The debt of public hospitals in China exceeds 200 billion

Source: Daily Economic News December 28, 2015: the hospital with overcrowded patients is in high debt? According to reports, when the Standing Committee of the National People's Congress recently reviewed the report of the State Council on the progress of deepening the reform of the medical and health system, Gao Guangsheng, a representative of the National People's Congress, revealed that by the end of 2014, the long-term liabilities of 8677 government run public hospitals totaled 233.3 billion yuan The news make complaints about the entire pharmaceutical circle, and the medical representative, Tucao, said, "in recent years, the difficulty of seeing a doctor is not eased, and the profits of pharmaceutical companies have been compressed It has raised public hospitals' debt platform I am really drunk." The reporter also noted that this is the first time that the financial situation of all public hospitals in the country has appeared in the media According to statistics, the number of beds in public hospitals accounts for 87.8% of the total number of beds in national medical and health institutions, and the number of people admitted to hospitals accounts for more than 60% of the total number of beds in China It can be said that public hospitals are the "main force" of China's medical system, and the problem of "difficult to see a doctor, expensive to see a doctor" is mainly concentrated in public hospitals But the more public hospitals with concentrated medical resources, the higher the probability of debt Gao Guangsheng said that of the total liabilities of 233.3 billion yuan of 8677 public hospitals in China, 52% were hospitals above prefecture level, 9% were district level hospitals and 39% were county-level hospitals Who is Gao Guangsheng? Is what he said authoritative? According to Baidu, Gao Guangsheng is the director of geriatric department of the fourth hospital in Harbin, Heilongjiang Province, and has worked in the medical field for more than 30 years As a representative of the National People's Congress, in recent years, he has put forward some suggestions, including the establishment of a medical insurance system, care for rural doctors, etc., and also has unique views on vocational education, inheritance law, etc According to reports, Gao did not mention the source of the data According to this analysis, the above-mentioned statement about "the total liabilities of public hospitals is 233.3 billion yuan" lacks certain authority However, several medical professionals interviewed by the reporter said, "there should be no water in this data." Shi lichen, the director of medical consultation in Dingchen, Beijing, said, "with the advancement of medical reform, the drug markup has been gradually cancelled, and the interest chain of medical support with drugs has been cut off However, the medical service reform that should have been the main income part of the hospital has not been fully launched, and the probability of high debt of public hospitals has also been increased accordingly." In addition, in some places, the limitation of total payment for medical insurance has also contributed to the high debt of public hospitals "At the beginning of the year, the total amount of medical insurance payment was defined for each hospital, but this amount is likely to deviate from the actual situation The hospital prescribes medicine to patients, but there is no supplement from the medical insurance, thus forming a debt." He said For a long time, selling medicine to make money has become the main income generating mode of almost all hospitals in the country The reporter learned that the compensation of public hospitals in China mainly comes from three channels: service charge, drug mark up and government subsidy The low medical service charge in China is a public secret for a long time Most of the outpatient fees of professors or chief doctors in the top three hospitals are less than 10 yuan / person time At the same time, the insufficient financial investment also makes the "gate" of the profit-making mode of selling drugs As a result, a chain of interest has been formed between medical staff and pharmaceutical companies Some drugs in mainland public hospitals are several times more expensive than those in Hong Kong In May this year, the general office of the State Council issued the guiding opinions on the pilot comprehensive reform of urban public hospitals (hereinafter referred to as the opinions), comprehensively denied the drug markup, implemented the policy of "zero margin", and completely blocked the way to make money by selling drugs It is worth noting that the implementation of zero drug difference rate in public hospitals also puts forward higher requirements for local financial subsidies "If the local financial strength is not enough, there will be problems in hospital operation and it will be more difficult for pharmaceutical enterprises to collect money." Bian Chenguang, an industry veteran, said According to data from tonghuashun, the total receivables of 19 A-share pharmaceutical commercial companies in the first half of 2015 was 72.35 billion yuan, with an average of 3.8 billion yuan for each listed company According to the opinions, by 2017, the pilot of comprehensive reform of urban public hospitals will be fully launched, and the burden of medical expenses for the masses will be significantly reduced Obviously, this process, in addition to the implementation of zero drug margin, also needs to go hand in hand with reforms such as the price of medical services, in order to avoid the debt expansion of public hospitals.