The key ministries and commissions are not unified to the medical reform opinion Cross swords fiercely in view

The key ministries and commissions are not unified to the medical reform opinion Cross swords fiercely in view
The key ministries and commissions are not unified to the medical reform opinion Cross swords fiercely in view
The key ministries and commissions do not unify the view to the medical reform opinion and cross swords fiercely Source: The youth upgrades on weekend: Click by 2008-03-27: 93 timeswww.pharmtec.org"L One that piece together is mediated " ," the road of retrogression of planned economy is going in the new medical reform scheme " Cite 11 force of ministries and commissions, produce the broken callus within the next few days by 9 new medical reform schemes which internal and external organizations gives advice for. The reporter hears and interviews the targets many times in the interview that sends out so sharp criticism. Though expert and personage in the know of medical reform are all avoiding the story behind the draft sedulously, but they are claiming " We can say " Medical reform pros and cons analyze in,it is intricate one parts"medical reform historical romance " It has been already enough to shape. In addition, whether can solve " the difficulty and high cost of getting medical treatment " as to the new medical reform Question,last explanation seven set medical reform scheme chief editor, Xin Gu, Professor of Peking University. The games of many ministries and commissions This " historical romance " Basic train of thought: In 2006, 4 key national ministries and commissions drafted a set of new medical reform schemes respectively, went through the discussion of more than 3 months, these 4 sets of schemes have not coordinated out no unified scheme; In 2007, the country trusts 6 internal and external organizations to design the independently parallel medical reform scheme, these 6 organizations increase progressively to 9 successively. At present, according to personage in the know, the draft of the overall scheme of the new medical reform has already made, the ones that deserve the draft with Peking University " Government's leading factor is sent " The scheme is a main fact, but on the whole it is that " one that piece together is mediated " . 4 key ministries and commissions do not unify at the working conference of hygiene of Jiangsu Province held on January 17 to the medical reform opinion, Chen Zhu, minister of Ministry of Public Health, reveals: "The scheme on the whole of the medical reform has already taken shape, it is estimated that national two Conferences will announce to the society after holding in March of this year, meanwhile, relevant policies, related file are being all made. " Minister Chen Zhu said " The scheme on the whole of the medical reform " Behind the ones that shaped, there is a time consuming and quite long " scheme historical romance of medical reform " . Three years ago, it was July of 2005, claimed in the research report which Ge YanFeng, researcher of Development Reseach Center of the State Council, presided over: "The medical reform of our country is basically unsuccessful. " This share reports a stone evokes a thousand layers of waves, has initiated the free discussion about the medical reform drawback of our country rapidly. Just under such a background, September of 2006, led by development and reform committee, Ministry of Public Health and 11 that national ministries and commissions make up many medical system reform coordination teams of ministries and commissions ' Hereafter referred to as " The coordination team of the medical reform " )Establish, has started the working out of new medical reform scheme in an all-round way. A personage in the know familiar with the new medical reform background tells reporters: "In fact, in the 11 ministries and commissions these, central 4 ministries and commissions, development and reform committee, Ministry of Public Health, work with social security portion and Ministry of Finance right away. Each of ministries and commissions has taken out a set of schemes, the coordination team of the medical reform often has a meeting together too, but the scheme that they take out is not very ideal. Each department does not set out in terms of scientific principle that the medical reform should be changed well, but stand in one's own department position going up and consider more. These four departments can not always take out a unified opinion together. " After discussing to last 3 months in the medical reform of such a many ministries and commissions, there was great turn at last in the new medical reform scheme. At the the intersection of ministries and commissions and the intersection of medical reform and the intersection of coordination team and regular meeting, chief of Ministry of Public Health Policy and Regulations Department XinMing Liu leave " the two layers of frameworks, ensure doubly " on question for the first time will it be December 4 2006 Community hospital reform,last community hygiene system. In this scheme, single (nearly 100%)s will buried for the hygiene medical care of urban community in the government . The urbanite can go to community's hospital to enjoy nearly free medical care according to the resident card, the gross investment of the government is estimated to be 269 billion yuan. The battle on opinion of the medical reform: " mend and support " ," mend needing " ? According to the introduction of personage in the know: "here piece ( Ones that put forward in Ministry of Public Health) The scheme just launched a pilot project later, did not spread out completely. Very great resistance lies in some other one key ministries and commissions object to. Because the opinions of 4 key ministries and commissions are unable to unify, the medical reform group looks for 6 academic organizations to connect the formulation of the new medical reform scheme. This insider explains: " Ministry of Public Health slope on mend supplier (mend hospital) ,Work with social security portion sloping on mend demanding party (mend patient) . This causes game between key ministries and commissions. Between Ministry of Public Health and work and social security department, the Ministry of Finance blends some, the development and reform committee has admixed some too. " So-called " mend the supplier " ,Strengthen the input to the public medical organization of the government, let worker's income of medical care be high, keep the par of medical organization running at the same time. This is known as too " Raise the supplier " Thinking. So-called " mend the demanding party " ,The government pays the bill, replenish to people and participate in the public medical insurance, thus advance the realization of the whole people's medical insurance. Gu Xin of the professor of the incumbent management college of government of Peking University is during May of 2007, the social development of Beijing Normal University and professor of the research institute of the public policy, he is a chief editor of the scheme of medical reform of Beijing Normal University, are called " it is sent that the market dominates " by the media at the same time Representative figure. The scheme of Beijing Normal University advocates government Israel when the financial budget of the newly-increased hygiene is put into " Mend the demanding party " It is a main fact. Take care of Xin to explain, the whole people's medical insurance is very important. His reason is: First, there is the whole people's medical insurance, people pay some ginseng premium, most just several hundred yuan in one year at ordinary times, people diagnose the illness cure the disease, needing little heading to pay hospitalization cost only, feel, see the doctor getting expensive right away while being natural so. That is to say, the risk of the hospitalization cost has been shared by everybody, has been shared by sick person and person without disease. Second, there is the whole people's medical insurance, there is group purchase in other words, the medical insurance organization can represent the interests of the persons who effect an insurance, negotiate with the medical organization, carry on group purchase to medical care. In this way, all sorts of drawbacks in medical service system have been probably restrained at least. Certainly, can be really well restrained, it depends on the medical insurance organization can well serve persons who effect an insurance. Nine sets of schemes " Mediate " When it is in the medical reform scheme make the unified opinion that the key ministries and commissions of 4 medical reforms are unable, a kind of new solution has been produced. Around the Spring Festival of 2007, the coordination team of the medical reform trusted 6 domestic and foreign organizations to carry on the design of the new medical reform scheme. These six organizations are Peking University, Fudan University, Development Reseach Center of the State Council, World Health Organization, McKinsey and World Bank separately. In four Mays of 2007, Beijing Normal University, the People's University of China added into design team of the new medical reform scheme again. In June of 2007, Tsing-Hua University becomes " the ninth set of schemes " Submission person. 8 sets of schemes " Have a hearing " ,Each side debates fiercely and looks like " Complete mess " At present, the discussion of the new medical reform is according to domestic media, divided into two sending big mainly: A group is Represented by Li Ling, Professor of Peking University, " Government's leading factor is sent " ,A group takes care of Xin,et al. representatives " The leading factor of the market is sent " . When the reporter proposes wanting to understand the background story that the overall scheme draft of new medical reform issues, Gu XinGang came out from the airport, he said loudly on the phone in ones that sat on the taxi: "I know you want to listen to the story, want to know what these 9 organizations are all tossing about. But I should not speak carelessly in this. We and related departments have signed the contract, there is such string in the contract, say this is secret. Waiting for this contract of ours to agree to cancel, I can say. " Some newspapers and periodicals once invoked Gu Xin's excuse vividly, described the secret of eight sets of medical reforms scheme in Diaoyutai State Guesthouse " had a hearing" last the end of May ,But it expresses he has never been interviewed by any media the situation that has talked about having a hearing this time to take care of Xin, and call " The descriptions of these medias are quite superficial " . However, Gu Xin tells this newspaper, since having a hearing that time, the fierce debate of each side has not been over, just like " Complete mess " . In fact, have gone through " have a hearing in these 8 sets of schemes fiercely " And then, in June of 2007, Tsing-Hua University united Harvard University to draft the 9th set of medical reforms scheme. According to insider, this set of schemes of Tsing-Hua University are like eighth set of People's University schemes, should study national the intersection of medical reform and commission of coordination team submit is and in the first seven scheme and go on, draft by oneself. According to media, Chinese Academy of Sciences is planning to submit " the 10th set of schemes " ,This means too, Chinese Academy of Sciences may become the 10th independent organizations which participate in the medical reform scheme. The reporter has attempted to contact the main participant of the scheme of Tsing-Hua University Professor Liu YuanLi, before stopping submitting the articles, Liu YuanLi's telephone has been failed to put through all the time. The second Peking University sends the view to cross swords fiercely at present, many medias report, the main thinking of the overall scheme draft of the new medical reform comes from Peking University and Fudan University. When Gu Xin hears this statement, show, " though the full text of the new medical reform scheme has not been announced yet at first, but all sorts of signs show, it seems that there are various opinions " . Meanwhile, he says: "Whose opinion national scheme has been adopted, might not represent how correct that person's opinion is. I mean that should not propagandize such a thing at all. Who say right and incorrect unimportant. " Subsequently, Gu Xin tells reporters, a major thinking regarding medical service system is reformed, should belong to " Peking University and Development Reseach Center of the State Council " . He says at the other end of the telephone: "Since beginning the free discussion of the medical reform in 2005, Development Reseach Center of the State Council proposes, should set up ' basic health care systems of the whole people ', or ' national basic health care system '. Mainly meaning it is free that the whole people see most young diseases of this statement, set aside the money by the country. Frankly speaking, little disease socialized medicine system. Li Ling of Peking University is to support this thinking too. Advocating seeming to accord with the opinion of health authorities of them. " Cross swords fiercely in view that according to media, even inside Peking University, the difference of changing the scheme opinion of seeking medical advice is formed " " Liang group. Before the Spring Festival of 2007, Peking University received the invitation of the coordination team of the medical reform and participated in making the medical reform scheme, it is Lin JianHua, Vice President of Peking University to cure the leader who changes the scheme at that time. Lin JianHua has convened a dozen professor, teacher of health care field of key research in Peking University to have a meeting and discuss after receiving the invitation, have confirmed several key themes. Every expert assign relevant special topic to according to one's own past research field, exchange and discuss one's own the intersection of research results and thinking with group member two three week while being every. It is quite fierce to cross swords in view in this course, the scheme originally scheduled to be submitted on April 12, 2007, postpone not can submit until about 20 daysing. The main difference postponed lies in, medical care should be dominated by the market or the government dominates. And this set of schemes submitted finally, have basically kept supporting " government's leading factor " , represented by Li Ling, Professor of Peking University group view. The expert claims new medicine changes to and goes " The road of retrogression " In the afternoon of October 23, 2006, Political Bureau of the Central Committee held and studied and gave lessons collectively for the 35th time, the content given lessons is to introduce the relation of foreign medical reform experience and hygiene industry of our country, the speaker is exactly professor of Deputy Director of China Center for Economic Research of Peking University Li Ling and former officer, Liu Jun, Deputy Chairman of Chinese Medical Association of the Ministry of Health. It is generally acknowledged the intersection of Political Bureau and collective speaker of study, by to in charge of the administrative department, give a recommendation relevant topic. Have media even in right away provide such conclusion at that time will it be July 2007: "The industry generally think, this will become a watershed of China's medical system reform, government's leading factor has already basically finalized the design, the battle of the medical reform direction ends, the next job is to make the medical reform scheme with higher speed. " In the afternoon of December 26, 2007, the 31st meeting of the tenth Standing Committee of the National People's Congress is held in the Great Hall of the People of Beijing, minister Chen Zhu summarizes the overall goal of deepening the system reform of the medical and health at the meeting: "There are basic for health care system on one that if you can't build, cover on urban and rural residents,is it safe, effective to offer to masses, conveniently, cheap public health and medical cares basic, promote everybody to enjoy the basic health care service. " When the new medical reform will emerge soon, many people do not have a good prospect very much. Analyze according to a personage in the know: "Send the system that is to put it briefly one ' mend the supplier ' in government's leading factor, it is to throw the money into the hospital directly. It is the one ' mend the demanding party ' system that the market sends, throw the money to our every patient, passes patient's independent choice hospital, actually a market economy method, the scheme in fact ' mend the demanding party ' is obviously better. "This medical reform scheme goes the road back, get back to that era of planned economy, medicines are expensive, reduction very briefly, it is difficult to see the doctor, build more communities and and build the community with state-run capital. But they have not thought of creating the situation of a kind of competition through the way that the mechanism guided the private capital. Such a way is planned economy ways. It is still unable to satisfy the social demand that planned economy works out a scheme even more, market economy can create the vigorous demand, expensive problem of ugly disease of seeing the doctor of settlement that could be real. " Medical reform expert, the State Ministry of Science and Technology originally " 413" Xiong MaoYou, group leader of seminar of the medical insurance has analyzed: "This ' road of retrogression ' must not leave, poor efficiency and corruption are not all the best choice of China's medical reform. " Ministry of Public Health claims the new medical reform scheme will not select some one set Whether know about this set of schemes " It is surnamed every family " Question,it is domestic media in fact query too early. On October 12, 2007, Chen Zhu, minister of Ministry of Public Health, shows while accepting reporter's special visit of " Moring Post ", the medical reform scheme, in making intensely, the final scheme is not to select some one to select fully The scheme, and will merge many sets of schemes, will propose a set of schemes. As to the trend of the new medical reform scheme, Gu Xin says that still remains to be seen, the text of the scheme has not been announced yet after all. Moreover, he says, no matter what the scheme detail of the new medical reform is, but most likely extraordinary sense of principle finally, concentrate all things which sound correct on together first? �'s extensive bad plan crab makes Gun and throbs with fear and fines ��'s cricket Xing to send Sex Pian yellow Zhen? In a word, Gu Xin thinks, the country has already said, the new medical reform needs pilot project. If the country can choose different related schemes to launch a pilot project in different areas, that is a very interesting thing. Meanwhile, Gu Xin says, no matter how the reform direction about medical service system disagrees, but " mend the demanding party " Thinking getting more current to be more become already and system in policies. The government finance will be from 2008, rural new cooperative medical service and basic medical insurance of urban residents will effect an insurance to replenish competence the most low, rise to 80 yuan from 40 yuan for each person quickly. Can expect, with " mend the demanding party " The enhancement of efforts, the medical security system will be complete gradually, the medical system reform will probably get onto the right track of benign cycle. How medical service system reforms, Gu Xin thinks, marketization is no matter. Medical insurance organization carries on group purchase, may lead the medical organization to improve the quality of the service in the environment of the competition. The area where it can not be abundant as for those competitions, such as the rural area, especially mountain area and outlying district, certainly the government is not merely necessary " Mend the supplier " ,And necessary " Raise the supplier " . However, in the large and medium cities, in the coastal developed area, the area where every social capital is willing and probably enter, it is totally unnecessary for the government to invest more fund to come " Raise the supplier " . If the government thinks some services are necessary and is buried by the finance singly, can well then find the appropriate service provider through serving the mechanism bought. The government pays the bill, " supplier " Raise, that is to raise people and build the organization, this kind of method has already been made for more than 50 years, basically unsuccessful. "We have public institution which a lot of governments raised, are fermenting the reform? Why 's thinking prevail in the field of medical care? " Gu Xin expresses to this that is puzzled. Gu Xin the intersection of special visit and piece see the doctor difficult to solve for ordinary people while being difficult, perhaps about new medical reform content whom they care about most. Perhaps, the ones that can cause reader's sympathetic response most are: The new medical reform could be solved at present on earth " The difficulty and high cost of getting medical treatment " Basic question? When ordinary people encounter burst of serious disease, can the new medical reform offer the method which resists the risk? As to this, reporters have done telephone interview to Gu Xin. Youth weekend: The people who have been to the hospital will all go through and register standing in a long queue, all sorts of questions that the procedure has been heavy and complicated, doctor's attitude is not good,etc., what is the main reason for producing these questions? Gu Xin: The supply of medical care is insufficient, the hospital lacks the competition. Youth weekend: Is the new medical reform expected to solve this problem? Gu Xin: It seems now that not yet. Because the reform focal point about the new medical reform is not here now. Youth weekend: Where? Gu Xin: Now, some people do not have money that see the doctor at all. How could let them think highly of the disease. The country must think of the track. Youth weekend: What kind of track does that think out now? Gu Xin: There is a piece of track, it is a piece of track that the ordinary people like very much too, just see the small disease freely. What everybody reach being public be lasted diseases light community hygiene service organization,medical care expenses (for example registration fee, last fee,etc.) Extremely cheap; Medicines implement a price differential, cheap too. Youth weekend: What kind of statement is this track implemented on concrete policy? Gu Xin: " build the basic health care system of covering urban and rural residents " . This sounds good. However, want not to need the money, and then something will happen. Assume you have a meal without needing the money, then the people of the restaurant start not to earn the money, restaurants are few, or food variety offered in the restaurant is few. And then, no one will come to invest in and build the restaurant. Next, on shortage, everybody has no restaurant to eat. Do the low price, even free, sure to bring shortage, everybody sees " the basic one " in the end The disease is difficult. The characteristic of planned economic system is that any things are very cheap, but there is not anything. There is anything once in a while, want the entering by the back door, that is to make the corruption. In addition, there is no free lunch all over the world. It is natural all over the world there is no free medical treatment, who gives the money of this free back? The country comes to foot a bill. That who come on, divide the money? It is officer that come on, divide the money certainly, chance that practice fraud have. Youth weekend: If see the doctor freely, does the consequence return to the medical care of the times and shortage situation of medicine of planned economy? Gu Xin: We must believe first, the government, in order to solve " the difficulty and high cost of getting medical treatment " Intention neither fine nor problematic in but thinkings overall. This is coming back to Chairman Mao times. We will do in this way now, will affirm the question is in heaps. The present person practices fraud, it is not the money of a cigarette originally to drag for. Only we see the doctor to want to line up, but should line up to buy everything originally. " basic medical treatment " "basically " Have not defined youth weekend clearly: How does everybody see the doctor that new medical reform really let? Gu Xin: Let the intersection of everybody and little disease go the intersection of community and hospital, don't any disease go, coordinate, think, thus hope, the difficult problem of seeing the doctor has been solved. Youth weekend: Then has got serious disease? Gu Xin: The present scheme maintains basic medical treatment will be provided funds by the country, free, but serious disease, non- basic part, it is not that the government pays the bill freely, depend on the medical insurance. But what is connected with at present " Basically " Did not say clearly. " basic medical treatment " There is not the one that define in medical science in these four words, ambiguous too on the medical policy. Propose one ask once " Basic medical care is chartered " Subject study,here piece " wrap up" Having already studied for a long time, the fee of subject has bungled much, but " wrap up " What do li have on earth? Can't urge till now, or keep secret. In a word, we do not know what disease calculates the small disease, can enjoy " basic medical care " free on the whole on earth . Small disease can not be found out, serious disease is not clear naturally. The new medical reform proposes setting up the whole people's medical insurance. In the town, the basic medical insurance of urban residents, protect serious disease and serious disease clinic. I worry about the medical care that this insurance protected, ones that offer with the community that was introduced just now, the free so-called " basic medical care " on the whole ,Go wrong in connecting. Not doing well, if some disease which my dear friends gets is neither big nor small, then the community will push away for the insurance, the insurance may be pushed back to the community again.


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