Medical network - February 3, 2012, Beijing health reform important step, in the first five 3 armour hospital pilot medical apart, cancel the thousands of people long for drug addition, cancellation of the registration fee, the fee, for medical services. Ji shui tan hospital is the first batch of health reform, to separate a medicine.
For the past 4 years, just the closing of the NPC the government work report points out that separated the full implementation of medicine this year. Cancel the drug addition, medical service back to normal price, make people have a feeling... Results obtained in the health at the same time, the first batch of pilot experience of jishuitan hospital Tian Wei recently had an interview with Beijing youth daily reporter and then four years of "profit and loss account" north green press its detailed, ranging from the perspective of medical experts, another line managers' thinking.
▍ separated medicine, drugs become the points of loss in the hospital
North green quote: health care hospital after losses of more than 100 million a year, but in people's eyes, the flowing water of hospital is always high, is almost a "windfall" industry. So "lost" where is the hospital?
Tian Wei: hospital every year as if water is very high. Our hospital running water $30 a year, namely income is 3 billion. However, spending more than 30, losses of more than 100 million every year.
Many people don't understand, but carefully tally up the profit structure you will understand. Prices of a separated medicine is flat into flat out, that is to say, a dollar to buy medicine, a dollar sold to the people. A bottle of medicine from entering the hospital to sell, however, there is certainly a natural loss, medicine is broken, is out of date, are a loss. From the point of view of commodities trading, ping into flat out must be at a loss. Plus associated with medical staff, medicine, pharmacy staff, warehouse of cold chain equipment, management and so on, these are the costs.
▍ many medical services price adjustment, the operation will be increased this year
North green quote: although it is the loss point of hospital medicine, but medicine is health is very important step, separately drug kickbacks from the old road is certainly can't go.
Tian Wei: a Shanghai pharma division before receiving kickbacks is not exposed? It is said that the doctor took a 40% rebate, a medical representative took 10% rebate, but the problem is, why pricing in a 50% rebate levels? Put the medicine price by 50%, not line? Why do you want to set the price so expensive?
North green quote: last year is not adjusted for more than 500 medical service price, also let go of the special medical services, such as more like price, don't these results?
Tian Wei: how much the price, but medical services may involve tens of thousands of items, and had let go of the project and can account for how much weight? I want to in advance reform, should be released open projects and share price.
North green quote: this year and will adjust the number of medical price, operation also go up. You have doubt, from the perspective of a doctor, said surgery isn't cheap, how to raise?
Tian Wei: in fact, the labor value of the largest hospital's operation. Surgery cost is very high, need to use all kinds of equipment. To see a doctor, medical words a person can, but do a surgery at least two nurses, at least three doctors on the operating table, four and five major surgery, the anesthesiologist 2 people. Time is short 2-4 hours of surgery, long 5-6 hours, and more than 10 hours. Surgery have paramedics, recovery room personnel.
General surgery a few hundred to a few thousand dollars, now that there are a large number of consumption in the operating room. We calculated that each operation break-even point, is a pure loss. A, kui one.
North green: you say so, and everybody is not consistent with actual feeling seems to be. The feeling of a operation does not come cheap.
In the Tian Wei: surgery? In medicine and medical equipment. A medicine is expensive, a medical equipment is very expensive, this can make a bad cycle, real hospital labor cost are at a loss, the past is to rely on medicine, now cancel the drug for medical, can only rely on equipment, but as our hospital was 5% bonus, these not enough to fill those losses. And equipment price also to reform immediately.
Then look at other places, was in the hospital, the nurse is also low. We hospitalization day 28 yuan, nurses, nursing staff labor price, cannot be reflected. In the hospital, every day there are larger losses.
▍ reform lies in the selling price
North green quote: according to you say so, now the hospital have no profit space?
Tian Wei: there is some, one is the inspection fee, one is the radiation, the inside there is a profit. This is the hospital bigger profit space. But after medicine apart, the other, or not to be able to fill. Annual government subsidies for hospitals also to have certain losses of more than one hundred million a year, but I said is already with the government's subsidies, if you don't have to fill, 5-6 billion a year of losses.
North green newspaper: what's the problem?
Tian Wei: price upside down. Labor price actually is one of the biggest share in the medical, the world is so, accounts for 70% to 70%. But our medical industry, the price reform is far behind the other industries. After the reform and opening up, many industries have established labor prices, but there is no established health care.
North green quote: although the hospital is facing price down loss problem, but the feeling of the people is expensive. Where it lies?
Tian Wei: common people feel medical treatment is expensive, mainly is the medicine and medical apparatus and instruments, if it is to pay the money, feeling must be very expensive. In fact, if in a foreign country, such as in the United States, the doctor also is very expensive, do a sanity check, see a doctor a few thousand dollars, then truly treat tens of thousands of dollars, at one fell swoop down ten dollars. If not really seen disease in a foreign country, may I also have no experience. My son is also a orthopaedic surgeons, lived in the United States, this feeling is very obvious. However, foreign health-care system can reduce a lot of burden.
North green quote: recently also mentioned the relevant departments, health care reform will maintain the balance of the medical price, don't burden on ordinary people. So, people may sense the change of overall price? To see a doctor or you?
Tian Wei: medical treatment is expensive, how health care reform is a key. To establish national insurance mechanism, the insurance to pay for most of the medical burden. Could you take a sum of money by the government to do national insurance fund, and commercial insurance, combined with a more senior pure commercial insurance. Different people can buy insurance, but each insurance can be superimposed.
Stack is not allowed in our insurance now. You enjoy health, for example, to the hospital, I am a man of high income, I want to go to the special service, but it is not allowed, you want to use health insurance, you can only live people ward. If you live the special ward, a point not to submit an expense account. I don't think this is reasonable, I handed over health care costs, can not burden the part I above, but should cancels out originally for the corresponding costs. Since I pay extra, this just is reasonable.
▍ reform: what's the most difficult: is to switch to decades of price system
North green newspaper: why the health care industry price upside down so outstanding?
Tian Wei: this problem goes back to the reform and opening up. Reform and opening up, various industries began to price reform, health care, who was not involved in. Industry, for example, like a hair cut, how much money thirty years ago, how much money today. If the haircut today or two dollars, suddenly say to a few hundred dollars, we cannot accept right away, will think "isn't it has been two dollars of labor value, how to hundreds of dollars", is the same reason.
North green quote: where in the world to reform?
Tian Wei: healthcare reform will increase labor value now, people feel very strange, "why are you still up, the doctor has been very expensive", because this is forgotten in 30 years labor prices, the distortion of the current medical price, and let everyone see it inside a problem. Today everyone again more and more high to the requirement of medical treatment, but no one was willing to according to the requirement of medical level is associated with economic price. Have been behind the modern treatment method, the greater the medical cost, but higher cost we can't bear. Contradiction in here right now, cause health reform difficult.
North green quote: health care over the years, what is your feeling?
Tian Wei: health reform is to reform the price system. But the problem is, if you drop the price, people can accept. Can medical high cost, labor cost is not up, the hospital was losing money. Health care really need to hit a fundamental, to have a real change.
Nonprofit hospital, actually can balance a budget price, labor cost should be how many money, how much medical cost of goods, obey the rules of the market, but it requires the hospital shall not profit, nonprofit is not equal to the doctor would not eat. Hospital is public, but is a professional medical personnel, they also want to eat their career. Under the normal price system, doctor-patient contradiction is sure to have great significance to improve.
Tian Wei in 1983, graduated from Beijing medical college of clinical medicine (Beijing university), in 1994 the Japanese national medical doctor's degree of the university. In 1995, vice President of the Beijing jishuitan hospital; In Beijing jishuitan hospital create spine surgery in 1997. As innovation practitioners of spine surgery in China, the first new concept from Japan back to the modern spine surgery. Since 2003, Beijing jishuitan hospital dean. Is an expert in the state council special allowance. |
