Medical reform should finally use any modes!

Medical reform, should finally use any modes!
The medical reform scheme will be issued soon. Two months ago, Premier Wen Jiabao holds the standing meeting of the State Council, review and pass two files of relevant medical reforms in principle. The meeting points out, advance five reforms, aim at implementing the public service properties of the health care industry, regard basic health care system as the public products to provide for the whole people, make great efforts to realize everybody enjoys the basic health care service.I think, can be " implementing the public service properties of the health care industry " now Reach common understanding, end in the past " road " in respect , " mode " Dispute.During these years, the expert of immortal from various places has torn the throat in the free discussion of the medical reform, there emerged a some " European modes " of relative superiority to must strive , " U.S.A.'s mode " ,Though really there is a great deal of different notably, it is adhering to " public service properties of health care industry " Question at,have fundamental difference. By the look of supply of general medical care, like higher education basic overall arrangement, Europe takes public hospital, public university as the core, it is basically free to serve, does not ever have commercial properties; U.S.A. takes private hospital, private university as the core, but the overwhelming majority in these private hospitals, private universities, though remedy some service costs in order to charge, are also all " non-commercial " Properties.
Not only America and Europe, the hygiene industry in whole world is all with " non-commercial " The mode taken as the leading factor, in addition there are no other modes.
What is " The non-commercial organization " ? World Bank East Asia and private economic chief expert, Zhang ChunLin of development department, of Pacific Ocean area have provided very distinct imitating the picture: From the economics meaning, it is a kind of " organization that can't distribute any net profit to its people of control, so-called controlling people can be member, administrative staff, director or truster of this organization " . This is an essential feature that differentiates profit-generating enterprise of non-commercial organization, known as not " distributing restraining " either . Do not " distribute restraining " Do not mean the non-commercial organization " The owner " ,Mean any individual and organization invests in the non-commercial organization, on donating once.
Zhang ChunLin points out, proceeds from standard property right theory, the non-commercial organization should be different to run, or inefficient at least. Because the investors of the non-commercial organization are unable to become the persons who asks for surplus of its income and assets, have not pursued the impulse of the profit. As regards administration structure, there is a board of directors in though non-commercial organization, but the board of directors usually has a self- fixed characteristic that melts, allow the board of directors to appoint the next term of directors. In addition, because of those without all of non-commercial organization, will not be similar to the thing that company's stock is purchased etc., its board of directors and manager's floor will never face purchasing and combining the threat of the market - -But even so, the non-commercial organization is still developing vigorously. Investigate, in U.S.A., the non-profit-making hospital compares with profit-generating hospital according to the authority, in serving efficiency, service quality, there is no obvious difference.
In the medical reform is disputed, the lofty tone maintains that " adheres to the market-based direction " Economic for scholar,property right just for theory expert, there are getting more accidental on this. According to the intersection of property right and theory, found non-commercial organization, this kind equate " meat bun fight the dog " with Investment behavior,at all it is unreasonable happen; This kind of those without all, so excited as the profit and pressure of market, and the organization which the insider that totally needn't be responsible for investor controlled, mechanism its, than most backward the intersection of state-owned enterprise and backwardness yet, at all is unreasonable to survive.
Several years ago, our country drafted" non-governmental education promoted the law ", while asserting the non-commercial properties of non-governmental educational institution, the loudly loud throat of industry and some experts and scholars, requiring speaking plausibly and volubly that must be written in the law " Investors can make the rational repayment " Words, that is, start from this kind " whether allow, make money, who can make the investment " Idea.
According to the things different to exist of logic of the theory, but exist in reality in a large amount. The markets of the medical treatment and education are so broad, we can say everybody is the consumer, but on various billboards of rich and powerful people of the whole world, can hardly see one run the school, open the boss that the hospital builds up a family fortune. The rich run the hospital after getting rich, have not got rich by running the hospital.
Moreover, if really look like some economists to describe, the medical care of U.S.A. is " marketization " Of mode, we but unable to explain with general the intersection of market and law why diagnose the illness most your in U.S.A.. The statistics show, in 2005, the expenditure of British government accounted for 87.1% of the total expenditure of the hygiene, U.S.A. was 45.1%; The hygiene expenditure of British government accounted for 16.2% of total expenditure of government that year, U.S.A. was 21.8%. That is to say, the U.S. government is on condition that push over half of the expenditure of the medical fee to individual and its employer enterprise, the financial burden is still far much heavier than the British government. " it is expensive to see the doctor " in this Excessively expensive manifestation. Supplying the end, there is sufficient market competition; In the intersection of demand and end, than at public expense to choose for consumer of main fact rational certainly for consumer of main fact. But the actual result is to see the doctor expensively, and more and more expensive, this is spoken obstructedly. Likewise, although Britain's mode takes governmental investment as the core, has not also restrained the folk capital from entering the medical industry. If really what some experts of ours played up exists seriously in Britain " It is difficult to see the doctor " Phenomenon, according to general the intersection of market and theory, have demand have, supply right away, " see the doctor difficult " The phenomenon should disappear naturally. This is said too obstructedly. Since it is obstructed to say, don't stubbornly stick to old ways in the face of changed circumstances again.
Theory that, but can't be identical and realistic that the logic of putting down those is as sharp as cutting edge. In fact, we can also see whether a medical organization has commercial inclination, with public private to must concern. A lot of public hospitals have strong commercial impulse, make " great prescription " by every possible means , make the unnecessary inspection for patients, that is that shows the example. On the other hand, the society like long age hospital of Taiwan generally acknowledges it is sheerly the private hospital of charitable properties, it is open to come to the continent, limited by current management system, thinking of must be commercial at all, can only press " The profit-generating hospital " Come to register, very fantastic too.
Now, define " public service properties of health care industry " ,I thought it natural that should do, first, the government should treat to the common, private non-profit-making medical organization equally without discrimination. An ultimate property right belongs to the private non-profit-making medical organization of the society, belong to the ultimate property right " The whole people " Medical organizations public,have basic difference. So, the government should be duty-free and duty-free together to them, even should replenish and replenish together. Open the gate wide to welcome to put to the private capital into the non-profit-making medical organization, the more, the better; Second, supervise to all common, private non-profit-making medical organizations strictly. During the public hospital reform, should inhibit, correct it commercially and excitedly completely. Learn to know the new supervision means, prevent the investors of the private non-profit-making medical organization or control people, consume these two kinds of most common ways with the great amount of salary or post, obtain economy to reciprocate in a disguised form; Third, under the situation of health care resources overall in short at present, establish profit-generating medical organization to the social capital, also encourage through the industrial policy. However, those totally confuse the reform to general enterprises on the hospital to advocate, what shareholding system transformation, annex and recombinate, wait a moment in management buy out, every dozen " The property right " The ideas, all save completely.
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