"In the process of gradual deepening of medical reform, the prevention-oriented approach needs to be further implemented, the prevention system and mechanism need to be improved, the funding investment and social mobilization work still need to be strengthened, and the government's leading role in public health needs to be more prominent." .
“In 2005, there were 4.1 billion person-times in the country, and the number in the last three years was between 7.7 billion and 7.8 billion, meaning that every Chinese person has to see an average of 6 times a year; the total cost of health care in China is rising. The rate exceeds GDP growth, and may exceed 5 trillion yuan in 2017, almost six times that of 2006."
"The hospital building was built, and the MRI equipment was installed, but there are a shortage of excellent doctors and few experts who can operate the machine. This is a serious problem. In 2017, Honghu People's Hospital recruited 30 undergraduates, leaving only 3..."
On the eve of the National Conference of the two countries in 2018, the China Net "Reconciliation" APP platform and the China Cancer Foundation held the "2018' I said to the Prime Minister's words" and the 10th issue of the "Review of the Library" series of salons. "Specially invited CPPCC members, experts and scholars, etc. to offer advice and suggestions on the topic of "medical reform."
Question: 90% of resources are currently used for treatment, and prevention is only 10%
Countermeasure: prevention is the main prevention, prevention is better than cure
"In the process of gradual deepening of medical reform, we are increasingly aware of the importance of prevention. However, the lack of corresponding prevention systems and mechanisms, the serious lack of funding and the ability of social mobilization have seriously affected the overall efficiency of China's health care." Wang Yu, a member of the CPPCC National Committee and former director of the National Center for Disease Control and Prevention, spoke of the big issue of “prevention firstâ€. “The leading role of the government should be more prominent.â€
Wang Yu said, "Prevention is always the policy of China's medical and health work, and it is particularly emphasized in the "Health China 2030 Planning Outline", but what measures do we take in prevention? The reality is far from enough."
Wang Yu’s speech caused everyone to resonate. Fan Li, a member of the National Committee of the Chinese People's Political Consultative Conference and the former vice president of the General Hospital of the Chinese People's Liberation Army, believes that health education is an important means of implementing prevention. "It is too late to engage in health education."
Fan Li analysis, there is a relatively common phenomenon in China, most of the young and middle-aged groups do not understand medical treatment, and the elderly group with chronic diseases is seriously ill, and the young people who do not understand medical care can not care for the elderly group suffering from chronic diseases. Fan Li suggested that the government should invest a lot of manpower and material resources to carry out health education for young people, on the one hand to improve their ability to care for the slow and middle-aged patients, and on the other hand, to encourage young and middle-aged groups to actively participate in building a healthy China; In addition, it also provides health knowledge and improves their lifestyles for young and middle-aged groups who are already chronically ill. In this way, we can help the intergenerational generation to gradually get out of the evil cycle and achieve the strategic goal of “prevention firstâ€. "Otherwise, the number of large hospitals has been built, and the number of beds has increased. They are passively coping."
According to Fan Li’s data provided to China Net reporters, as of 2016, the number of elderly people suffering from chronic diseases in China is close to 150 million, of which more than 60 million are disabled and half-disabled. The old age, disability and dementia have become China's aging society is currently the biggest challenge. If it is not timely and effective, "prevention is the mainstay", China's medical reform results will continue to face great challenges.
Zhao Ping, member of the National Committee of the Chinese People's Political Consultative Conference, chairman of the China Cancer Foundation, and former president of the Cancer Hospital of the Chinese Academy of Medical Sciences, shared a set of data. "In 2005, there were 4.1 billion people in the country, and the number in the last three years was 7.7 billion to 78. Between 100 million people, it means that every Chinese person has to watch 6 times a year on average; the increase in the total cost of health care in China exceeds the growth of GDP. In 2017, it may exceed 5 trillion, almost six times that of 2006." Chairman Zhao Ping believes that chronic diseases consume most of China's medical funds, and these funds are difficult to maintain the health of the people. It is necessary to strengthen the concept of prevention and implement the policy of treating illness.
“Now many hospitals use more than 90% of their resources for treatment (diseases), and prevention only accounts for 10%.†Zhao Ping suggested that specific measures should be taken to strengthen prevention. Prevention is public health and the government has an unshirkable responsibility. In a sense, getting sick is a personal matter, and prevention is the responsibility of society.
Question: A county hospital recruits more than 30 people and only leaves 3 people after 1 year.
Countermeasures: Break down the barriers to talents and improve the treatment of grassroots medical and health personnel
“The grassroots hospital is the gatekeeper of the people's health. Take Hubei Honghu People's Hospital as an example. In Honghu City, 85% of the people are treated in the city hospital, and 15% are transferred to large hospitals in Wuhan and other places, but this 15% turn The patients who treated them consumed 55% of the medical insurance costs.†Yong Yong, dean of the Honghu People’s Hospital (Xiehe Honghu Hospital) from the primary hospital, said the basic hospital’s paralysis: why 55% of the medical insurance costs cannot be left in Honghu Hospital What about such a basic hospital? - No one, no technology, can't catch the 15% of patients.
According to Yong Yong, the Honghu People’s Hospital recently built a new building, increased the number of beds, and the service capacity has been greatly improved, but the problem is still serious: “The hospital building was built and the MRI equipment was installed. But there is a shortage of excellent doctors and the machine can be operated. There are very few experts, which is a serious problem. In 2017, Honghu People’s Hospital recruited 30 undergraduates, leaving only three, some chose postgraduate studies, some chose a better platform, and the surrounding counties and cities were different. There is a shortage of talent in the degree."
Wu Mingjiang, a member of the National Committee of the Chinese People's Political Consultative Conference and the former director of the Department of Medical Affairs of the Ministry of Health, said that in the past 10 years, the houses and equipment of grassroots medical and health institutions in poverty-stricken areas have improved significantly, but how professionals can “retain and use them†is a There are no difficult problems solved.
Yan Yong introduced that low incomes in primary hospitals are common, which is the main reason why it is difficult to retain excellent talents.
Zhao Ping said that the average annual income of county-level hospitals in China is about 80,000 yuan, the average annual income of employees in prefecture-level hospitals is 12 to 150,000 yuan, and the average annual income of provincial-level hospital employees is about 200,000 yuan (before tax). The hospital's treatment will be higher. "Why do outstanding talents stay in small places with lower annual income?" The question thrown by Zhao Ping is thought-provoking.
General Secretary Xi Jinping pointed out that it is necessary to focus on the enthusiasm of the majority of medical personnel, starting from the aspects of improving salary, development space, practice environment and social status, caring for the physical and mental health of medical staff, and enhancing the professional honor of medical staff through various forms to create a full The society respects the good atmosphere of medical rehabilitation. Wang Yu said that local governments should introduce active medical and health talent encouragement policies and leave outstanding talents in primary hospitals.
It’s not just a talent issue. “If the health of the people is an important indicator of the government’s performance evaluation, healthy China is expected to be implemented.†Fan Li said.
Question: Cancel the "medical treatment with medicine", how does the hospital survive?
Countermeasures: Turning independent non-profit health industry units into full-funded institutions
"Pharmaceutical separation is a direction of the reform of public medical institutions clearly proposed in the national medicine reform program. For hospitals, the direct role of the pharmaceutical sector has disappeared, and the huge expenditure of the pharmaceutical sector has become a burden for hospitals." Beijing CPPCC member, Beijing Wang Chengxiang, dean of the Third Affiliated Hospital of Chinese Medicine University, said, "Take the Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine as an example. After the cancellation of the drug, some subsidies were adjusted. The income of western medicines will lose more than 10 million yuan per year."
Jiang Yansheng, who has been fighting cancer for 20 years, is inseparable from dealing with medicine. He said, "The western medicine fee has indeed dropped, and the patients have received benefits. Everyone feels it."
The report of the 19th National Congress of the Communist Party of China pointed out that the "medical treatment by medicine" should be completely abolished and the system of guaranteeing the supply of medicines should be improved At the 2016 National Health and Wellness Conference, Li Keqiang called for the elimination of the “medical treatment by medicine†mechanism and the public welfare of basic medical and health services.
Wang Chengxiang said, "Some hospitals are central units, some are grassroots units, and some are enterprise units. The third affiliated hospital of Beijing University of Chinese Medicine belongs to the Ministry of Education. The Ministry of Education does not have any funding and compensation in this regard. After the hospital took medicine, the hospital did not receive medical expenses, and hospitals like this were losing money to sell medicines."
Wang Chengxiang suggested that the independent non-profit health industry units be transformed from the differential appropriation institutions into full-funded institutions. In addition, regardless of whether the hospital is central or local, it is the mass of the locality of the service. After the cancellation of the “medical medicineâ€, except for the central subsidy, the rest should be settled by the territorial subsidy.
Question: How do private hospitals develop?
Countermeasures: support the society to run doctors, reduce inefficiency and low-end supply
Supporting social education is one of the important strategies of the Party Central Committee and the State Council on strengthening the building of a healthy China. In the "Implementing a Healthy China Strategy" put forward by Comrade Xi Jinping in the report of the 19th National Congress, 10 major tasks were deployed, the ninth of which was "supporting the society to run medical care and developing a healthy industry."
Wang Sili, a member of the National Committee of the Chinese People's Political Consultative Conference and vice chairman of the China Medical Foundation, said that the 19th National Congress of the Communist Party of China will "support the society to run medical care and develop a healthy industry" as an important part of implementing the healthy China strategy, and inject new impetus into the development of the health industry. This is an inevitable requirement for providing comprehensive and comprehensive health services for the people and achieving a well-off society in an all-round way.
Encourage and guide social forces to organize the development of medical institutions, promote the formation of public hospitals and social medical institutions to promote mutual development and common development, not only can increase the supply of medical and health resources, optimize the structure, meet diversified needs, but also play a social medical institution mechanism The advantage of flexibility.
Wang Zhili believes that reducing ineffective and low-end supply and expanding effective supply, private medical institutions must carry out comprehensive innovation centered on institutional mechanism innovation, which is of great significance for solving difficult medical problems, inadequate medical resources, and improving the health of the people throughout the country.
Zhao Ping added that in 2016, the proportion of personal payments in China's total health care has fallen below 30%, the government paid 31%, and the social capital paid more than 40%. Social capital management has gradually become an integral part of the process. The national policy is clear, but there are still problems that need to be seriously faced in the management of social capital. (China Net)
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