All over the public hospital reform compensation drugs added gap time to be determined

2nd, the State Council executive meeting on the adoption of the "Public hospital reform pilot Guidance", the request for the masses to provide safe, effective, convenient and inexpensive medical and health services.　　Since the enactment of the new health reform program last April, after 10 months of brewing, the "road map" of public hospital reform has finally been officially displayed in front of the people. What is the impact of public hospital reform on patients? What obstacles need to be overcome in the process of reform? ...... 　　　With a question mark, this reporter interviewed Shanghai, Shandong, Guangdong, Sichuan, Tianjin and other health departments and hospital officials, listen to their voices. To alleviate the masses "difficult to see a doctor," "The Doctor Expensive" "before the reform of the investigation, we found that the allocation of health resources is not scientific, is the masses ' doctor difficult ' direct inducement. In 2005, Weifang had 1.76 beds per capita and only 2.96 health technicians, and the masses were in a passive ' doctor ' situation. Weifang City Health Bureau director Huang said. At the same time, the big hospital facing the fierce competition, has on the project, the equipment, expands the scale, causes the limited quality health resources most flows to the city.　　The situation that the grass-roots health resources are small, the quality is low, the function is weak, the quality resources are scarce is not only not improved, but more serious. Huang Analysis, the people "to see a doctor expensive", it originates from the hospital operating mechanism unreasonable. The long-term vacancy of government compensation makes the public hospital too dependent on its own income, and the trend of profit is serious.　　　The mechanism of "taking physic medicine" exists, which causes medical behavior to be distorted, open generously, use expensive medicine, inspect and so on. Guangzhou VIII People's hospital president Xiaoping said, "on the reform of public hospitals guidance," the introduction of the gradual elimination of drug addition, change to medicine to foster medical situation, is the general trend. Intuitively, of course, it is good for patients. Because according to the current drug addition rate of 15%, cut off this piece, drug prices can be cheaper 15%.　　And from the practical experience, medical services and other costs in the patient's medical burden accounted for a small proportion, and the proportion of drug costs, such as hepatitis and many other chronic diseases, the diagnosis will not need any medical services, but need long-term medication. "Reforming the compensation mechanism and phasing out the drug-adding policy is a boon to patients," he said.　　"Fudan University affiliated Zhongshan Hospital party committee deputy secretary Shenhui said. "As the dean of the public hospital, I am very confident in the guidance that it has shown the way forward for public hospitals."　　　　"De Tao, director of the first maternal and infant health Care hospital in Shanghai. How the compensation mechanism is in place "however, if the compensation mechanism is not in place, it will be possible to directly affect the enthusiasm of the medical staff." Shenhui admits, the drug adds up to the hospital total income half of the year. Canceling the bonus means there will be a big gap in the hospital.　　This gap who to fill, how to fill, will have a direct impact on the hospital operation, medical staff stability. "Now have not seen the details, if the compensation mechanism is not reasonable design, staff income reduction, the workload unchanged, whether there will be ' pot ' phenomenon?"　　Shenhui said without misgiving. De Tao showed the same concern that the publicThe pilot hospital reform has only published the "road map", but there is no "timetable".　　According to the "opinion", the compensation mechanism is the first "cut" and then "mention", drugs added into the "cut" off, service charges and government compensation in the end how to repair, we all have no bottom. In this respect, De Tao suggested that if the government did not have the funds to compensate, it could support the policy. Public hospitals have high quality medical resources and can use these resources to carry out special medical care.　　Hospitals use these funds to make up for the funding gap that is needed to operate, and to increase the income of doctors. Xiaoping said that the most fundamental thing is to increase public investment in government, because how to achieve the balance of interests between patients and hospitals, is the most difficult and the core of the reform, the problem is not resolved, reform can not be promoted.　　Of course, this form can be diversified, not necessarily financial direct subsidy, but also through the improvement of urban health insurance, rural new farming and other social security system to solve, expand the coverage of protection, improve the level of protection, both to reduce the burden of patients, but also to maintain the normal operation of the hospital.　　At the same time, Xiaoping also said that the pace of reform should be controlled, the pace can not be too fast, 15% of the drug addition needs to be phased out, in the process, gradually improve the government's health investment, and gradually improve our health care system.　　Public hospital reform not only has to be "compensated", but also to overcome many other obstacles. The problem with public hospitals now is that the effectiveness of medical resources, because there is no assessment, is often not very much the concern of the Deans.　　"Chengdu Huaxi Hospital in Sichuan Province, said the responsible person. "It is important to innovate the human resources management system," the official suggested. In the aspect of safeguard mechanism, we should reduce the risk of medical personnel and eliminate their worries. The internal distribution system of public hospitals should take the quantity, quality and effect of the labor provided by the medical staff as the main basis of the performance appraisal, and combine the scientific research teaching and the risk position to determine the distribution standard to achieve the incentive function. "Specific programs are being studied in Sichuan Province, the Department of Health is studying the implementation of the pilot reform of public hospitals.　　Sichuan Province will Nanchong as a pilot area for public hospital reform, according to the head of the Sichuan Medical and health system. Sichuan Province Health Department director Shen Yu said: "In provinces such as Sichuan, the public hospital reform pilot can not choose all areas of better conditions, but should choose the development of health services relatively lagging areas." Only in this way can we truly explore the mode of reform and development of public hospitals suitable for western underdeveloped areas.　　"At present, Shandong identified in Weifang, Dongying public hospital reform comprehensive pilot." Baowenhui, director of Shandong Provincial health Department, believes that the most difficult part of public hospital reform lies in the change of hospital compensation mechanism.　　At present, the proportion of government subsidy in the income of each hospital is very small, the reform of public hospital should embody its commonweal and innovate the system mechanism. "Health reform must control drug prices, carry out centralized procurement on a provincial basis, and in 60% governmentThe basic drug system was implemented in the primary medical and health institutions, and all the essential drugs were included in the new rural insurance reimbursement, the proportion of reimbursement was higher than that of the non essential drugs.　　"Baowenhui said.　　Tianjin Health Bureau director Chengzin told reporters, Tianjin City v Center Hospital was identified as a public hospital reform pilot. He said that in the promotion of public hospital reform, Tianjin will increase government input to implement the performance pay system. First of all, we must do well the adjustment of health resources and increase the investment in public hospital construction.　　Second, to further improve the public hospital compensation policy, to undertake public health tasks of the hospital (mental, infectious, occupational disease, tuberculosis, burns), by the Government to increase the level of wage subsidy for in-service workers, the establishment of the basic wages of employees to give 50% of the fixed subsidy. Shanghai Health Bureau Director Jianguang said, the next step, Shanghai will be based on reality, focusing on the suburbs of the three-level hospital construction, medical resources vertical integration and so on. Strengthen the training of personnel, speed up the improvement of medical standards, so that more people to see a doctor "look satisfied, look at ease." (Reporter Horse Feng He Limping Wang has Jia Wei He Juhong)