The best scalpel can not solve the social concern either

The best scalpel can not solve the social concern either
The best scalpel can not solve the social concern either
Author: Pan wish will it be July 10 2008, assist the intersection of city and first the People's Hospital the intersection of clinic and hall Fan charge window people closed to wait for crowded to capacity in Hubei. CFP " best scalpel solve the social concern either. Without combination with the public research in policy, developing the even more advanced scalpel can't turn into the effective social system either, so, what we need is not an advanced scalpel, but natural science and social science cross and integration, solve the problem through studying the system. " Recently, while accepting reporter's special visit of " scientific Times ", the health care reform of the hygiene of the People's University of China and Wang HuFeng, director of research and development centre, make above-mentioned expressions. The combination health care reform that the medical reform needs soft hard science is not merely a question of a field of medical treatment, but the case that a typical discipline cross. Medical treatment is a technological question, and the medical system reform is a policy question, category under the jurisdiction of public policy. Can't treat this problem from an angle or a field simply. "Go up and adjust from basic idea, know. " Wang HuFeng says. In the formulation of the medical treatment system, can see such a question: Health care reform concerns the national economy and the people's livelihood, and how to apply this system engineering of the science decision to the medical reform, also the most difficult. "Some needs natural science to participate in, some needs social science to participate in. And social science and combination of the natural science are very important, the medical reform needs this kind of combination. " Wang HuFeng thinks, the formulation of the medical system reform scheme, needs participation of the medical field, because they can announce the most basic law of the things through natural science; And because the economist's joining involves questions such as the assessment of the input and output, medical price,etc.; According to angle of public management, there is different understanding, except follow the basic law of medical science, consider efficiency, should also especially pay attention to the fairness. "The doctor will pay attention to medical technology, and the economist considers cost and sustainable ability of economy more, how be efficient how do. However, the most efficient way might not often best embody the fairness, in much management, the fair and efficiency that give is at the time of a rational match, want some efficiency of loss. Otherwise, the hospital can totally be with the privatization, because is the most efficient like that. " Wang HuFeng says. The reason why the public hospital has been existing all the time, because it should bear the problem that the market can not solve, for example functions such as medical treatment of mother and child care, population below the poverty line, public health,etc.. "These are not efficiency, but fair problem. Government thing been to want can't give market, otherwise the poor scorn disease for, type blow vaccine. " The flat magpie is the ancient well-known doctor of China, but few people know two elder brothers of his are doctors with superb medical skill too. Cure the not disease at on the medical circle, the supreme realm is " " ,Secondly" Chinese medicine is cured to want the disease " ,Have " already played and cured the disease " . "The eldest brother of the flat magpie can cure the not disease, can let people not have disease after seeing; Flat second elder brother of magpie to cure disease for the first time, fall ill, it watches by him to be better quickly generally; They both are not very famous, but the flat magpie manages beyond cure, so is very famous. " "It is even more important to the society that however, exactly ' to cure not disease ', but our system is to study these policies and services more favorable to the society. " "The issue of the medical reform scheme does not mean the end of this reform, only mean beginning. How a large amount of work fulfills, how to let more persons understand it, need time, need the combining together of soft hard science even more. " Wang HuFeng says. Wang HuFeng thinks, the following implementation should have a meaning even more. "The science decision is based on the scientific assessment, the scientific assessment is based on the scientific data. Should set up relevant database now. How is the result that medical reform implements, can't only rely on and say, but should take out generally acknowledged index and data. These indexes want the test must live for time, especially in some pilot areas, there are accurate data and assessment, we could say after this reform, where are corresponding input and result of reform, what indexes have changed, then go to summarize, popularize, otherwise with what to let others believe? " Assess the category belonging to soft science too in policy. "The policy will cause the changes of some indexes directly. Now, should go, establish the system of such assessment, regard it as system go following, construction and improving. " And a cooperation question of the soft hard science. "For example chronic disease is intervened, can do relevant research in the field of natural science, the research results can be turned into the public policy through health care reform. And the public policy could really influence the society, thus reach the social effect. This is transformation of scientific and technical result too, there are many questions that can be canvassed inside. " There is a close medical system in the world to know the characteristic to grasp the law in marrow of the medical reform, but there is no all the same medical system. Britain is the country that sets up the welfare system in the world first, what they believed in and insisted is that everybody enjoys free medical care. "Britain sets up medical care systems of the whole people first. This kind of method of salary distribution and values that they advocate are deep-rooted, so till now, though all party groupings often canvass, dispute the national hygiene service system existing problem and need the improvement, however, always no party has the ability to overthrow this mode. In other words, free medical care mode and culture, ideology and economic strength of the country of Britain come down in a continuous line. " Wang HuFeng introduces. This set of medical modes of Britain, behave in its colonial country to some extent too. In addition, some countries of North Europe imitate one after another, these countries are similar to Britain on the cultural tradition, political idea, adopt this set of medical modes after improving slightly. What Germany took is the form of the social insurance. "Whom insurance emphasize citizen corresponding in right and obligation, correspond to while being what is called, mean the citizen must undertake the obligation, that is to participate in the insurance, having ability of paying the fees must pay the fees, including enterprise, individual or employer and employee. If there are special circumstances, the government can succour. " In the past two years, a lot of countries are studying the system mode of Germany's medical insurance too in the world, including countries such as South Korea and China of Asia,etc.. "Though Germany is adjusting the policy constantly, can see after setting up insurance system, basic policy have change up till now, that is, must try personal obligation, can enjoy medical care. " And the health care reform of U.S.A. is to generally acknowledge that fails. "U.S.A.'s economic strength is very strong, not lacking the advanced scientific findings either, but Americans do not think the medical treatment system is good. Because general residents' hospitalization cost is very high, and medical body The internal trade is very serious. " The medical treatment system of U.S.A. is highly market-based. As far back as Clinton period, conduct the medical reform on there are 400 experts specially for the president and offer advice, until present the intersection of and the intersection of Palestinian and horse, medical system of U.S.A. have substantive change yet. The great amount of hospitalization cost has not been relieved, the number of people not participating in the medical insurance instead rises to 40 million at present from 24 million before 10 years. Wang HuFeng analyzes, " I think, in that the medical system is very special, a lot of problems need by solving, arranging by means in the market, especially public health field. However, one such as U.S.A. is while worshipping freedom, worshipping the country on the market, it unavoidably will be that the method of the market is squeezed and come as a hard blow at to some. Want, carry on reform is will than pay attention to everyone is equal, pay attention to fair country to be much more difficult at this time. " No matter Britain, Germany, U.S.A., they pursue suit, complete medical treatment system constantly. However, such a reform is unable to move even a single step. "Idea that a reason is is deep-rooted, another reason is a game among each interests group. " Wang HuFeng says. In U.S.A., the benefit group has very great forces, and all there are representatives in the Congress in group of these interests, once the reform touches its interests, they will vote 'No' firmly. For example, insurance company, bar association, a lot of federations and intermediaries of small enterprise, they are all lucrative parties in the extant medical system. "it how there is to because consider from politics nobody let's work ( Medical reform scheme) ,400 experts equal 0 too. " On the contrary, some developing countries, under planned economic system in the past, though the economic level was not high, but the medical achievement is quite high, such as Cuba. "This means, under planned economy, the supply system economy, under the environment of everybody which advocate equalitarianism, still more easier the hygiene medical treatment system is arranged. " "Should see through these in medical reform of China, can't be confused by the surface. Medical system to arrange a kind of system, just, can imitate the foreign mode at will. The reason why every country has current systems, or receive the economy, politics, cultural tradition of this country on the influence of these factors. Can summarize and draw lessons from the mode of these countries from theory and academy, but copy a certain mode to choose in practice as the policy, it is impractical. " Wang HuFeng is without mincing words. But Wang HuFeng points out, our country has very good conditions, relatively high-efficient in making policy finally, should bring health care reform into the important agenda, can well make it. It equilibrates each side to be whether the only effective means seem in the intersection of tiger and peak Wang in interests, a good decision can not break away from social reality, in other words, the improvement or improving of any social welfare, are all on the basis of the current foundation. Wang HuFeng thinks, the reform of the social welfare generally has several characteristics. First of all, system is rigidity, can only go and can't leave, no matter foreign countries or our country, the thing that the government should guarantee to be promised is possible, this kind of commitment also should have sustainability. Secondly, more absolute level that the welfare can't be simple. Should not compare with the other countries horizontally briefly, for example proportion,etc. that the hospitalization cost submits an expense account. "With other consumption being different, medical treatment can't totally satisfied, in keep health, it treats and cures function at the life to be limited medical treatment. " Wang HuFeng thinks, the reform of the welfare should make ordinary people satisfied, let them realize this is that one is promoting, updating constantly, and the welfare that can expect. Moreover, pay close attention to implementing effect, can't stand up relevant enthusiasm transfer of field, the result can only be to go down. "In our country, it is often a question of implementing links, and not the problem that the policy can't be issued. It is so, pay close attention to the interests of different colonies even more, should carefully think out in advance, otherwise it is very difficult to go on. " Wang HuFeng says frankly. He thinks, the marketization or complete government's leading factor that should need the to be simple medical system, it depends on whether the service item is suitable for the government and offer or be suitable for the market to offer, if suitable for the market to offer, the government should go to manage, supervise it. If involve the question of the public health, it would be best if the government offers. "Only stand on an angle looking at problem, the persons of other fields will not accept. " And the medical reform is a very typical example exactly: In our country's present medical system, it is the only correct choice that both sides all mend supply and demand. "The view of mending the supplier thinks: Give money hospital, let hospital provide service, just, needn't engaged in the insurance. This often causes the fairness to be strong, but efficiency is bad. The hospital is raised, it is long, can guarantee efficiency if not having means; And mend the demanding party to propose, buy and serve through the insurance, can encourage the efficiency of the hospital, but it is often very difficult to accomplish the justice, because the international experience shows, simple benefit is needed will only lead to the fact the hospitalization cost is very high, the fairness is very bad. " Wang HuFeng says. "Stand in different departments looking at problem, will find that have nothing in common with each other. From the view of medical department, will be thought input of the country to be too few, the medicine price is being always lowered; From the view of hospital, the country has not allowed selling medicines, put it into too little; Look from the view of medical insurance, will think that throw into all the money, the problems have been all solved. " After a social policy is carried out, if go wrong, that bore losses and the consequence is the ordinary people. Wang HuFeng says, should consider the development space of the relevant colony, but not " exactly collapse " One party. Rational system arranges, in view of their development, so want supply and demand to all mend. "The medical reform involves four major fields, it should follow different fields to need a point of simple laws or dichotomy methods, choose the appropriate policy to do. " Wang HuFeng emphasizes, the so-called science decision, the most valuable content that should reach every reform and summarizing the experience to come out, unless it form common understanding, and it consolidate come down,no matter in theory or in practice, should not pay the tuition repeatedly. " scientific Times " (2009-4-14A2 focuses on every week)


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