" medicine is conspired " in our country The phenomenon is serious The industry that divides medicine becomes the reform is inevitable
Reporter 17 JinBiao Xia large to propose four part, " whether implement government affairs separate, in charge of, do, separate and medicine separate, not profit-generating to separate from that non-profit-making " ,As the medical reform direction. While parting in four " Medicine is separated " Been disputing on bigger all the time, it is a difficult point of the medical reform too. " medicine is separated " To what extent is divided? After medicine is separated, how to compensate the income from sales of lost medicines of hospital? How to equilibrate the interests relation between hospital and dispensary? This line of questions still remain to explore in practice. For this reason, this newspaper organize reporter reach to interview the investigation in two places in Nanjing and Wuhu, Anhui that are practising medicine and separating, interview and write a group of articles, expect to answer to the above-mentioned problem to some extent. The procuratorial organ of Huizhou of Guangdong Province announced the post crime case related to people's livelihood investigated partly newly not long ago, favour the intersection of urban area and the intersection of river and the intersection of hospital and serial bribery cases Chen, attract people's attention among them. This institute presidents former Wang, medical matters department section chief and concurrently, head of the department of surgery, Deng, director of gynaecology and obstetrics, Zhu Chen, head of the department of emergency call, " Totally exterminate " . In fact, this incident is only the iceberg corner, it is " open secret " that the doctor utilizes prescription right to collect commission . Domestic a lot of retail price of medicines mostly production cost 10 time about, some up to 20 even. Only for have enough spaces go, pay returning, public relations expense such great amount of profit. The timid high, ordinary people of the medicine price look down upon the social contradiction such as being ill and return because herein to a great extent. " medicine is conspired " Medicines producing, number of the enterprise of circulating of our country is numerous to raise the medicine price at present, cause it in the medical field of circulation " Commission " Waiting for the illegitimate competition behavior to prevail, some distribution personnel generally rebate doctor's prescription according to 5% to 15% of the even higher proportions of the medicine price, let the doctor write a prescription more. 2005, Ministry of Public Health launched the special renovation to move, hoped to put forth effort to solve a few unit personnel of administrative organ and medical treatment and utilize administrative examination and approval authority and piss of the post to this, take " commission " , the question of trying to gain illegitimate benefits,etc., but the result seems unsatisfactory. The medicines commission that Department of Commerce once bribed the commerce has been counted: The national assets annexed every year are about 772 million yuan, account for 16% of the tax revenues of the whole year of national medical trade. This year with correctly " Two neat medicines " The trying of the case, is amazed by and exposed " medicine is conspired " again , the inside story which raise the medicine price: Protagonist of the incident - -False medicine is " shown the fungus first plainly" ,Its each of producer price only 5, get hospital patient but price swell fiercely to 46.1 in the hand, the price rises violently by more than 8 times. According to the investigation, money Heng source medical Trade Co., Ltd of Guangzhou is from " two neat medicines " with 5 yuan each Sell this one that permits a leave in batches " Show the fungus first plainly " ,Then this company sells to Guangdong medicines and health protection Company at each high price of 34 yuan; And Guangdong medicines and health protection Company sells three courtyards to Zhongshan with 36 yuan for each one, three institutes of Zhongshan have risen 10.1 yuan while selling a patient. According to the introduction of insider, generally a piece of medicines will be distributed through the exclusive distribution, area, several links such as the medical representative, hospital dispensary could reach on patient's hands. Our country have nearly 5000 the intersection of medicine and enterprise, more thanth medical retail trader at present, opening that medicine produces and sells compete for the intensity and is far higher than the medical service field. Meanwhile, the medicines which the medicine enterprise produces, in order to model medicines in the majoritily, the homogeneity phenomenon is serious, the whole country can be produced " Show the fungus first plainly " Enterprise less than over one hundred. Similar medicines plenty of, who commission that give it is certainly who higher position stock. Then the competition among the medicine enterprises develops into " The commission fight " . The economic research center Professor Zhou QiRen of Peking University points out, commission is interests that pharmacists give up at the competition pressure, it is this part of interests, does not fall into the patient's pocket, has entered some hospitals and the doctor's purses. And it is the patient who uses medicines that this sum of commission is single in final buying. " raise medicine with medicine " Expedite the emergence of the medical interests chain in our country, " one of medicine " Have a long history. In planned economy era, the medical circle integral level is very bad. The hospital needs a large number of fund survival and development, it is pitiably little that the government subsidizes. In order to guarantee the medical organization can continue developing, the government adopts " raise medicine with medicine " Policy. According to regulation, every distributor sell medicines of hospital, hospital can go up by, 15% sell price. This part of price differential is resulting interests of the hospital. We can say, depend on taking " medicines " This bowl of rice, the national big and small hospital can survive. Though this kind of operating mechanism once played the positive role to the development of the hygiene industry of our country, it is deepened but gradual with that of market economy, the long-standing abuse of this kind of mechanism comes to light day by day. The public hospital of our country, as the non-commercial organization, it generally replenishes the method at present: List in national budget, support through the reallocation of the national income. But almost all the medical organizations get incomes from managing directly now. In recent years, some domestic large and medium-sized hospitals are from the profit that is obtained in medical procurement and sale, it will generally account for 50%-70% of the whole income. A doctor says to the reporter: "By the look of a certain intensity, the phenomenon is what the country consents tacitly to to get commissions, on the basis of ' raise medicine with medicine ' the system, the price department has given the manufacturer enough profit spaces while giving medicines and making the price at factory, cost price of odd yuan can reach the producer price of dozens of yuan definitely, the profit of the producer can rebate hospital and doctor. And such a method is more concealed, it is relatively difficult to investigate. " Because of the particularity of the medical trade - -Doctors and patients' information asymmetry of both sides, lead to the fact too the incident that the doctor takes commission is apt to happen. In the course of making a diagnosis, the patient makes its each link in the course of treating obey a doctor to the shortage of medical knowledge. So with some medicine and with how much medicine at all depend on doctor's prescription, the doctor has an opportunity to choose costly medicines with much commission. Break " medicine is conspired " Need to advance medicine to separate a lot of experts to think, break " medicine is conspired " Need to move forward " Medicine is separated " . The old gentle tinkling of pieces of jade in Research Room under the State Council thinks, implement medicine and separate core and difficult point that is the system reform of the health care. The medicine assigning to industry is the choices of most countries in the world, practice has proved it to developing and improving medical technology, guaranteeing the rational administration is effectual. Separate medicine as soon as possible, cut off hospital, doctor and medicines from source the economic benefits while managing are contacted, guarantee a doctor constructs and cures, writes a prescription to the ill due to illness, this is an inevitable choice of system reform of medical and health. But in practice, the industry that divides medicine is a world difficult problem, there is not mode that can be duplicated. Though a few countries such as U.S.A. are implementing the medicine assigning to industry, these countries do not totally separate medicine in the emergency call and respect in hospital completely either, they are exceeded the high difficult problem of the hospitalization cost too. In some countries of Asia, the integrative system of medicine is more general. 1999, South Korea implements the industry that divides medicine, an unexpected one is the hospitalization cost is not not only reduced, increase by a wide margin instead, original and anticipated far from each other with the South Korean government, ended up with failing later. The reform in this respect of Japan does not dare to move forward even after stalling for a long time either. As far back as 2002, our country began the attempt of the industry that divides medicine. Nine ministries and commissions such as the State Development Planning Commission,etc. jointly issue a file: <
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