I reconstruct speeches to give advice for for medicine

I reconstruct speeches to give advice for for medicine
I reconstruct speeches to give advice for for medicine
Pick up the neglected and to supply the deficient and talk about the medical reform Hygiene Zhang ZanNing, chief of institute of law of Southeast China University <>Fully reflect people first, solve anxiety for the people, construct the aim of the harmonious society. In operating specifically, specially propose the following suggestion: Could be the key to success and realizing first, how to use limited medical resource for all people to involve the medical reform like this. I suggest, medical insurance systems of the whole people can be divided into three levels (can also call it the tertiary medical insurance system) : First class medical insurance. Namely to A, B two kinds of infectious diseases and schizophrenia (excluding nerve disease and psychonosema) Implement the whole people in full and treat the system free. Second medical insurance. Namely to class-C infectious disease and other ordinary diseases, implement the general medical insurance system, namely the medical insurance treatment or socialized medicine treatment undertaken together by country, collective and individual usually spoken. Among them to enclosing health care, the treatments of common disease, frequently-occurring disease, chronic disease and national basic medicine used perinatally, in the treatment of medical insurance (submit an expense account on the proportion) Can offer greater favour. Should consult the mental hygiene to include with psychological medical treatment in second medical insurance range. Usually speak " The whole people's medical insurance " ,Narrowly-defined medical insurance, namely refer to second in general and speech. Tertiary medical insurance. Refer to it to the medical resources in short supply, luxurious medical care, or medical science is still treatment of disease different to cure at the present stage. Organ transplant, recover medical treatment, cosmetic medical treatment, resist aging treat, inborn physiological defect treatment of disease, by the personal commitments in full, but does not repel a patient to accept the right that charity organization, society, collective, individual offer in principle. Except tertiary medical insurance, no matter nobody, there are other privileged medical insurance strata. Second, implement the great mode of Ministry of Public Health Medical reform opinion "draft "( Four) Though is very good, in the current " administration of little hygiene " Under the system, it is very difficult to accomplish. First of all, must start with the great hygiene system, change the passive state of medical treatment by all means of Ministry of Public Health fundamentally. Establish big hygiene administration and great hygiene law idea. Secondly, it is an independent department law that should establish hygiene law. Having established the law of ten departments in the current regulation system of our country, but not established the position of the department law of the hygiene law. Third, on the basis of establishing the great hygiene law concept, big Ministry of Public Health is established. Administrative norm, policy relating to hygiene, Ministry of Public Health has the right to make the relevant norm to erupt simultaneously gently independently. When involving policy norms such as industrial hygiene, agricultural hygiene, railway hygiene,etc., Ministry of Public Health does not need to consult with departments such as engineering letter department, the Ministry of Agriculture, Ministry of Railways,etc. or send the documents together. Ministry of Public Health exercises the mechanism of management function of the hygiene in the name of the State Council, to the regulatory document of the policy of Ministry of Public Health, national every relevant department should fulfil unconditionally. All executive functions related to hygiene, Ministry of Public Health and local hygiene administrative organizations at all levels have the right to exercise the right of supervision and management. Do not need to carry on in the relevant organization with departments such as the intersection of Engineer and letter department, the Ministry of Agriculture, Ministry of Railways,etc. to be so-called and jointly enforce the law. Large Ministry of Public Health is the administrative management modes of most countries in the world, the small current mode of Ministry of Public Health can't already meet the need of the hygiene reform. Should be in line with international standards in this. Third, according to China's actual conditions, medicine should break up the family Though in most countries, medicine is to break up the family, in China " one of medicine " Had a history of more than 5000 years already. To the seventies of last century at the beginning of liberation, what our country implemented was one of medicine. From the eighties of last century, after breaking up the family in medical management, the big and small slip has been never broken. So, I think, it is exactly a great characteristic of China that medicine is assigned to, and a kind of fairly good successful characteristic. So, needn't be all studies foreign country. Certainly, in order to integrate with the world, in pharmacy research and medicine are developed, it is essential to introduce western scientific management idea, patent system, market economy mode. Four, two places " The contradiction " ,Must dissolve "draft "( Two) Have proposed insisting on in the basic principle " Government's leading factor " With " government's fund-raising " It is a main fact, and also " give play to the market mechanism " ," promote the forming of ordered competition mechanism " ,This is contradictory, it is impossible to accomplish. I think, can not practise market economy and competition mechanism in health care industry. Even if the hygiene industry of the capitalist country, does not practise market economy and competition either, such as forbidding medical advertising, discovery and medical treatment on medical science are invented and can not be patented etc.. "draft "( Nine) Successively mentioned to want " Follow public service properties and the social benefit principle " , " competition " , " overcharging and turning over, difference subsidy " ,Should " improve and distribute the incentive mechanism " ,And also " emforce the management on payrolls " Wait for the concept, this is contradictory or different to accomplish too. For example: Have implemented the hospital " Overcharge turning over, difference to subsidize " How still " The competition " ? " emforce the management on payrolls " Like and " distribute the incentive mechanism " Also contradictory. Can't avoid the intersection of worry and the intersection of Jiangsu Province and abundant the intersection of city and the intersection of institute of traditional Chinese medicine and Liu of doctor add, rise new medical reform very much difficult to succeed in in substantially as putting forth effort to solve the doctor worry. Everyone admit doctor medical mainstay of battle line, which one medical organization diverge from doctor to be difficult to survive, but the doctor faces a lot of puzzlement at present, the doctor's image and status are not high in national people's mind, some masses that unsatisfied even call doctor still " White wolf " , " killer " Wait, make the relationship between doctors and patients at present more and more tense. Analyze the whys and wherefores, abuse the hospitalization cost due to medicine, excessive checking, arbitrary charge,etc. and rise with the doctor too fast relevantly all without exception. In order to prevent from and correct the above-mentioned malpractice, solve and see the doctor the expensive problem, the country has reduced the price of medicines many times, Ministry of Public Health has made a lot of measures of checking unhealthy tendencies and malpractices too, a lot of areas adopt the method of restraining the proportion of medicines, medicine from separating etc., but produce little effect, the people are still unresolved when seeing the doctor expensively. Take the fact that the doctor uses the antibacterial medicine as an example, American-European the intersection of developed country and antibacterial medicine use medicine amount of money account for the intersection of hospital and the intersection of administration and total value, have only 10% to be about, but our country is up to 35%~40%, some are at the basic level the hospital is up to more than 50% especially. In order to make the doctor rational the antibacterial medicine of application, prevent the doctor from abusing antimicrobial, Ministry of Public Health has issued " the antibacterial medicine employs the guideline " for this, but how about the result? In order to lighten the people's medical financial burden, solve and see the doctor this expensive difficult problem, Ministry of Public Health has stipulated clearly too: Method that the medical organization should firmly abrogate the independent accounting of every department, the medical income ties to doctor's income. But How many medical organizations are carrying out this regulation in fact have? Does not the doctor want to press? Shuo Fu � Jing's ostrich is all fierce that the spring onions school woulds like to pay �� vulgarly to fall from the sky or outer space Stem �� revitalize �� of �� locust the intersection of swan and ���'s sole? The author realized in the past: " it is very difficult to become a pure doctor " ,Feel, become one very tired doctor nowadays, it makes one people to be tired in satisfied doctor. First, the body is tired, the doctor works in the medical forefront, in order to rescue and cure the disease people, it is a common occurrence to attend to dinner and have a rest, get up early, go to bed late doctor accustomed to already, how much festivals or holidays others can go, make a sightseeing tour, but the doctor rushes about in the medical forefront, year after year, can be non- tired on doctor's physical power? Second, the brain is hard, the doctor since cures and studies the universities and colleges to graduate and move towards getting up clinically at that time, doctor's brain is highly nervous, because people's life is weightier than Mount Tai! He not only wants to learn the clinical experience from doctor of the high age and service seniority, plans to meet doctor's examination of the license, this is very important closing! After getting medical practitioner's card, who dares half-heartedly there are the medical file of the high standard and strict requirements the case history is written,etc. in hospital! Because the medical renewal of knowledge is very quick, as the doctor must do and learn until old until old. Third, the heart is hard, nowadays the relationship between doctors and patients is more tense, the doctor's psychological burden is heavier and heavier, will get into trouble with the law soon slightly because of carelessness, such as meeting some unreasonable patients, the doctor is not only the grievance of hitting and abusing etc., it is massacred by patient or its relative that what is more. Have how much doctor change one's profession because the heart is tired, how much doctor does it have because heart tired insomnia, many dream, anxiety. The hospital, for survival and development, everyone knows that pigeonholes the heavy burden on the doctor's shoulder at the same time, the economic task index substantially as finishing being assigned in the hospital, it is a problem that doctors will have a meal. The doctor faces the pressures of all respects such as the society, hospital, patient nowadays, undertaking high risk, high strength, high work that pays, so the doctor's heart should be the most tired. The doctor's body, brain, heart are so tired, but it is seriously out-of-balance to pay and reciprocate, less than 40,000 yuan at 75% doctor annual pay of investigation, 82% discontended with income doctor, some the intersection of developed country and income of doctor Chinese about 40 times in doctor (U.S.A. is 59 times among them, Japan is 35 times) ,And compared with near neighbour, the Hong Kong doctor income of our country is 22 times of the mainland doctor's, Taiwan is 14 times; Singapore is 48 times, South Korea is 26 times. In addition, according to talents exchange service center of Ministry of Public Health, more than 1 million people pass the clinical medical practitioner's qualification test in China in the most recent 6 years, but 400,000 people have not registered, analyze 400,000 people abandon the reason why medicine change one's profession, except other factors, the reason why the young doctor has too low salary can't be ignored. China cures the SCTE and ever acts as two investigations, the national doctor's children would like to be only 17% of proportion of the doctor, while inquiring that unwilling to do doctor's reason, their answer is very simple: Doctor too low treatment have at present, risk and labour intensity too large, pay and reciprocate proportional. In view of the above reasons, I propose, the new medical reform scheme must solve the doctor's worry emphatically, reflect labour value of doctor really like U.S.A., let doctor wholeheartedly, not reasonable affording to shut rule, not legal, no longer simple the doctor " The hospital creates income " And checking, writing a prescription, operation,etc., does not let the doctor serve as the slave of the money again. Only worries such as the doctor's life, working and studying,etc. have been solved, some covert payment, great prescription, check just easy to solve while being excessive. It is easily solved too that the medical expenses of our country increase too fast, the broad masses of the people are just satisfied naturally. The medical reform must be touched under minister of the Sun 's of county hospital of Tanghe of Henan Province of the system county and county the present health care system has three kinds of situations: First, work out the organization in organ's undertaking of organ of health bureau and office, such as liking defending running, run in the Red Cross, ground disease run the intersection of personnel and salary and work funds belong to the intersection of county and finance, support all. Second, the office belongs to second unit with public health function, for instance, disease accuses of centre, Health Inspection Institute, healthcare hospital for women children, public hospital, defends the school, name whether undertaking support all, implement to undertake to do a job until it is completed funds in fact, namely annual the intersection of county and finance give sure funds only, the insufficient part is tried every possible means to create income and solve by the unit, the ones that create income badly can only reduce the salaries to workers and release the standard. Unit that is mainly the medical attribute three, institutes of traditional Chinese medicine of hospital, county and all health clinics in towns and townships are determined the undertaking as to support the unit badly such as the county, namely still keep unit undertaking properties, the funds, besides unit medical income, the insufficient part is supplied by the county, finance of township. In fact, as to author's Henan Tanghe where one stays, what the county finance is implemented is mending definitely, mend 90,000 yuan for the county hospital every year, institute of traditional Chinese medicine mends 95,000 yuan, 20 health clinics in towns and townships mend 1,200,000 yuan definitely altogether. Only 60,000 yuan of each of health clinics in towns and townships on average. As to these units, a ridiculously inadequate effort to save a grave situation, these units nearly accept propping up by oneself, manage properties, can only survive and develop by the medical income in corporatization of assuming sole responsibility for its profits or losses. It is that the public health function born is weakened at first that there are drawbacks in the system at present, if plan immunity, infectious disease preventing and curing, disease is supervised, AIDS is treated and cured, function of sterilizing, monitoring, subdueing killing, endemic disease and preventing and curing etc. in disease is controlled; The gynaecological disease general survey of mother and child care, pregnant and parturient women enclose perinatal health care, neonatal death to monitor etc.; Defend training to professional and technical personnel and rural doctor of the school,etc., because of the reason short of money, the difficult normal norm is launched, go to the countryside the work of investigating etc. is difficult to guarantee because of funds such as vehicle and petrol. Secondly has influenced and dampened the working enthusiasm of the masses of workers to a certain extent, because the salary was not ensured, the welfare treatment is low, lack the incentive mechanism, working enthusiasm is difficult to arouse, professional technique team difficult to stabilize, some the intersection of business and backbone have much to job-hop, engage in trade, or retain the job but suspend the salary. Especially the defending protecting staff members of the health clinics in towns and townships, are all public beneficial hygiene services because of what has been engaged ined, take social benefit as the core, seldom achieve the economic benefits, therefore few bonus and welfare treatment can be spoken. It is very difficult to support the family, working enthusiasm is lower, there are more ones that retained the job but suspend the salary and went out to work as a temporary labourer. Third, it is very difficult for the hospital to establish the correct management idea. Under the realistic hygiene mechanism, the president has to consider existence and development of the hospital, have to consider the worker's salary and bonus, so is the heavy economic benefits in management, light social benefit, lay stress on managing instead of make light of defending, generally adopt the distribution method relying mainly on efficiency-related wages, even take some illegitimate competition methods to fight for patients. Fourth, mislead and corrode some medical workers thought, make them produce the favourable behavior of becoming seriously. The managerial system at present and assigning under the mechanism, the illegal distributor in some medical fields of circulation takes advantage of a weak point, some of one deducts a percentage the medicine is thrown into The hospital, therefore will present " covert payment, commission, writes a prescription arbitrarily, the haphazard inspection " ,but most doctor in case of exactly daily medicine,it is medical for distributor have administration deducted a percentage and lasted theirs privately. It is said medicines that have deduct a percentage proportion very high, this prove medicines price timid and high too, the space of profit is quite big, price department of this has responsibility too. How to expel the drawback must safeguard the social public service properties of the public medical health organ of our country at first, its duty and task are to meet basic health care demands of the broad masses of the people, the ones that realize it is put forward that 17 is great " Everybody enjoys the basic health care service " Goal. Secondly the government must implement the full-amount fund input to the public hospital, just like input to the middle and primary schools of the government at present, the salary is released by the finance, the school building is built by the government, make the school leader gather to stress management, stressing teaching, the teacher imparts knowledge and educates people attentively, school and teacher have no worry on the welfare treatment of the salary. Third, in order to solve the commercial bribery problem of the medical realm of sale, it is unrealistic to implement medicine to break up the family at present. Can implement hospital medicines " Zero raises the price " ,Namely how much is entered, how much is sold, it extremely causes the condition of deducting a percentage medicine to stop up, the medicine that doctors shouldn't use start more, the illegal medicine dealer is inorganic can ride. Have so not only lighten patient's burden but also saved a large number of medical resources for the country, the more important thing is to avoid medicines and abuse the poisonous side effect caused and are able to bear the environmental pollution of medicine etc. to endanger potentially. Fourth, after the government puts to the public health care unit into in full amount the funds, can implement on the economic mechanism of management " Two lines of revenue and expenditure " ,Funds that hospital need appropriate by government, income of hospital take, turn over government finance, control bad phenomena such as the arbitrary charge, checking, excessive medical treatment, excessively checking arbitrarily,etc. effectively in this way. Fifth, how to improve the working enthusiasm problem after supporting completely for salary which solves the medical worker, the hospital should make strict rules and regulations, set up strict examination mechanism, implement the reform of personnel system as soon as possible, compete for posts, the salary floats completely, mechanisms of management such as the responsibility system,etc., really make sure the able one has, the mediocre one is left, the more pay for more work, less work, less pay, can not work, the performance is got in touch, competent to work both at the top and at the grass roots, it can be low to be can be high, select the superior and eliminate the inferior, help to stimulate and arouse working enthusiasm, bring up the flexible employing mechanism that outstanding talents break out. Six of its, the government should set up and amplify the unit supervision supervision mechanism to health care, the functional department that actually the medical department was the government, in order to make it fulfil government's function well, must set up complete management, restrict system, guarantee, have, it makes to be must all right, prohibit stopping, the government decree is unblocked. Seven of its, with the further growth of national economy, the country can consider implementing free medical treatment systems of the whole people. It is reported, not so good as of our country the intersection of economy and the intersection of developed Egypt, Pakistan and Thailand,etc. and country, already basically implement the free medical care of the whole people still at present. It is " two lines of revenue and expenditure " Worry Professional committee of association's medical legal system of Chinese hospital Wang XiuHua " the draft was " involved " for the new medical reform scheme announced a few days ago Two lines of revenue and expenditure " Implementation,"two lines of revenue and expenditure " Been regarded as the effective action of solving the public beneficial desalinization of public hospital by people all the time, but how is the feasibility for the current stage of this method? What respects question may appear after putting into effect? How to reply? This is a problem that must pay close attention to and solve medical reform. First, this measure will initiate the new one difficult to see the doctor? " two lines of revenue and expenditure " Management,in fact it is somewhat return in budget appropriations systems in full's. , probably easy to do badly and samely to do to present before the reform, even do and do the same situation. Unreasonable in present medical resource distribution, under the insufficient and extravagant situation that exists at the same time of resource, the expensive problem of seeing the doctor may get relieving at various degrees, but the difficult situation of seeing the doctor may appear again. And go to the appearance of the inefficient situation of medical organization with the traditional system, a lot of medical organizations are by present " fight for " The patient turns into " Push away " The patient's situation will be difficult to avoid. Second, how to break through administrative cost and bottleneck of the efficiency? Though the public medical organization must keep it public beneficial, the public medical organization is different from other public departments after all, under the big environment of market economy, it is still an economic entity at the same time, so its charge can charge the picture equal sign with general administrative cause. And the medical organizations at all levels, because of the existence in factors such as its scale, region difference,etc., its charging act extends to this field in if government's behavior in the form of high difference, will meet the double difficult problems of cost and efficiency then. Third, can the public finance afford the huge expenditure? The national public medical organization accounts for more than 95% of the total number, if implement " two lines of revenue and expenditure " at present Manage, how much can the expenditure put into to " hold the bottom " to the public medical organization ? People seem not to have precise estimation at present, but there is a kind of phenomenon that have to make persons watch out for, that is to income and implementation of the public medical organization at present " Two lines of revenue and expenditure " The the last finance is put into comparing mechanically, therefore a kind of unrealistically optimistic mood emerges, in fact this kind of contrast lacks the reason. A lot of people point out simultaneously: In a situation that personal income and business income of the medical organization of medical worker fail to break off relations, the income institute of the medical organization appears " Prosperous " The state, is implementing " two lines of revenue and expenditure " Hard to carry on because of disappearance of internal motive force after management. Could the government bear the financial pressure brought from this? Moreover, for a certain period a lot of medical organizations in debt because of being crazy about the construction of epitaxy excessively manage, and the disappearance of supervising the mechanism leads to the fact again the rate in debt of the medical organization is higher and higher. If implement " Two lines of revenue and expenditure " Manage, this kind of debt will undoubtedly come to government from the corresponding transformation of medical organization, could the government take enough financial resources out when the time comes? Fourth, how to prevent new power from seeking and renting? In theory, for using " a line of revenue and expenditure " Go to " guide " The medical organization pursues the interests to maximize, " two lines of revenue and expenditure " System design undoubtedly desirable. But if according to aspect practised, it has increased the medical organization and another " a line " of the government finance department ,And this line one " The elasticity " ,Have offered the space for the fact that the power of the related departments sought renting. Particularly, because grasp appropriation standard, number and speed of the medical organization in financial department, it is big in the present society Unless under climate, in not playing chess interests with departments financial in medical organization,will you please seek to last behavior power may produced to avoid effectively? It is one that must cause the attention and question that allows of no optimist. Is it possible to fifth, solve the problem that produced under the market economy environment with the thinking of planned economy? Someone points out, the government can only charter the hospital now. And the pharmaceutical factory is the market economy, it is impossible for the government to wrap up. Medical treatment by medicines, make a diagnosis and recover whom a plurality of key element form, get back to planned economy the medical links among them only, even it is difficult to make the results of times of complete planned economy. These views are not unreasonable. From a different perspective, the cost that the public finance is invested is born by the taxpayer too after all, if our relevant policy can't reduce the wasteful use of resources and solve efficiency and bow the problem effectively, no matter what a bright prospect can be derived out theoretically, must be double cautious while putting. In addition, though by the look of macroscopic, the social market mechanism is more and more complete, but we are still difficult to get rid of the thoughtcast formed under planned economy theoretically, it is not to open up the new thinking to meet the question, it is not to look for and solve the method of the problem according to the new situation changed, but the times from planned economy conscientiously " The weapon storehouse " The ones that look for and solve the problem in China " The magic weapon " ,In fact this is one kind " The thought sluggard " Manifestation,it is necessary it last we vigilantly. Should second hospital be how does the government invest the key public hospital of urban deep and vast innovations of directors of people of general term for paulownia, phoenix tree and tung tree of Anhui Province to reform? Where does the government put into as the main fact? According to the actual conditions of the medical organization at the basic level of our country at present, I think the government puts into sloping second hospital. The scale of the tertiary hospital of our country is generally relatively large that the government should control the scale of the tertiary hospital at present, 500 berths have been already few, but still the difficult problem of generally seeing the doctor. The masses see the doctor very hard, register, see the doctor, pay dues, take medicines, has an injection and must all line up; In hospital difficult, a lot of in weight one difficult to ask bed, patient of disease. A large number of patients make the doctor work overloadingly, physical and psychological weariness, the pressure is overweight, not only has aggravated the state of the difficulty and high cost of getting medical treatment also increase the medical potential safety hazard. Large hospital diagnose the illness difficult, increase individual seek medical advice expenses and seek medical advice difficult not merely, also the one that has caused the large hospital has seen the doctor expensively. The difficulty and high cost of getting medical treatment has also stimulated the tertiary hospital to expand rapidly, has already appeared in " super hospital " of many 4000 berths at home . So the government should control the scale of the tertiary hospital, otherwise the tertiary hospital continues expanding, will aggravate the unreasonable overall arrangement of medical resources, will increase the hospitalization cost of the masses to bear, influence fairness and accessibility of medical care. The large hospital is difficult to see the doctor on one hand, on the other hand medium and small hospital of many under second can not still have enough, this is a current situation of the medical organization of our country at present. The government should choose second hospital first to put into Second hospital is mostly counties (market) The district level hospital, it is the clinical treatment type hospital, is a main place that the broad masses seek medical advice, it is a tap of the tertiary medical network in urban and rural areas. New and agricultural after implementing jointly, the seeking medical advice of the masses chooses to change, the investigations of a lot of places show, the hospital at county level has already become peasant choosing first in hospital, over half is in hospital patient selection to seek medical advice in the hospital at county level, this is mainly because the masses think the hospital at county level " Technology is not weak, the journey is not far, the price is not expensive " . Develop the hospital at city level of the county in a more cost-effective manner, it is the important measure of optimizing the structure of medical service system in urban and rural areas at present. Improve second hospital of the intersection of synthesis and competence of making a diagnosis and giving treatments, can guarantee medical problem of the overwhelming majority in the hospitals of counties and cities settlement effectively, not merely can relieve the question of the difficulty and high cost of getting medical treatment of tertiary hospital of big city effectively presently, also realize newly and shut agriculturally " Serious disease does not produce the county ' Market) " Important goal key measure. So government should gather, financial resources pair county ( Market) Grades of the intersection of hospital and construction well, can reduce hospitalization cost not only help the patient seek medical advice but also so, of promoting health care service but and, justice. It must strengthen the county (the city) to solve this problem The financial input of the district level hospital, the support of the policy that offer, set up rational compensation mechanism and scientific patient to flow into the mechanism, give full play to the county ' Market) The function of the hospital, offer swift, high-quality, cheap health service to the broad masses better. The first class hospital, especially health clinics in towns and townships and urban community hygiene service organization, also need to increase input, but they should be so as not to protect for the main task, according to regional different situations of people, allocate a medical worker, the government replenishes appropriately. Cooperate with the medical first aid job of second hospital actively while doing a good job of medical care of community, form the good health care network. Set up reasonable patient, flow into mechanism set up reasonable patient flow into mechanism to solve the intersection of the difficulty and high cost of getting medical treatment and effective measure of problem one of, it is second mechanism of changing the place of examination from hospital to tertiary hospital especially. On one hand, the difficult patient can't solve oneselfing in second hospital changes the place of examination to the tertiary hospital, can't nip and does not put. On the other hand, the problem which second hospital can solve, can't change the place of examination to the tertiary hospital blindly. The Ministry of Health will make to the unified patient standard, procedure of changing the place of examination, should set up tied mechanism first, the patient goes to the tertiary hospital to go to a doctor, must be the first visit, verifying of second hospital, to disease which second hospital really can't make a diagnosis and give treatment, appear from the hospital according to changing the place of examination singly, the tertiary hospital accepts the clinic only, arranges in hospital according to changing the place of examination. Secondly, draw the medical expenses standards of sophomore period, tertiary hospital, promote the rationalization, practical of medical care. Third, medical insurance, making the proportion of different submitting an expense account newly and agriculturally jointly, should widen and submit an expense account disparity on the basis of hospital of different ranks, as to going through formalities of changing the place of examination and patient to the tertiary hospital to go to a doctor of proper motion, proportion that should and reduce to submit an expense account according to the expense standard of second hospital. Setting up encouraging compensation mechanism at present, second hospital need improving the infrastructure badly, increase the input in apparatus, strengthen construction of discipline and personnel training, widen the service range, the demand of meeting a patient and seeking medical advice, but these input which have lacked the government is unable to finish. General self- development capacity of tertiary hospital of our country is all very powerful at present, and second hospital needs the government to enrich the blood, there are two kinds of methods: First, set up encouraging compensation mechanism. Allocate funds, count the mechanism of allocating funds of allocating funds, investing allocating funds according to infrastructure and heavy-duty equipment etc. according to making the berth according to the authorized personnel at present, may all produce the drawback. I think I will set up encouraging compensation mechanism, in a situation that the portfolio of the hospital increase, in check, treat, use medicine rationally rationally rationally and at the normal foundation that charge, the government accords with the business incomes of the hospital ' Do not include medicines, apparatus, consumptive material income) Press the certain one The proportion is subsidized for the finance, in order to reflect the reform spirit of awarding the diligent and punishing the lazy. Second, improve the technical, labor service expenses standard appropriately. A lot of technical labor service expenses standards are lower than the actual cost at present, the hospital survives by selling medicines, the balance is obviously reduced, survive and develop very difficult, only improve the technical, labor service expenses standard appropriately, could make the hospital enter the benign development track. Meanwhile, want, introduce to the intersection of market and competition mechanism, let the intersection of hospital and independent management, accumulate, selfdiscipline, self-development oneself. (staff reporter Feng LiZhong puts in order) Need policy and law " The drive of double round " The triumphant new medical reform of firewood will of department of public health of Shanxi of pure cloud of grandson of law school of Shanxi university systematic has the reforming step by step of clear goal. Say, the medical reform is reform and innovation to the traditional system of the medical and health in the strict meaning, and the system is the organic system composed of policy and law. So, the policy and complete network of the law are improved, it is " double round " which drives the reform ,The policy is a pioneer of the reform, the law promotes the reform to tend to reason even more, make the rule of the reform have all-round three-dimensional effect that advances, in order to set up long-efficiency mechanism to advance the reform to reach the anticipated social goal. The policy and complete network of the law are improved, it is the basic health care institutional improvement of countries all over the world and universal law that the system improved, also undoubtedly our country finishes medicine and changes to the affair, improves and ensures the systematic requirement healthily. The medical reform is a social system engineering, cross over public health, medical care, medical treatment and ensure producing circulating in four major fields with medicines, involve economic policy, public financial policy, hygiene policy, social security policy, population policy, employment policy, environmental policy, policy for education, legal policy,etc.. It is interweaved and coordinated each other that the multiple task is intricate, it is a comprehensive, globality, systematicness, structural and linking cooperating, gradual advancement, arduous and complicated reform that relatively finely melts, involve the interests chain of the some of circles of medical and health distortion. Therefore, medical reform policy and design and execution of the legal system are multidimensional, need the intersection of political science and house, sociologist, economist, hygienist, jurist go on large view prove and connect hands in parallel to solve the problem. However, designed the great dispute of educational circles in medical reform system frame like a raging fire in recent years, mainly concentrate on economics, public management, hygiene, social security in the ambit of studying etc., jurist's voice is faint, close to collective aphasia. Face the medical reform and ensure the unique era that the system innovates and improves to assign a topic healthily, the law researcher is obligated to put forward one's own explanation and solution, participate in making the related scheme of the medical reform, further deepen, thinning and medical reform policies and measures and legal norm of melting in fact, promote the setting-up of the basic health care system and ensure systematic completion healthily. The law researcher participates in the main meaning in which the medical reform scheme is made to lie in: First, basic the intersection of health care and foundation of system, ensure systematic standardized operation and sustainable development offer law the intersection of theory and support and service healthily. Second, offer standardized principle, method, procedure, frame and essential content for the fact that policies and measures and local regulation of the system reform pilot project of the medical and health are built. Third, continue improving the basic medical and health policy for the Party and government, improve and ensure the system healthily, stabilize the civil order of the medical and health, promote China's economy and social environment, offer decision-making reference. Fourth, favorable to social security law, constitution study the intersection of hygiene and law, the intersection of social security and study, the intersection of hygiene and the intersection of economic and management, public management, public policy science,etc. and dialogue and development of discipline.


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