Advance the common understanding of the circle of needing to condense the hygiene of the medical reform

Advance the common understanding of the circle of needing to condense the hygiene of the medical reform
Advance the common understanding of the circle of needing to condense the hygiene of the medical reform
Staff reporter Meng celebrate general the intersection of Korea S. and Lu Arouse enthusiasm =Increase incomes? Is the doctor's income high or low at present? Is primary problem of the medical reform to lack the money? " addition of medicines " Turn into " thing fee of medicine " Rob Peter to pay Paul? Are there time tables in the public hospital reform? March 6, the wide hot question concerned by the public and medical worker in the staff reporter seeks medical advice and changes, have interviewed the member of the CPPCC National Committee, Chen Zhu, minister of Ministry of Public Health in the guard station of two Conferences. Chen Zhu says - -National two Conferences in recent years, member of the CPPCC National Committee, Chen Zhu, minister of Ministry of Public Health have been one of the focus personages who the media has chased all the time, national two Conferences of this year is no exception. From enclosing stopping up in front of the Great Hall of the People door, pressing hard outside committee member's guard station restaurant, in the face of the questioning of the reporter, this has ever done to a barefoot doctor, the technological officers who has studied abroad abroad for many years again, always answer all the questions. The afternoon of March 6, on the panel discussion interval of Chinese People's Political Consultative Conference(CPPCC) meeting, Chen Zhu has accepted the exclusive special visit of the staff reporter on the hot question of medical reform that the public especially medical worker paid close attention to. Chen Zhu says excitedly: "The hygiene work is very challenging. I hope the comrades can understand what kind of thing I am thinking, I hope to obtain understanding and support of the whole system. " Q: Arouse enthusiasm =Increase incomes? A: Can't totally draw the equal sign. Reporter: Premier Wen Jiabao proposes in the government work report of this year, the medical reform should " arouse medical worker's enthusiasm " ,This is very apt to let people think of improving medical worker's treatment, increase incomes. Could you tell me whether the two can draw equal signs? Chen Zhu: Arousing medical worker's enthusiasm should arouse the medical worker sense of calling and sense of duty first, make them promote one's own technology and professional ethics level constantly. This should be the goal that the aspring medical worker pursue at first too. The medical reform has offered the rare development opportunity to medical worker, this is the important component of arousing medical worker's enthusiasm. For example, the Premier's work report proposes launching rural children's leukemia, congenital heart disease medical treatment and ensuring the pilot project. Thick to regard as, children leukemia take place 10,000 more than example, need more serious congenital heart disease of operation infant have 60,000- 8 Wan 1 year newly 1 year. This means pediatrics, blood disease, heart study these specialities and strengthen greatly, medical worker's serious disease treats and cures competence and gets great improvement. Until medical insurance raise funds competence to promote, the intersection of treatment and cure and range of serious disease will expand, is not this exactly an opportunity that China's hygiene industry soar? Meanwhile, we increase the input into public health, include new China the first time go on and prevent and control to various disease so in an all-round way on the history, pursue health promotion,etc., is not this the enormous stage putting up development of undertaking for public health personnel? It is here to arouse medical worker's enthusiasm and still behave, should liberate the productive forces through system innovation. And latent energy that the present system be unable to let the medical worker fully contribute while arranging, if the medical practitioner registers, the current stiff system has fettered the full play of doctor's latent energy to a certain extent. So, now we consider how to make much more rational some files of operation, let the doctor move, liberate the productive forces. Please note, this is a rational, norm, flowing in an orderly manner. I do not agree very much the doctor of the public hospital goes to the profit-generating hospital to some operation more, there is a strict regulation too in the world in this. Our present high-quality medical resource is more deficient, so I agree to liberate the productive forces in reflecting the public beneficial category even more, release the doctor's latent energy, including supporting the rural hospitals, tertiary hospitals of city to support the community in institutionalized coordinated cooperation, large hospital etc.. Certainly, this is only a big principle, we encourage profit-generating medical organization and medical worker to reach an agreement too, flow in order, give the private hospital a due space etc.. In addition, should strengthen the performance to check and rate and break mess, let the technological labor service value, consummate medical skill of the medical worker get the reasonable economic compensation. Distribution system should work more to those and excellent person who work slope, to large responsibility those, have a big risk and the intersection of quantity and large, the intersection of intensity and loud medical worker slope. What I want to emphasize is, doctor's income is promoted and ability is promoted, accomplished something on the undertaking complement each other. Arousing enthusiasm is the professional dedication of strengthening the medical worker constantly, strengthen their feeling revered to the life, strengthen the heart of the big love which safeguards people's health rights and interests and dignity. Doctor, especially the doctor of the public hospital, must not break away from professional dedication to discuss incomes, discuss the money. Q: Is the doctor's income high or low at present? A: Doctor's income should be in conformity with development level of national economy. Reporter: About the doctor's income, there is a kind of strange phenomenon now. On one hand, a lot of doctors are badly paid complaining, does not match with paying; On the other hand, have many people but say the intersection of doctor and too high income at the society, some doctors " have too large liking " . How do you see this kind of contrast? Chen Zhu: The doctor's income was once very low, had already changed greatly in recent years. To be objective, the input to the health care of the government has increased greatly during these years, meanwhile, the input of the society is increasing too, our medical all-inclusive cost growth rate is not low, but the growth of medical worker's quantity does not have medical all-inclusive cost that increase fast. This means, the medical worker relative income increases. Especially the large hospital, the increasing degree is very large. Look from the whole country, (large hospital doctor's income) in the past few years Average annual increasing degree is up to 15%- 20%. Some doctors say that is badly paid, may compare with income of the medical worker of developed country, it is absolutely been than,and to compare with is more scientifically. Not absolutely than,it is overall in team last developed country really income. But our income wants and national economic development, the people at present can afford competence, medical treatment and ensure the development level of the system to suit. Team of ours is very difficult. Once there was a kind of statement, China safeguarded the health of 1/4 of the people in the world with 1% health care resource in the world. It is the health safeguarding 1/5 of the people with 2%- 3% resource now, comparatively the cost is lower. This is exactly the lovely and respectable of team of ours, this is a team with noble medical ethics and devotion. Medical worker and hygiene technological service should receive society's more respect. Q: Is primary problem of the medical reform to lack the money? A: The more important thing is OK a handful of money flower is good. Reporter: The medical reform is a world difficult problem. Someone says, medical reform especially public hospital reform, primary problem is the money. How do you see? Chen Zhu: I say, it is not the fund to cure and change the largest problem at present, but is mechanism's question of the system. I do not say the money is out of question, but not merely a question of the money definitely, how about in practice put into If can flower good. The control of the hospitalization cost is very important. Like the flour and water, if the medical insurance is the flour, this increases together, but can not control the expenses, still excessively making a diagnosis, induce and does not act as consumption, equivalent to mix much water, the flour must be added. We are developing countries, where is so much money input? We need to increase to the supplier and input of the demanding party, but will emphasize the control of medical resources at the same time. Excessive medical treatment and diagnosing that really exists, must acknowledge this reality. Also just because of this, we emphasize that mend and cure the mechanism with medicine in reform, if does not give up such unseasonable policy of medicine of mending medicine, it is useless how much is thrown. Not interfering the service system of the health care to take the road to create income in commercialization, because of the information asymmetry, the hospital has a lot of methods that induce higher medical treatment to be consumed, it is useless how much is thrown. So, change our system mechanism, include changing our behavior, it is very important to change medical worker's understanding of enthusiasm,etc.. Q: " addition of medicines " Turn into " thing fee of medicine " Rob Peter to pay Paul? A: These are two kinds of totally different management modes. Reporter: Everybody cares about the topic of the medicine thing service charge very much recently. Someone propose include many medical worker too among them, say and charge the medicine thing service charge according to the prescription, the doctor can evade the policy by prescribing more, the money that the patient diagnosed the illness will not be reduced. Somebody queries, an original" addition of medicines " Turn into " medicine thing service charge " Rob Peter to pay Paul. How do you see? Chen Zhu: Collect " thing fee of medicine " It is a management mode taking cost as the centre. The present key is, the content of technological service of the prescription and managing the operating cost that the hospital must afford and can receive reasonable compensation for the medicine thing. Besides these, the part of the undercompensation after the addition of medicines is cancelled, first should be increased input by the government, 2 yes resume the balanced state by the promoting of value of technological service. There are two kinds of solutions. First, technological service item charge price adjustment is for instance the intersection of surgery and fee,etc., unreasonable state want, change originally. Another method is pay according to number, hit all cost inside, mean that has dispelled the disadvantage that mends medicine with medicine naturally. Such as children's leukemia, presume first a payment of certain amount is chartered, all cost is inside, after total value control, will make behavior of hospital change, change from a original one so as to profit for in the center into, regard cost as in the center, from regarding creating income and turning the centre into in order to serve as the centre. I think this piece bale, solve together all, reasonable paying price have adjusting single projecting mend medicine with medicine, this is a way to generally adopt in the world too. Meanwhile, can pay some chronic disease according to the number of people. These two ways can both turn into and prepay making, according to the assessment of medical quantity of service and quality in the past several years, such as assessing the situation, resource distribution situation that main disease has illness coming on in one year, basically make amount, prepay to you first, settle account by the end of the year. All these are methods which advanced countries generally adopt in the world. Talking about the question of prescribing more, what I want to say is, we have management system on prescription, prescriptions are commented on, if it is unreasonable, can be supervised the system and caught to, there are corresponding control measures. The doctor should change a brain, it is an irresponsible attitude that the brain is moved in prescribing more. Q: Are there time tables in the public hospital reform? A: Can make certain experience to try in exploration in two years. Reporter: It is another one hotter topic to manage the clinical route. The doctor proposes, there are not two all the same patients in the world, there are not two all the same doctors, manage according to clinical route, student that graduate just that, and clinical old doctor of experience have what distinguish for 30 years? In addition according to imagination of you, include until the intersection of number and pay, clinical the intersection of route and management in a series of public hospital reform measure inside, the time table specifically? Chen Zhu: Manage the growth more favorable to a doctor in the clinical route. I have ever worked in France, I wondered at that time: Why could resident doctor of France take charge of the whole locality? Understood later because they had more normal clinical route and healing solution. Certainly, this kind of healing solution is not iron-plated. Disease want, classify, can divide different the intersection of risk and degree into in every disease according to cause of disease, clinical manifestation,etc., for instance early, middle, later period of tumour, tumour with getting inferior, comparatively better prognosis, medium-sized prognosis and poor prognosis,etc.. These factors should all consider in more intact clinical route. Reasonable clinical route should satisfied the same kinds of disease person who divide into and by stages mainly, this is a meaning in the question of the clinical route too. The clinical route is managed and realized better in many countries, for instance, there are 1100 kinds of clinical routes in Germany, the clinical routes of countries such as Austria, France,etc. are very rational too. Our country has just begun to do this thing, made 112 kinds last year. Our plan is, make the clinical route of 300 kinds - main disease of 400 kinds in two years, basically contain 97%- 98% of the main diseases. In addition, I hope to treat and cure the respect at several serious disease and obtain to obviously break through at least in the pilot area in two years, such as children's leukemia. Public hospital reform, try to try to find out to certain experience in two years. Q: What is wanted to say to health care team the most? A: Gain and loss that don't lie in for the moment. Reporter: On one hand, common people do not hope the expenses increase; On the other hand, the doctor does not hope the income is reduced. How balanced is it? As medicine is improved into the deep water, what do you want to say to health care team most? Chen Zhu: It returns to reasonable to be an ideal state, should be on the track of this direction. The balanced basic way is to enlarge medical treatment and ensure the system. Enlarge and ensure the system, the people see the doctor and seek medical advice especially will be more calm in ability to resist risk of serious disease, the proportion paid by oneself in the serious disease treatment can obviously drop. To hospital, guarantee quality through the reasonable charge, can create better social benefit and economic benefits too. Inside the hospital, can well increase the benefit too through strengthening management, optimizing the procedure. For example, our country is in hospital days on average if reduce to 9 days from 11 days, lack for 2 days, mean the efficiency of the hospital can be improved by 15%- 20%, mean the unit income will obviously increase. So, the hospital should explore potentiality constantly by oneself. I think proving it a bit, as to the public hospital reform, there is not this content in the initial medical reform scheme, it was I that put forward voluntarily. I think, the public hospital if does not start, then in a few years, even we are rich, also It is very difficult to draw its developing direction back. If the idea does not change, it is useless to invest even more money. It is a wind vane of the reform that the ones that keep the public hospital are public beneficial, do well in this thing, other things are more easy to solve. In other words, the full play of medical worker's enthusiasm is for realizing high efficiency, there is high efficiency that will inevitablely increase incomes. The total big plate of hospitalization cost, especially after ensuring the institutional improvement, the demand that will stimulate the masses and seek medical advice, the ones that did not see the doctor all saw the doctor, meaning the increase of the hospital income in the past; But if the income increases and is excessively made a diagnosis and is consumed, the people could not get better health benefit. Since a real reform, that is adjustment of interests pattern. I will not compromise to some commercial interests, will not compromise to some harmful trend in our team either. For example, two pieces of rural children's serious disease (leukemia and congenital heart disease) which the Premier mentioned in report ,The society sympathizes with degree very high. If someone wants to cut regarding to the input of this respect as Tang Monk's meat, so sorry, I will rise in revolt against you. I know this must give offence, however, I will not shrink back. I also want to say to this team of ours, should keep the aim firmly in mind and don't forget the promotion of professional skill is the foundation of settling down and getting on with one's work. It must place oneself in the midst of oneself the total overall situation of country's economic development to consider one's own mission and task to accomplish something. That is to say, we should think of the people's sufferings at first, this is the most basic. If our behavior is non- good, professional skill can not reach an ideal state, must lose support of the people, right away the foundation that settle down and get on with one's work of team soon. Please remember, our undertaking is the people's hygiene industry, the essential feature is the undertaking charactered by public beneficial, so, some respects should be born. What see clearly present principal contradiction, consider more the people's interests first, do the work of serving the people well, will inevitablely get support from respect and different fields of the society, and problems such as the income,etc. will be thereupon settlement.


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