The People's Daily on free medical care feasibility: can only is a kind of ideal state

Sources: the People's Daily

        "Medicine doctor must produce cost, the cost is not individual to assume, is the financial bill

        "Even if the bill is financial" free medical care ", the money is also in financial from national tax

        "The core of the discussion medical model is not whether or not free, but how to give consideration to fairness and efficiency

        Our newspaper "details" column on March 26, published article, "which countries to provide free medical care", our foreign correspondent in more than 70 countries medical system and medical insurance system to survey found that only a handful of countries completely free medical care, usually people mention of free medical care countries in an still needs to pay for the cost such as expenses for medicine, etc.

        The cause of hot debate. China's health care system construction in a short time, made great achievements, but, see a doctor to see a doctor, the difficult your are still to be urgent to solve problems, to free medical care patterns of concern, highlighted the public to the high cost of anxiety. So, free medical care is feasible? China how to crack your doctor?

        Question 1: what medical insurance system more reasonable?

        【 response 】 adapt to the social and economic development, due consideration to fairness, efficiency and sustainability

        The world bank policy research report, low-income countries suffered from illnesses, need more powerful public policy priority to the limited medical health resources allocation; But rich countries also not for medical and health departments to provide unlimited public budget. No matter in developed and developing countries, the urgent task is to cost control and more effective use of the funds.

        "Fairness and efficiency is the social security system of fundamental problems. Basic medical treatment to ensure a system to emphasize the supply of government responsibility, adhere to the fair, universal, public welfare, social and economic development to adapt the principle, but stressed that organizations and individual responsibility." Huazhong university of science and technology, tongji medical school professor YaoLan said, in order to improve the efficiency of medical and health institutions and avoid excessive use of medical and health services, many countries health care system are note government leading with market mechanism combination.

        Two meetings this year, have representatives think, our country national condition decision the cure of the impossible by the government, the package, state, local, unit, individual and even the whole society should work together with the power and solving problems. Medical and health services only by the market mechanism cannot adjust the fairness of the ensure medical service, all by government regulation also can not meet the diverse needs of the people, and must therefore be introducing market mechanism and stick to the government's leading role, realize the maximum benefits of both parties; At the same time, we should distinguish the basic and the basic demand, basic medical and health security responsibility should bear by the government, the basic medical treatment is mainly to the society to do, to adapt to the patients multi-level needs of medical treatment.

        The world bank is engaged in public health experts ZhangShuo think, see a national health service safeguard level and national strength is to adapt, should see health care spending per person with the country's per capita GDP level. China's per capita GDP has already reached the middle-income countries, and the per capita health care spending basically and other middle-income countries average level consistent. ZhangShuo suggest that China medical service support should set the policy guarantee those most poor vulnerable groups, through the second means such as compensation, provide basic medical and health public products.

        South Africa's medical system consists of two parts, namely free medical care and health care. To public hospital basic free, but long queue time, medical environment is bad, so many medium above their medical insurance will earners, to private hospital. According to statistics, South Africa only use medical treatment at public expenses of 68%; 16% of the people who use only medical insurance to private hospital; Another 16% of people are neither to private hospital, also to public hospital sees a doctor.

        Question 2: free medical care is feasible?

        【 response 】 "completely free medical care" can only is a kind of ideal state

        ZhangShuo said, there are completely free free medical care, free medical services to discuss when the free range, connotation, space make some definition. Now use the basic free medical care country divided into two kinds: one kind is little money but can enjoy a very low-level medical services, such as some African countries as well as Laos and Cambodia, India and other developing countries. These countries have established public clinic, provide some basic free medical services, but security level is low, often lack of medical care, is in the country's poor the lowest level of security, far can't satisfy the average resident needs; Another kind is the developed countries, general development for medical insurance, a doctor spend relatively less, but in order to enjoy the insurance, the residents of the high tax burden.

        Experts think, implement the completely free medical care, only is a kind of ideal state. The medical service if completely free, the marginal cost of people to pay almost zero, medical treatment demand will a large release, would cause the waste of resources, medical cost growth, the huge financial pressure.

        Zhongshan university social security research, director of the center ShenShuGuang professor says, in the system can consider free medical care, but completely free may lead to the efficiency is low, the medical service quality are unlikely to improve.

        YaoLan introduction, medical and health belongs to "market failure" field, "if is free medical services, ginseng protect supply person need not pay a certain proportion, or the proportion is too low, may produce an excessive use of medical service behavior. The excessive use of medical resources, is also a huge waste."

        Our overseas reporter survey is also proved the experts said.

        In Britain, the patient to examine, make an appointment to see a doctor in a public hospital waiting time is too long, some surgery may have to wait several months or a year or longer. The reporter had because gum inflammation going to the clinic to see a doctor, ask in the booking office, have about two weeks later. Many patients to timely treatment had to choose high private hospital, causing personal medical spending increase.

        In Spain, by the end of 2009, the medical deficit of over 63 billion euros, and continues to grow. In order to cut the deficit, some local governments to cut back on the public health system in the financial expenditure, the move was part of the citizen and the opposition of the medical institution. Since the Spanish public medical system relies mainly on the tax on government support, and in the circumstance of economic recession, the medical system sustainability is challenged.

        Question 3: how to crack your doctor?

        【 response 】 improve security standards, expand the benefit from the crowd; To speed up the reform of public hospitals, a medical apart

        In 2010, China's total health expenses to GDP percentage is 5.15%, medical institutions diagnosis and treatment to 5.82 billion people, more than 2005 years to add 1.72 billion, increased by 42%. In 2011, the policy range reimbursement ratio increased from 70% to or so, basic drug prices fell about 30% on average. Can say, with the continuous improvement of the medical security system, basic medical this public product has started to enjoy the for the whole people. But, due to the large population, economic development level is not higher reason, medical security level is low, in different areas and different people and between urban and rural areas, medical insurance reimbursement policy not too, people enjoy primary medical treatment service is not the same.

        When to see a doctor, excessive medication, the virtual high prices also led to a medical costs. In Britain, the countries such as India, "medical centre" system, the doctor is responsible only for diagnosis, a prescription, the patient can take it to any enterprise to buy medicine, the doctor does not exist for ChiHuiKou and disorderly to prescribe medicine.

        "Pay attention to 3 d medical insurance system, the effects of that coverage, submit an expense account level, service coverage. The system in our country at present the basic covers realized, but reimbursement ratio is not high, the medical institutions, medical and health services not at all the coverage." YaoLan said.

        Chinese people's university of China's social security, director of the research center ZhengGongCheng said: "the current medical insurance reimbursement level is still low, the actual coverage expansion, and also have space in the process of medical inspection, DaChuFang repeat the phenomenon such as exist, many people still feel medical burden is heavy."

        Therefore, to solve the "high cost", on the one hand, need to increase security standards, expand the benefit from the crowd; On the other hand to speed up the reform of public hospitals, a medical apart.

        In fact, our country also is headed in the direction. This year's "the government work report of the proposed, to speed up improvement of the national health insurance system, and promoting public hospital reform and break up with drug medical mechanism. Health minister Chen Outlines also says, the new catalogue covering basic drugs is expected to include large hospital medical institution of the necessary use, 300 hospital and at the county level in 17 countries contact public hospital reform pilot city will also try water medicine separation; By 2015, the individual pays the proportion of less than 30%.

        Medical security is considered worldwide problem, testing the government economic bear ability, system innovation ability. Hope with the reform of public hospitals, basic drugs system and a serious illness assistance system perfect, the common people's doctor can further reduce the burden.