(2), the problems of health development
China's medical and health care in the 6 million medical personnel work constantly strive to support the 1.3 billion people's health care, which is an irrefutable fact. That is why the World Health Organization has also praised our country for protecting the health of the world's largest population at the cheapest cost. However, when we re-examine China's health, serious reflection, we will find that China's health development lags behind the development of the economy and other social undertakings, health care system and the people's growing health needs do not adapt to the contradiction is still quite prominent, the development of the health sector is incomplete and uncoordinated problems.
First, the government investment is decreasing, the per capita medical cost is very low. As a result of the implementation of the "decentralization of profits" of the financial system, the government's fiscal revenue and expenditure accounted for a sharp decline in the proportion of GDP, which led to the government's public **** health expenditure accounted for the proportion of GDP all the way to the slippery slope, the government's investment in a serious shortage. In the 1970s and 1980s, government investment accounted for an average of more than 30% of hospital revenues, and in 2000 this proportion fell to 7.7%. 2003 to combat SARS, the government investment has increased significantly, but also accounted for only 8.4%. 2003, the national total cost of health was 659.8 billion yuan, accounting for 5.6% of the GDP, to a relatively high level in developing countries. However, government investment accounted for only 17 percent of this amount, with enterprises and social units bearing 27 percent of the burden, and the remaining 56 percent being paid by individual residents. With regard to individual health expenditures, in 1980, the proportion of urban and rural residents' personal health expenditures in total health costs was only 23%; by 2000, it had reached 60.6%. There are also data showing that: in 2000, the government's total investment in health care was 476.4 billion yuan, 400 yuan per capita, 600 yuan per capita for urban residents, 200 yuan per capita for peasants, and 930 yuan per capita for Beijing residents, according to the level of residents in Beijing the government needs to increase its investment by 700 billion yuan, so it is clear that the government's investment in public **** health is seriously inadequate. This is actually the focus of the health development dilemma.
Second, the rapid development of health care causes high medical costs, increasing the burden on patients. China's large-scale instrument ownership has increased greatly, the production capacity has increased greatly. Due to the low level of government investment, hospitals operate mainly by charging patients. The masses of medical payments, not only to bear the cost of medicine, but also to bear the salaries and subsidies of medical personnel, some hospitals rely on loans, financing the purchase of advanced medical equipment, the construction of ward buildings, a considerable portion of the patients to rely on the burden of medical fees to repay. This is bound to raise the cost of medical care.
Thirdly, the coverage of China's health care system and medical insurance, which is organized and implemented according to urban and rural areas, ownership, and employment status, is too small to reflect the principle of fairness that should be followed in a society; in 2002, rural residents, who accounted for two-thirds of the country's population, enjoyed only one-quarter of the total cost of health care, while urban residents, who accounted for one-third of the population, enjoyed more than three-quarters of the total cost of health care. Inequity is also reflected in the increasing concentration of medical resources in large cities and high-income groups, while the vast majority of human and material resources are concentrated in large hospitals, the primary and rural medical and health-care network, which once had a low level of basic medical care, is disintegrating, and the majority of low-income earners, especially peasants, are unable to obtain basic medical care, and have to pay for almost all of the costs of treatment, such as checkups, hospitalization, and medicines, on their own. The first step is to make sure that you have a good understanding of what you are doing and what you are doing.
Fourth, since the reform and opening up in 1978, especially in 1992, China's move towards a market economy, the high cost of medical care, while the polarization of the rich and the poor began to appear, the wealth more and more concentrated in the hands of a small number of people, 90% of low-income people's incomes accounted for a smaller and smaller proportion of the degree that they could not afford to pay for medical care, and their yearly income is often not enough to even stay in the hospital once. As a result of the economic difficulties, the utilization of medical and health services by urban and rural residents has declined, and effective demand has shifted. Surveys have found that 48.9 per cent of China's residents do not go to see a doctor when they are sick; some buy their own medicines, while others do not take any therapeutic measures. Among those who went to see a doctor, 29.6 per cent were not hospitalized even though they had been diagnosed by a doctor as being in need of hospitalization. The analysis of the survey concluded that 38.2 per cent of those who did not seek medical attention, were not hospitalized and did not take any treatment measures were due to financial difficulties; 70 per cent of those who should have been hospitalized but were not were due to financial difficulties. The proportion of urban and rural low-income people who should have been hospitalized but were not reached 41 per cent, much higher than that of the general income group. Recent statistics also show that half of the farmers in rural China cannot afford to see a doctor for financial reasons. The proportion of farmers in the central and western parts of China who die at home because they cannot afford to see a doctor is as high as 60-80 per cent. More than anything else, this highlights the impact of polarization on the health care of low-income people. The direct consequences of inequity in health, the decline in the health of vulnerable groups, negatively affecting the development of the national economy; the resulting political problems, but also can not be ignored.
Fifth, there is another outstanding problem in the development of health care is the irrational allocation of health resources, the excessive concentration of high-quality resources to large hospitals, large and medium-sized hospitals in the city, concentrated in a large number of new and high-tech medical equipment and excellent medical and nursing personnel, while the grass-roots level of health resources is seriously inadequate. This is one of the major causes of the problem of difficult and expensive access to health care for the public. According to the Xinhua News Agency, urban residents, who make up about 20 percent of the country's total population, enjoy 80 percent of the health care resources, while the rural population, which makes up about 80 percent of the country's total population, enjoys less than 20 percent of the health care resources. According to a 2003 Ministry of Health document, urban community health service centers, compared with urban general hospitals, account for only 2.2 percent of the staff of hospitals and are technically weak, lacking qualified general practitioners, with 1.4 percent of the housing and 1.6 percent of the income, which is very weak