The supernatural wood in Shaanxi pursues the whole people's free medical care The expert claims not to recommend extensively

The supernatural wood in Shaanxi pursues the whole people's free medical care The expert claims not to recommend extensively
The supernatural wood in Shaanxi pursues the whole people's free medical care The expert claims not to recommend extensively
Treat the supernatural wood in reason " The whole people's free medical care " --Visit Yu Hui, researcher of Ins of industrial economy,Chi Acad of Social Sciences The intern takes the place of the new medical reform scheme issued recently in Songyang, cause the extensive concern of the whole society. But just before the new medical reform scheme has not been put out yet, the wooden county of the god in Shaanxi Province benefits for March 1 and takes the lead in implementing " the whole people's free medical care " at home Ensure the system, patients of urban and rural residents having supernatural registered permanent residence of wood, in the fixed medical organization, will enjoy " Free medical care " Policy favourable. This system is considered to be greater innovation on the basis of new medical reform scheme. OK the one that treat in health care reform " The wooden mode of the spirit " ? Researcher of Chinese Academy of Social Sciences industrial institute for economic research Yu Hui interviewed by China Economic Times reporter thinks, " wooden mode of the spirit " The starting point is very good, but there are a great deal of drawbacks that mechanism's defect brings in the course of implementing, not worth recommending extensively. " wooden mode of the spirit " Non- strict the whole people's free medical care is according to the stipulations of " free medical care implementing methods of the whole people of wooden county of spirit ", in supernatural urban and rural residents of registered permanent residence of wood ' Except the personnel not participating in cooperative medical service of urban and rural residents and worker's basic medical insurance) ,Implement the medical card of the clinic and submit an expense account and make in hospital. Can enjoy clinic of 100 yuan to replenish for each person every year, submit an expense account to presume that get up in one pair of lines correspondingly according to different hospital properties in hospital, 200 yuan for every person for one pair of lines arises in the township hospital, 400 yuan for every person of hospital at county level, the hospital is 3000 yuan for every person outside the border of the county. The ones that get up under one pair of lines are in hospital the hospitalization cost is paid for itself by the patient, getting up is paid the expenses above line to all check by the county finance. The most noticeable one is the special medical treatment such as organ transplant within submitting an expense account in the range too, the upper limit of submitting an expense account for each person every year is 300,000 yuan. Calculate tentatively, " free medical treatment systems of the whole people " Pursue, spirit wooden the intersection of county and finance need, replenish 1 at least one year. The fund of 500 million yuan, it is about 400 yuans that per person replenishes, well-above the new medical reform scheme by 2010 per person replenishes the standard which reaches 120 yuan. As to " the whole people's free medical care " The system, the first response of local common people " needn't foot a bill to see the doctor " . But in the view of my sunshine, " wooden mode of the spirit " Do not rigorously enforce the free medical treatment systems of the whole people in the meaning. "What is called the intersection of the whole people and free medical care, should the intersection of government finance and complete support, resident think old complaint needn't foot a bill or join medical insurance any originally, and compare with god's medical reform scheme of the wooden county, it must be the crowds participating in various medical insurance in population of household register of this county in covering the colony, have not benefited the whole people. One pair of lines arises too in the system of submitting an expense account in hospital, though it is not high to get up in one pair of lines, this is not the free system that a government totally checked. " Yu Hui thinks, compared with national new medical reform scheme, there is no innovation on system in the frame design in the wooden mode of the spirit, light spot reflect in high to bind line and financial subsidy, far higher than new the intersection of medical reform and scheme at the subsidy standard that set for to great disease treatment mainly, this it is the intersection of government and based on that oneself rich financial capability is made one the intersection of increase and medical treatment that put into with medical treatment ensuring attempting of efforts, should not be interpreted as the whole people's free medical care. "What the national new medical reform scheme is taken is the road to the whole people's medical insurance, the fundamental key of the policy lies in increasing the input into medical care one. It is not a way of the whole people's free medical care. " Hui Yu point out in view of of our country national conditions, leave the intersection of the whole people and free medical care though can the most loud range reflect the fairness, but its have enormous moral hazard at efficiency, may bring financial respect, have consequence continued to think. The wooden mode of the spirit of moral hazard is met similarly and puzzledly when being put out. Implement " the whole people's free medical care " In the first month after the mode, about 9,600,000 yuans that total value reaches that the finance of wooden county of the spirit submits an expense account. Stimulated by free medical care, ask the doctor to pour into the hospital in a large amount, cause the extreme shortage of the sick bed. The serious illness patient is unable instead in time in hospital, the patient is unwilling to leave hospital that have already fully recovered, cause wasting bowing the problem with efficiency seriously of medical resources. Yu Hui thinks, the government finance though can reflect the fairness to the greatest extent while wrapping up completely, but the demand is swelling constantly in free cases, it will be seriously insufficient that the public products are being supplied, if there is no strong encouragement to restrain on system design, will cause moral hazard and reverse choice. "Under encouraging free, doctor and patient all have one kind to excessively take up the inclination of enjoying medical care of the government finance, this kind will bring the reverse choice to conspire, the finance is unable to make ends meet, unable to maintain existing medical treatment to ensure competence. The government will fall into a dilemma, continue improving medical treatment and ensuring competence finally, the finance will be hard to carry more on, and once reduce, will cause greater social concern. Countries implementing free medical treatment systems of the whole people such as Britain,etc., it was all once unable to get rid of the low drawback that brought of this kind of efficiency. " Yu Hui says. Should strengthen single number and pay the coordination problem how tied mechanism solves fair and efficiency? Yu Hui thinks, it is very important to pay the design of the mechanism. "From making a diagnosis to observing, treating, recovering in hospital, the god lacks a kind of form number and pays the mechanism in medical reform scheme in the wooden county. " Yu Hui thinks, single number pays the mechanism and can play very strong restraint function, when reaching number and paying the limit, the doctor will remind the patient to leave hospital in time, otherwise be undertaken the following hospitalization cost by oneself. Can prevent the doctor from being excessively delayed in the situation that a patient is in hospital from system too in cases the medical facilities are sufficient. "Involve this mechanism in the new medical reform scheme clearly too, propose exploring progressively in the future that realizes the clinic is prepaid according to the number of people, in hospital and pay the method according to the science of general number advance, can set up a kind of encouragement tied mechanism at the same time between patient and doctor in this way, can guarantee a patient enjoys appropriate medical treatment and ensures serving, can control the scale of the expenses effectively too, avoid excessively wasting. " Yu Hui says. "But improved single number and paid to take to before the similar case expenses were analysed scientifically and calculated smartly, can set up overnight absolutely not. U.S.A. pays the most complete country of mechanism as single number, it is up to 900 multi-type to cover number, and there are ten or twenty kinds of our country covers number at present, still need to explore for a long time. " Yu Hui thinks, are lacking the complete one fairly and organizedly with efficiency to pay under the mechanism, the spirit, this medical reform of wooden county, mode though the starting point is very good, it is difficult to avoid a great deal of drawbacks that the system defect brings, not worth recommending extensively at the present stage.


|