rural medical service system
China's long-term unbalanced development policy is one of the main reasons for the gap between urban and rural areas, and this redistribution model is also reflected in the provision of public services. In cities, residents can enjoy more adequate public services conveniently; However, in rural areas, not only the public service facilities are very limited, the service level is very poor, but also the farmers themselves are relied on to solve the problems to a considerable extent. The rural medical service system is no exception.
This shows the huge gap between urban and rural medical and health conditions. This huge historical debt cannot be eliminated in a short time.
(2) The lag of government transformation is the institutional environmental reason for the lack of rural medical service function.
China's market-oriented reform has been going on for more than 20 years, with the gradual transformation of economy and society, which objectively requires the government to make corresponding transformation, that is, from a management-oriented government to a service-oriented government, and one of the key points is to reconstruct the social public service system. However, due to the lag of government transformation, the contradiction between the current lack of public services and the shortage of basic public products is increasingly prominent. Especially in the vast rural areas, the original economic functions of township governments (mainly urging seeds and collecting money) have shrunk or even disappeared, but they have not adapted to the changes in the situation to achieve transformation. On the one hand, the basic function of tradition has gradually lost, and its status has been widely questioned; On the other hand, a large number of farmers urgently need public services. For example, rural medical services have even regressed to a certain extent.
(C) The lack of necessary funding guarantee mechanism is the direct cause of the difficulties in the operation of the rural medical service system.
In the rural three-level medical service network, the county level can still ensure the basic operation, while the rural level is full of difficulties. Since the end of 1980s, most township hospitals have changed from "compartmentalized management" to "compartmentalized management", and the rights of "people, money and things" have all been delegated from the county to the township government. Rural finance is very difficult. In some places, even basic personnel funds are difficult to guarantee, and career development funds are even less. Coupled with the decline of the collective economy, the part that originally relied on collective economic subsidies also lost its source. Judging from the current system, there are still the following specific problems: First, the funding base is low. Although the rural medical and health expenditure has increased rapidly in recent years, it is still lower than the reasonable expenditure demand. Second, the proportion of public funds and career development fees is very low, so it is difficult for many county and township health institutions to "support people", let alone develop. Third, in the three-level medical service network, the expenditure is still concentrated at the county level. Fourth, the phenomenon of misappropriating rural medical and health funds occurs from time to time. Fifth, the proportion of special funds is large, and the autonomy and flexibility of using funds in primary medical institutions are poor, which sometimes can not adapt to local conditions and reduce the efficiency of using funds. In short, the supply of funds is not standardized and there is no guarantee. It makes the rural medical service system very difficult to operate, and it is also one of the main reasons for the general disintegration of the team, the decline of personnel quality, the decline of service quality and the competition for benefits with the people.