We must face up to the distortion of the medical system

GlaxoSmithKline's bribery scandal is just the tip of the iceberg The widespread corruption in the domestic pharmaceutical industry is well known The profit-seeking mechanism of "medicine complements medicine" in hospital has formed a complete grey interest chain with pharmaceutical production enterprises and circulation enterprises In 2009, China launched a new round of medical and health system reform, which is to cut off this interest chain The basic level (township hospitals and communities) broke through the old system of medical support by drugs, which led to the comprehensive reform of financial compensation, personnel, distribution system, medical purchase and distribution system of the basic level medical institutions, and started the substantial reform of reconstruction of the basic level medical and pharmaceutical health system which embodies the public welfare and benefits the people But in the past few years, the reform is only at the grass-roots level, and the grass-roots level accounts for less than 20% of the total medical expenses It is far from being able to leverage the long-term hard medical interest chain On the contrary, the rapidly increasing medical insurance and government investment add fuel to this interest chain With the basic medical insurance covering nearly 1.3 billion urban and rural residents, the coverage rate is more than 95%; the government's investment in medical and health is rising rapidly From 2007 to 2012, the average annual growth rate of government's investment in health is 30%, which is the fastest growing period in history, and the medical cake is growing larger and larger From the data point of view, in 2008, the total cost of national health was 1.2 trillion yuan, the cost of hospital drugs was about 350 billion yuan, in 2012, the total cost of health was 2.9 trillion yuan, and the cost of hospital drugs was more than 900 billion yuan Since the new medical reform, the income of pharmaceutical manufacturing industry and circulation industry has grown rapidly, the profit of enterprises has grown rapidly, and they have fully enjoyed the dividend of the reform However, the common people enjoy limited medical reform dividends, excessive medical treatment and drug use are serious, the cost of drugs and consumables is falsely high, and the government expenditure has increased, but the burden of patients has not been reduced, which makes the common people feel little about the achievements of medical and health reform GlaxoSmithKline's bribery scandal has opened the head of the grey interest chain of medicine The corruption of medicine has consumed the credibility of the government, eroded the doctors, hindered the healthy and orderly development of the medicine industry, greatly damaged the health of patients, led to frequent malignant events of Doctor-patient Conflict, which has reached the point of common indignation The government must be determined to face up to the problem of distorting the medical system Just as the military was forbidden to run enterprises in those days, the mechanism of supplementing medical treatment with drugs was abolished with the spirit of a man of valor The hospital, some doctors and the links of drug production and circulation were cut off to form a solid gray interest chain, so that the hospital and doctors could return to their duty of saving the dead and helping the wounded, and the drug could return to the function of treating the sick Recently, the author just came back from Sanming City, Fujian Province Sanming is similar to other regions in the country The government has been absent for a long time, forming a revenue generating mechanism for public hospitals, and the phenomena of "medical supplement with drugs", kickbacks, large prescriptions and large examinations are common With the rapid increase of insurance coverage and reimbursement rate in recent years, medical expenses have risen sharply, and medical insurance is difficult to maintain At the beginning of this year, the overall reform of all public hospitals in 12 counties under the jurisdiction of Sanming City was carried out The government assumed the responsibility of running public hospitals Through the comprehensive reform in financing, service, supervision, talent and medicine, the mechanism of supplementing medicine with medicine was abolished vigorously and the grey interest chain of medicine was cut off The annual salary system is implemented for the president and doctors, and the zero difference rate is implemented for all drugs The income of drugs is separated from the income function of hospitals and doctors, so as to effectively reduce the false high price of drugs, and truly leave the dividend of reform to patients and doctors The reform method of Sanming public hospital is highly operational and can be popularized In a word, the government should speed up the reform of public hospitals, abolish the income generating mechanism of "medicine for medical treatment", and turn public hospitals into real public hospitals At the same time, anti-corruption and anti-commercial bribery in the field of drug purchase and sale are regarded as important means to promote medical reform and respond to the strong appeal of the people.