort, not self-discipline or morality on the part of doctors.