We need to set up the medical insurance mode participated in together

We need to set up the medical insurance mode participated in together
We need to set up the medical insurance mode participated in together
Author: Wang DanHong's future medical treatment and health care, not only should give play to the role of doctor but also produce nurse, family elder, community's staff member and patient's own function. On April 6, the new medical reform scheme of our country is announced formally. From new reform policy and measure, people can expect that there is a better future to see the doctor to seek medical advice. In fact, see the doctor the difficult problem is not only China, also a problem faced in the whole world. And set up the medical treatment and health care mode that each side participates in together and already become a kind of common understanding. Hold in Tsing-Hua University recently " The forum of Tsing-Hua University " Go, dean and concurrently senior Vice President Dr. Arthur and Gerson of University of Virginia mention, future medical treatment and health care, not only should give play to the role of doctor but also produce nurse, family elder, community's staff member and patient's own function. Perhaps some people have such a impression on U.S.A. on medical care is in short supply, namely everything of U.S.A. is very good, the fact is not like this. In U.S.A., can everybody win medical treatment and health care? The concept obtained means a person can get the medical treatment of doctor, nurse or health care personnel or health service of the hygiene when needing. According to the introduction of Gerson, every 5 American philtrums have a person not to have a corresponding doctor while needing now; In 2008, 1/3 of the Americans says, because without solvency, they have not got corresponding medical care when needing, or found the corresponding doctor. In U.S.A., it is unlikely for you to ask a person like this: "Will you go to see your doctor of division of cardiology tomorrow morning? " The most common way to put questions is: "Is your time to meet the doctor within 2 weeks, in 3 weeks or in 4 weeks? " In 50 states in U.S.A., 12 states report to and lack doctor and relevant expert. Gerson points out: "Everybody is aging, when our age is larger and larger, we will need the doctor and expert correlated to senilization more, such as cardiology expert, urology expert and psychiatric expert,etc.. " The senilization of the American society is coming. Western society World War II finish, and a generation that born among 1946~1964 year generally called" Baby boom " ,From all world-wide to think, have 1 billion people, U.S.A. " baby boom " A generation is probably 78 million (account for 1/3 of American population) . Gerson says: "' baby boom ' generation occupied a large number of people of U.S.A., they are aging, march towards 65 years old. People need to see a doctor while aging more. As a result, in U.S.A. every in 100,000 people, old man's demand for doctor is 5 times of the 17 -year-old young people's over 75. By 2030, the person in U.S.A. 65 will increase by twice. " The elderly need more doctors and nurses, but meanwhile, the supply of the American medical personnel is not merely insufficient, and presented one to known as " Exhaust " Phenomenon. Gerson explains: "The ones that exhaust mean there is not fun in the work, in the past 10 years, in 20 years even 40 years, in working time when the doctors are weekly is over 100 hours, this does not mean a resident doctor, but doctors. " In U.S.A., it is a very important thing to get along with the family. To the doctors who has finished the study of medical college, a very important part is to get along with the family in their life, the time that they get along with spouse and child becomes more and more important, future doctor's work can't spend long time, and there should be more self- enjoyment. It is estimated in the following 10 years, the American doctor's retirement rate will rise to 20% from 10%. Even so, there are more and more, higher and higher era and social requirement for doctor. The same number of doctor will also face more, more complicated demands such as genetic engineering, gene therapy, individualized medical science,etc.. Gerson points out: "We are stepping into new technology era, a lot of openheart surgery does not need to open the heart now, in the following several years, more openheart surgery will be done by the cardiology expert rather than surgeon; From secreting the urine training to the neural training, we will also see more specialists do the operation, but this mean the intersection of doctor and quantity that we need will reduce, say the same number of doctor, can make different thing. " The demand is also swelling social senilization is increasing the demand attended to for the health care, but other many kinds of factors have aggravated this kind of demand. Gerson refers to: "' a generation in baby boom that we have ', our life quality has been improved, our mother will say to the pediatrician in child's cold: ' my child's cold, I want to get all things that may be got for my child, how much can you offer to me? ' the doctor says helplessly: ' let the child drink more water, sleep more, take more time to rest ' . " Gerson thinks, swelling people's demand too of arrival of cybertimes, this kind of situation is more serious in the city. People surf the Net inquire materials, talk, they see various medical type of world on Internet, and the advertisement which a lot of pharmaceutical factories and medical instrument companies do, they are very happy that the patient with smiles says in the advertisement. The medical insurance of U.S.A. has aggravated people's demand from the other side too. For example, those people with prudent insurance will say, " since I have this insurance, I can all that me want then, because I have ' insurance of God '. " In addition there is demand which the doctor guides. Gerson gives an example, in U.S.A., the doctor says to the patient: "You have a headache terribly, you need operation, you very serious stomachache have, you need the operation, heart of you very terrible, you need, make, put up a bridge surgery "Each service of the doctor's is paid. Not merely in U.S.A., in all parts of the world, there are many kinds of different expenses in the same operation. In different places of U.S.A., the expenses of the same heart bypass surgery can differ by 2~3 times, but in most cases, higher expenses do not mean better service. The chance in the predicament: Establish life quality improving and arrival of social senilization of a group, the demands for the medical health service of people are increasing constantly, but the medical personnel's supply is becoming more insufficient, how to tackle this realistic problem? "We need different ways to offer medical treatment and hygiene health service. " Gerson says, " increase and the medical personnel's deficiency of the demands of people, this is a kind of predicament, but mean a lot of chances in the predicament in fact. In U.S.A., we have systematic efficiency that many kinds of possibility raise medical attendance, reduce their cost. " Gerson proposes, changing begins from the patient at first, let the patient become a part in the solution. Let the patient accept Educate, understand how to look after oneself better, bear the responsibility to oneself. The thing that can do by oneself, don't call the doctor or nurse! Establish, instruct norm whether make the intersection of patient and manual, when does it prove, phone someone by one patient at the same time, how to send the information or E-mail to the nurse, when to go to see a doctor. U.S.A. has proposed one kind is called " Consumer's leading health care " New concept,namely consumer according to hygiene health service obtained pay. Generally, the patient hopes doctor and nurse can tell how they do, so, the medical personnel should help and educate the patient at the level that the patient can understand, let the patient accept the education as many as possible, observe and visit time and doctor's order. The more important thing is, establish a group participated in together by doctor, nurse, elder, community's doctor, community health care personnel. Gerson says: "The foundation of the job of this group is not based on ' I am a doctor, I am cleverer than you, other people are all assistants ', but cooperate on the basis of the group. In this group cooperates, all of us know doctor and specialist are very good, but everybody needs to cooperate by way of group. " World Health Organization calls change of this kind of nursing mode as " The specialized another division of labour of medical treatment " . Train a short time, the intersection of health care and person that qualification expect much undertake the corresponding work, health care personnel mainly work under the guidance of basic rule, but not when the basic rule does not correspond to actual conditions or wonder how to do, should ask a nurse, in this case, the nurse does better than the doctor. Giving play to the role of grand parents in the nursery work of community, a main force is the grand parents, U.S.A. is called this kind by nursing and health care which kinsfolks participated in " Elementary family's medical science " . A doctor has said, his patient has 50% to attend to by grandmother, another doctor says, 80% of patient of his is attended to by the nurse. In fact, the experience which grand parents look after when the greater part people all fall ill. The enlightenment that this fact gives to us that accepting a small amount of training people can offer the most basic medical science to attend to. But Gerson points out, this does not mean U.S.A. can reduce the elementary nursing doctor of 70%~80% at the same time. An important factor that grand parents participate in attending to is " They are persons who is worth relying on " . Gerson says: "Though grand parents are old men, they still can take action, their worthy our trust, they have looked after us, has looked after our parents too, in addition, they also want to do some things for the society. " Through simple training, grand parents can work on the computer briefly, or use the mobile phone to converse with the nurse or doctor, so, doctor and nurse have a very good assistant. Grand parents can participate in the nursing of two kinds of types, first, " acute disease attends to grand parents " ,They come in the house of children, look after cold, people Sun that have a headache or have a stomachache; Another kind is " Chronic disease attends to grand parents " ,They work for specialists such as their children or heart disease,etc., situation, health of taking medicine of inquiring the patient every day, help to promote their health. Certainly, grand parents' unfavorable side too of nursing, because if grand parents look after and does not want to be, then the patient will be more terribly ill, the doctor or specialist has to look after these more serious patients. If 50% of the elementary nursing can be finished by grand parents, should then let grand parents do, the thing that the doctor should do is more thinking, judgement and decision. Gerson emphasizes: "It is not the thing of letting them work as a nurse even grand parents can be competent that we train a doctor's purpose, otherwise, this is a kind of waste. The doctor should do the thing that a doctor should do, the institute doctor should become a thing of the teaching doctor, they want to study, but this does not mean everybody should study. " At the end of speech, Gerson says: "In a word, change and attend to the way, we need the patient to bear the responsibility to oneself more, attend to oneself; Need community health care personnel in coordination with diligent, no matter they grand parents, elementary to attend to the doctor or nurse; In this way, on the issue to can solve the medical personnel in short we. It is nonsensical that doctor and nurse do a same thing, it is a kind of waste too, this lets thing which the nurse bes be just let the nurse work as, the doctor should do different things. Patient, grand parents, nurse, elementary to attend to the doctor, doctor and expert, cooperate in coordination like group of us, then we are sure to be healthier. "


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