More than 90 percent of the medical disputes I've encountered are due to poor outcomes because the patient didn't have the money to pay for the treatment, or because the patient didn't have the money to pay for the treatment and had too high an expectation of the outcome.
Here is a reprint of the Southern Weekend for the Ministry of Health to strictly investigate the issue of red packets, society should come to care about the situation of doctors.
The medical industry is in the downstream of the entire pharmaceutical industry, with drug distribution in the midstream and drug production or introduction in the upstream; and on top of the entire pharmaceutical industry, there are even regulators of the pharmaceutical industry. This is actually a food chain. The higher the end of the food chain, the more profitable it is; the lower the end, the less profitable it is. The pharmaceutical industry is recognized as a profiteering industry, and the medical industry, because it is at the very end of the food chain, has the slimmest interests, and the profits flow to other sectors outside the medical industry.
The war against red packets is being fought. A province has recently issued an Interim Measures for Accountability of Medical Institutions and Doctors for Soliciting and Accepting "Red Packets" and Kickbacks. According to this method, who demanded and received "red packets", kickbacks amounting to more than 10,000 yuan, will face administrative demotion or dismissal. Recently held a national health work conference, the Ministry of Health also announced that the Ministry of Health is about to carry out a comprehensive special rectification of unhealthy practices in the industry, the first to open the knife is the doctor to receive red packets. The person in charge said, the health department to set up a telephone number for patients to complain, and all the doctors who receive red packets and kickbacks will be disqualified from practicing medicine.
Frankly, I'm not impressed. The medical profession is indeed plagued with problems, and social satisfaction is indeed very poor, and it can even be said that the medical profession is one of the industries with the lowest level of social satisfaction. The need to rectify the malpractice in the medical industry is beyond doubt. But precisely because of the many problems, more should not be rash. Just forced by the public indignation, do not ask why, not to be diagnosed, only on the surface of the phenomenon of the medicine to open, the result will often shift the contradiction, and cover up the deep-rooted problems.
So what is the deep-rooted problem? The answer is obvious when examined with the benefit analysis method. The medical industry is not the most profitable segment of the entire pharmaceutical industry. The medical industry is downstream of the entire pharmaceutical industry, with drug distribution in the midstream and drug production or introduction upstream; and above the entire pharmaceutical industry, there are regulators of the pharmaceutical industry. This is actually a food chain. The higher up the food chain, the greater the profit; the lower down the chain, the smaller the profit. As one expert has said, of the total cost of medical care for patients in China, hospitals charge very little for the labor of health care workers, which accounts for a very small percentage of the total cost - about 5% to 10% - and not all of this is paid to health care workers. Even the former health minister admitted that the low prices charged for most medical technology services "do not compensate for the costs consumed in medical services, and medical institutions can only be compensated from the sale of medicines, large-scale medical equipment inspections and the development of new and special projects, resulting in distorted medical behavior."
The pharmaceutical industry is recognized as a profiteering industry, and the medical industry, because it is at the end of the food chain, has the slimmest interests, and the profiteering goes to other sectors outside the medical industry. For example, a vascular stent, originating in the United States only sells 8,000 yuan, to China even sold to 18,000 yuan. Of the extra 10,000 yuan, the state collects 21%-30% of the total sales tax, which is conservatively calculated to be at least 3,780 yuan; the other 4,000-5,000 yuan is the income of the distributor; and the hospital receives a mere 5% of the management fee, i.e., 900 yuan. The medical industry is somewhat similar to a courier for a city express company, but it earns a little bit of money for the errands it takes to transfer medicines and other consumables from the distributor to the patient. What is supposed to be highly intellectual labor is paid almost as much as physical labor
. This particular form of "brain-body inversion" is prevalent in the pharmaceutical industry. Almost every region, there are only a few two or three mega-hospitals, brand-name hospitals in good condition, doctors earn a lot of money. The vast majority of small and medium-sized hospitals, where doctors, income is not above the average level of society, most of them are facing heavy pressure to survive.
But the least profitable medical industry, but the entire pharmaceutical industry with the most direct interaction with the community, as if the entire pharmaceutical industry, "Mr. Image". As a result, people tend to blame the medical industry for all the problems that exist in the entire industry, and the slander is rising.
This means that the truth is clear: it is not the doctors who are eating people, but a food chain that is eating people, and the doctors are forced to act as the end organs of this food chain.
The next question is, why is this happening? Or in other words, what creates this food chain structure? An expert has disclosed, "The high medical costs are mainly caused by the inflated prices of drugs, consumables and equipment. Of these, the distributors in the middle make too much money." It is not difficult to deduce part of the answer from this, which is the connivance of the regulators. Without the connivance of the regulators, the distributors in the intermediate chain could not have made so much money, and the pharmaceutical industry could not have been so shady. Another fact disclosed by the expert also supports this point: "The price department controls the hospitals very tightly, but what it controls is small money, and it does not control the high quality consumables such as medicines and equipment. For such products, the dealer to the price department quoted is how much is how much, the price department did not limit the price of such goods. However, patients often spend the most money on such high-quality consumables. Some antimicrobials cost more than 1,000 yuan for a single injection, and 10 injections cost 10,000 yuan; some medicines cost 20 yuan for a tablet, and a course of treatment costs several thousand yuan. This part accounts for a large proportion of the overall medical costs." Liu Feiyue, a young teacher who appealed to state ministries to curb drug prices, provided specific episodes of regulators' connivance with inflated drug prices:
"Metformin hydrochloride tablets made by Guizhou Shengjitang Pharmaceutical Factory cost less than 5 yuan, and the government's maximum price is 46.80 yuan.
Shanxi Evergrande Pharmaceutical Co. produces Luoxibao injection, the actual supply price from the company to the distributors is 2.10 yuan, but the price department set the retail price at 14.50 yuan."
It is clear that the sharp rise in the cost of medicine, to the point where it exceeds the actual affordability of the vast majority of the nation, is mainly the result of the ****ing conspiracy between the middle and upstream segments of the pharmaceutical industry and the regulators.
The final question is, why is there such a ****ing conspiracy? The answer is four words: profit-driven. As far as pharmaceutical practitioners are concerned, they are just businessmen, driven by profit, is there any other way? There is no substantive regulation, so of course they have to be free to do whatever they want. As far as the regulators are concerned, each functional organization is in fact an independent economic subject, with no difference with the general economic subject of the strong impulse to profit; deregulation can provide them with a vast space for rent-seeking, why would they not be happy!
And the continuous expansion of the pharmaceutical market, the pharmaceutical industry continues to expand, more can give some local governments to bring two direct gains: one is to stimulate GDP growth, bring performance; the other is to increase fiscal revenue, so the same is not happy! The pharmaceutical industry as a pillar industry, with the power to cultivate the pharmaceutical market, became **** knowledge. In this case, the requirement to strengthen the regulation of the pharmaceutical industry in the middle and upper reaches of the profit compression to a reasonable, that is, the average profit of the community within the range, is not a tiger's mouth to pull teeth? There is such a subtle contrast: on the one hand, the rapid development of the pharmaceutical industry - since 1990, China's pharmaceutical industry output value of more than 20% per year, far higher than the growth of the national economy during the same period, but also far higher than the average increase in the global pharmaceutical industry. On the other hand, China is ranked as one of the most unfair countries in the world in terms of the "financial burden of health" - in the 2000 World Health Organization (WHO) ranking of the fairness of the burden on doctors, China was ranked 188th, the fourth from the bottom. Whether there is a causal relationship between these two landscapes is really quite interesting.
It is clear that while the medical profession certainly needs to be reorganized, the problems of the medical profession are not primarily those of the medical profession, but of the pharmaceutical industry as a whole, and of the regulators in particular, and of the food chain as a whole, rather than the doctors alone being put into the limelight. Doctors have to suffer from exploitation from within the food chain and can only maintain basic survival, but also have to withstand strong public opinion and administrative pressure, and bear the accusation of thousands of people. In the long run, it is inevitable that they will be physically and mentally exhausted. Doctors are the caretakers of our lives. If doctors themselves are physically and mentally exhausted, how can we expect them to care for our lives? In this sense, good treatment of doctors, in fact, is good treatment of our own.