I do not know when, to the market has become a panacea, as if something to the market can be solved, medical market is not a new word, medical has long been to the market, the early reform and opening up, the health care system reform will be put forward to the market hospitals, the government "weaning" to find their own way out of the restructuring of public hospitals were privately acquired, and then the hospitals began to implement departmental independent accounting, doctors' income is linked to the hospital's efficiency, hospital leaders to assess the performance of the hospital's annual income. Then it, the hospital began to implement independent accounting departments, doctors income and hospital efficiency linked to the performance of hospital leaders to the hospital to assess how much annual income, Putian Department quickly rose from the public hospitals and even military hospitals contracted departments. In the end, didn't they admit that the health care reform had failed?

The United States is still a capitalist country, and by definition he is the one with the most active market economy, but all the doctors in his public hospitals are civil servants, their salaries are paid by the Government, and they only see patients!

In fact, the improvement of the doctor-patient relationship is very simple, so that doctors return to his own duties, doctors only see patients, do not have to think about this month's economic indicators to the department, how to recover the arrears of fees, drug ratio exceeds the limit, hospitalization limit exceeds the limit, and so on the economic problems.

That really is the liberation of productive forces, doctors will actively see patients to make money, income doubled several times or even dozens of doubled, medical care to become the elite preferred profession, the pressure of competition for doctors will be changed from scientific research / subject / SCI to medical technology / quality of service / health care management, real competition for the job, poor clinical ability to do scientific research or be eliminated, to be a doctor than the current requirements of a higher degree of medical care for the general public who can afford to see the disease will feel that health care services The people who can afford to see a doctor will feel that the medical service has been significantly improved.

Doctors will be selective in seeing patients, turning away the seriously ill/complex patients/those who can't afford it;

Medical charges must be increasing logarithmically, especially for high-end specialty teams and emergency care, booking a sky-high price just for the rich;

Emergency/Pediatrics and other public institutions shrink further or even close, you really have to have a relationship to see a doctor, and you really do get deaths from untreated emergencies on your days off;

When there is an epidemic, national control is reduced and no one wants to go to the front line if they are paid less money, and in turn, the infection/respiratory/critical care and other related disciplines go into reverse;

The quality of health care services will be significantly improved, but the price of health care will be on par with the price of veterinary care, and health insurance and commercial insurance will play word games with patients every day, that is, all sorts of excuses for not reimbursing them;

Lifespan per capita will change in an hourglass fashion; those who want to live longer and work hard for their money, the elderly poor may have a more miserable life.

[flash of light] medical care has special properties, and ordinary business is not the same, can not be completely through the market regulation, to see the doctor to cure how to surgery / medication and examination, the right to choose is not in the hands of the patient, in the hands of the main body of medical care, if the medical body is the essence of profit-seeking, then [tears run] [tears run] [tears run] [tears run] [tears run]

In fact, we are here in the war of words does not make sense at all, many times we think we are smarter than others, in fact, the country has long been in the field of implementation of small-scale experiments, most of our country's elite into the system of politics, so smart a group of people, want to do more than we are far away, health care is complex, health care reform is a world problem, in general our country's health care services for the population of 1.4 billion people, can be a smooth landing It is not easy.

As early as 2006 on the health care reform market and administrative words on the heated discussion, Qiu and the Suqian model ultimately declared a failure, the best of themselves due to economic problems in jail, the U.S. market-oriented private hospitals as the main body of the health care skyrocketed prices and health care administrative control weaknesses in the epidemic during the epidemic was also exposed, while the administrative Sanming model instead of short-term to see a lot of advantages, the overall I'm not too optimistic about it, because of the lack of incentives to the new technologies I am also not very optimistic about the administrative Sanming model in general, because of the lack of incentives for new technologies/medical care.

Peking University Li Ling group has done a lot of research on health care reform, but from the industry people, they still don't know much about the medical industry, but instead of Sanming health care reform leader Zhan Jifu understand a little bit more, but still not deep enough, why the godfather of Huaxi Shi Yingkang will jump out of the building, what is our current mentality of the medical people in the end, I hope that more understanding of the community/county/medical center of the doctor/medical administrator to be able to join the team of healthcare reform.

Media person Chen Xiaorong Dai boss objectively wrote a long article, recorded China's health care reform in the past 15 years endless smoke, deeply touching, we recommend that you read.

China's health care reform stumbles forward, there are some problems that may be unsolvable in the short term, there are some problems that some people do not want to change, there are some problems that those who want to change will not change, and there are also some problems that only change the parts that are favorable to them, which is a little bit deep to say more than that.

Some issues are not suitable to say on the network, because it is easy to be misunderstood, in fact, Chinese medical people are quite difficult, alas. [Tears running]

Personally, it is recommended to promote standardized/specialized training for residents, shorten the undergraduate medical school system to four years, abolish the specialist assistant physician, abolish the existing title review system, weaken the siphoning effect of large hospitals on talent, and leave the rest alone, right? [I want to be quiet] [I want to be quiet]

Most people in China do not have a high income, you call the low insurance into the public hospital to see a doctor, the other into a private hospital to see a doctor, but in the same majority of people have a low income, you call the majority of people, and from then on after getting sick there is a possibility that private hospitals scraped into the bottomless abyss. I think socialist countries should establish a perfect socialist public hospital system, medical staff should be according to the corresponding treatment of civil servants for management and distribution. Can also have auxiliary private hospitals and open private clinics for doctors, so that the idea of medical personnel, have a good idea and go, so that there are a few people or people with money can go to or think of themselves as good hospitals and clinics to see a doctor. But medical personnel two two identities can not be casually confused, in order to prevent messing up the social health care system. Thus, the people can get good medical treatment when they are sick.

Recently, good news came from Beijing that the National Health Commission, in conjunction with the Ministry of Finance and other units, responded to the recommendations of some deputies to the National People's Congress on reforming the current health-care system and progressively realizing free medical care, the basic spirit of which is to give full recognition to the deputies' recommendations, give fuller play to the dominant role and position of the country's public hospitals in the future, and progressively create the conditions for the realization of free medical care for the entire population.

Therefore, the above question raised by you is not only untimely, but also counterproductive. The following is only a brief sub-folding of the causes of the problem of doctor-patient tensions.

The present conflicts between doctors and patients are themselves a result of the marketization of health care, and the relationship between doctors and patients will become even more strained if health care is to be fully marketized.

Why is the doctor-patient relationship getting more and more tense?

First, it is difficult to see a doctor and there is a shortage of quality medical resources. High-quality medical resources such as tertiary hospitals are mainly concentrated in large cities, ordinary people who suffer from major diseases, primary hospitals can not be cured, hoping to be able to go to the big hospitals, but the big hospitals are overcrowded, not only is it difficult to hospitalization, hanging a well-known expert number is not easy, often also subject to the bullying of the number of traffickers. It is not easy to find a specialist to see, do not know what kind of disease, do not know whether the cure is good, all kinds of testing fees, travel accommodation menu and other costs have spent half. If they can be cured, the patients and their relatives will still feel at ease, but if they cannot be cured and have to continue to spend money, no matter who will have grievances, and if they meet with the lack of service of the medical staff, it will inevitably give rise to conflicts between doctors and patients.

Secondly, it is expensive to see a doctor. Nowadays, not only do private hospitals aim at making profits, public hospitals also have to rely on the market to generate income in order to survive and develop. Under the orientation of profits and the market, large prescriptions and sky-high test fees are bound to happen. To see a cold, one has to spend a few hundred dollars for a small amount, or a few thousand dollars for a large amount. In the event of a serious illness and hospitalization, the family's savings will be exhausted, and poverty due to illness and return to poverty due to illness abound. In this context, the doctor-patient relationship can not be tense?

Thirdly, Chinese medicine has lost its edge. Most of the grass-roots Chinese medicine hospitals established after the founding of the People's Republic of China have been withdrawn or merged, and the existing Chinese medicine hospitals above the county level, although they are labeled as Chinese medicine hospitals, are in fact managing hospitals and treating patients according to the Western medical practice and model, and do not give full play to the characteristics of traditional Chinese medicine, and the advantages of Chinese medicine, which are inexpensive and good value for money, have gradually disappeared. The same disease, looking for Chinese medicine, may tens of hundreds of dollars can be resolved, looking for Western medicine does not spend thousands of tens of thousands of fundamental problems. Under such a medical system, how can it not cause tension between doctors and patients?

Therefore, as long as the competent national authorities recognize the reality of the current medical field, change their way of thinking, and adjust and reform the institutional mechanism, with our existing national strength and conditions, it will be entirely feasible and achievable to improve the doctor-patient relationship, solve the problem of difficult and expensive access to medical care, and ultimately realize free medical care for all.

Thanks for the invitation Wukong, it's an interesting topic; personal opinion: unfortunately, I personally feel that the conflict between doctors and patients, can be alleviated partially, but not effectively.

Consequences of marketization of health care?

At present, after the state opened up the doctor's multi-practice, Dr. Tian Tian has many friends around him, started multi-practice or directly resigned to go to the private hospital. The feedback given is: the income breakdown is elevated, the registration fee is 20 dollars in public hospitals, and at least 300 in private hospitals; public hospitals see 50+ outpatient clinics in the morning, and private hospitals see 10-15 outpatient clinics, and there is plenty of time to communicate with patients about their conditions, and to explain their problems. Therefore, the doctor-patient conflict has indeed been effectively alleviated in the high-end medical resources section. But comparatively speaking, with the increase in the flow of doctors in public hospitals, the increase in the number of patients faced by each doctor, and the decrease in the time allocated to each patient, the doctor-patient conflict may further increase.

Can public hospitals be marketized?

Of course you can not, because at present China has no private insurance mechanism, of course, from the national insurance level, has guaranteed the vast majority of people's basic quality of health care, there is no doubt about this, China's basic health care situation, I think than the vast majority of the countries in the world, don't feel as if the United States looks like a universal health care coverage, but there is no sense, a while ago a friend went to the U.S., a gastroenteritis, the treatment of 1 week. No good, spent tens of thousands of dollars, you reimburse 90%, the remaining 10% is enough for you to suffer. Moreover, in the U.S., an appointment for a checkup is almost always calculated by month; in China, it's basically calculated by day.

Therefore, I think that at present in our country, we don't need to marketize all health care; the state guarantees the basic level of health care for the whole population and improves the coverage; the private sector, in market talk, guarantees high-end health care.

Personal opinion, for reference only.

You are welcome to follow my headline for more and more specialized medical science.

It cannot. Instead of easing the doctor-patient conflict, it will exacerbate it.

All things are divided into two, and so is the market, which also has its pros and cons; some things can be marketized while others cannot. This has been proven time and again by the repeated failures of the health care reform.

Personal opinion: such as medical and health care and other public welfare undertakings, not only should not be completely to the market, but should be considered to make it out of the market, at least from the main body to withdraw from the market, including the production and circulation of drugs, medical equipment.

I'm sorry to tell you that it won't, rather it will intensify!

There has been a major trend to push the healthcare market into the market, with the de-staffing of hospitals, and a large number of public hospitals across the country being acquired by the private sector each year, or merged and acquired. At the same time, with the relaxation of policies, a large amount of social capital to the medical industry.

A large number of private hospitals have sprung up, which has indeed alleviated some of the tension of seeing a doctor, but we have all found that there are several aspects of private hospitals that are very serious: 1, the quality of medical care is not guaranteed. 2, the high cost of medical care. There are a lot of medical accidents, many doctors are not technically mature. 2, the high cost of medical care, although the attitude of private hospitals is very good, but the cost is also high, many people can hardly afford. 3, is not perfect talent echelon, in general, private hospitals are very attracted to the talent, a lot of doctors do not match the technology and title, but also difficult to leave the talent, after all, the development of the immaturity.

If public hospitals remove their public welfare attributes, then the income of medical staff will be more reasonable, and those who have the ability will naturally earn a good income, while those who do not have the ability will be eliminated. But the charges are also rising, there is no constraints, only the market medical environment will eventually lead to more serious doctor-patient conflicts, on the one hand, many patients do not get good medical treatment, on the other hand, more medical errors, doctor-patient relationship how can not deteriorate, the contradiction does not aggravate it? By then also line will not only be hospital conflicts so simple.

I'm Qingbao Buyei, follow me to learn about rehabilitation and health care and enjoy a healthy life.

By marketizing the health care system, the conflicts between doctors and patients will become even more serious. Health care is a special business, human life can not be bought with money. For diseases, he is the common enemy of doctors and patients. Doctors are commanders, patients are combatants. Only through good cooperation and collaboration can we overcome the disease. This was the case in the past and should be the case in the future. If we kick towards marketization, we are treating patients as commodities, and the relationship between doctors and patients is one of buying and selling. It must be centered on money, and there can be no public good. The hospital becomes a business. The solution to the conflict between doctors and patients is to bring all hospital revenues into the government coffers, with the salaries of medical staff and all hospital expenditures paid for by the government coffers, and the equipment and construction of hospitals paid for by the government. The government will be responsible for whether the income and expenditure is a loss or a profit, and the hospital leaders and doctors will only be responsible for medical business and curing patients. Then the doctor-patient relationship will certainly be good.

This issue must be a very controversial one! As a urologist and one who has come out of the system, I am particularly concerned about and expect to do something for the improvement of the doctor-patient relationship, so I am particularly touched by it! In my opinion, this question is actually two questions, and its most central question is, how can doctor-patient conflicts be alleviated?

In fact, doctors and patients face the disease together, whether doctors or patients, all hope to overcome the disease, was a front, a trench comrades in arms, but how in China there will be such a big contradiction? The key lies in the level of trust, that is, mutual distrust! And the root cause of this distrust is still from the economy, that is, in China, despite the country in vigorously promote, but the ability to pay for health insurance is still limited.

From the patient's point of view, a large number of rural residents with a heavy family economic burden, basically no economic budget in the treatment of disease, that is, there is no money left over, once the disease requires hospitalization, for them, it is a considerable expenditure, may need a few years of income to pay for the existing health insurance policy, the reimbursement of rural residents and lower than the proportion of urban residents, especially in the provincial hospitals, reimbursement ratio is even lower, and the existing health insurance policy, the reimbursement ratio is lower than the urban residents, especially in the provincial hospitals, reimbursement ratio is even lower. In this way, by the economic burden will lead to patients and their families think a lot, because they can not afford to lose, spent a lifetime of savings, and even borrowed money from all over the world to treat the disease, if the treatment effect is not good, in the psychological sense of a huge gap will occur, unacceptable, especially in the case of a large family, and at the same time, the economy are not generous, it is more likely to occur, and this psychological gap, and ultimately be implemented by the object is to participate in the This psychological gap is ultimately realized by the doctors and nurses involved in the treatment! We have encountered a lot of medical disputes, the patient's family members came to the hospital and said straight away that they actually did not feel that the doctors and hospitals had not tried their best, but the family's financial situation was too poor, so they just wanted to come and ask for money, a situation that I believe doctors often come across!

From the doctor's point of view, every doctor wants to treat his patient's condition well and discharge him smoothly, who would like to see the patient's condition deteriorate and progress! But the effect of medical treatment is uncertain, and even has a great deal of unpredictability, the more unpredictable, the higher the risk of medical disputes, and some bad media and some irresponsible propaganda, which will also lead to the doctor had to protect themselves, but in this way, everything is handled in accordance with the safest method, do not dare to take risks to go to the Bo, that the patient, especially the possibility of critical patients saved Reduced, but if you take the risk to do, once failed, may be the patient's family will have to make a dispute, do not do, it is fine, in this way, medical care has lost its original purpose and meaning.

So the occurrence of doctor-patient conflicts, more because of the trust problem, I personally feel more and economic related, if all medical care can be solved by health insurance, patients do not have such a big financial burden, may be doctor-patient conflicts will be alleviated a little, on the other hand, if the patient and his family members can trust the doctor to understand and accept that the medical behavior has a risk, then the doctor will do their best to save the patient, otherwise, the The escalation of the conflict between doctors and patients will only make the patients suffer more harm, because there is a saying, do not do not make a mistake, if you do not trust the doctor, there is no reason to ask the doctor ah!

That is why I think that the easing of conflicts between doctors and patients actually has nothing to do with pushing health care to the market! In developed countries in Europe and the United States, medical and health care is supposed to be marketized, and their doctor-patient relationship is not like that in our country. On the contrary, doctors have an extremely high status and high income, and they are respected by both patients and the people! But it is not because it is marketized that it has achieved such an effect. In fact, whether it is marketized or not, as long as a few key issues are properly addressed, doctor-patient conflicts can be alleviated! I think the main points are as follows:

1. To do a good job of monitoring and publicizing public opinion, so that society as a whole recognizes the importance of respecting doctors and health care;

2. Do a good job of the top-level design of the health insurance system, the national health insurance should be biased in favor of protecting the real low-income people, use the limited funds for the poor people's medical insurance, promote the economic strength of the people to buy health commercial insurance, reduce the burden of the national health insurance;

3. Strict legislation and no leniency towards illegal medical malpractice;

4. Strengthen the quality training of medical and nursing personnel, and incorporate the assessment of medical ethics into the title assessment system;

5, vigorously publicize the doctor and patient concentric victory over the disease, vigorously expose unethical doctors and patients and their families, so that unethical doctors can not practice medicine, so that unreasonable patients and their families on the blacklist, in the whole society to form an effective supervision;

6. Improve the appraisal system of medical and nursing care, and high remuneration should be given to competent and outstanding medical and nursing personnel.

Of course, I still think that the solution to the economic problem is the most crucial issue among all the measures here. If we can really provide a very high reimbursement rate for the people's visits to the doctor, so that the doctors can focus on treating the patients and the patients will not be panicked because of the expenses, then the conflicts between the doctors and the patients will surely be reduced a lot!

If health care is put on the market, will the conflict between doctors and patients be alleviated?

A: It has been proven that pushing healthcare to the market is the root cause of doctor-patient conflicts, why?

1⃣️ my hometown ten years ago in order to financial dumping, the city all of a sudden like the sale of state-owned factories, three text is not worth two text to sell more than a dozen hospitals to the director of a class of people, from the hospital like doing business, focusing on the patient's bag of money, the director of the indoctrination of the doctor, treating the patient like a loved one, charges like an enemy. Patient bag of one hundred dollars, seventy dollars to check, thirty dollars to prescribe drugs.

2⃣️This appears to be which is profitable to prescribe. Do not want to open the knife, open the knife, do not have the ability to open the doctor down from the top, anyway, the hands of not poor. Hospitals after some days there are patients making a fuss, will not stop until compensation.

3 ⃣ ️ in order to expand the business, where there are friends and family to be like a pyramid scheme, the dean has a nephew from the field to come back to do the femoral head replacement surgery, due to the technology is not enough to ask the doctor, the results of anesthesia due to the death of the operating table. This is a big trouble on the nephew's side also do not recognize uncle, wife a few days to bring help people to make a fuss, only agreement to compensate for millions of dollars, because they just took out a loan to buy a hospital, there is no money to pay can only be staged.

4⃣️ Where would the boss not earn backwards? The wool comes out of the sheep, can only pressurize the workers, engage in the accountability system, no matter what the cat, there is income to take the full salary plus bonuses. There are several medical malpractice disputes a year, can only compensate while earning, are not all the majority of patients to bear.

5⃣️ now the hospital and returned to the financial full funding, medical staff do not get paid according to the business income, do more or less does not affect, what they level of surgery, a few years there is no doctor-patient disputes occur.

There is also the spring of the national anti-epidemic, the public health care for all, the doctors are praised by the whole country, and there are no disputes between doctors and patients, and practice has proved that the medical business can not be pushed to the market. There are mainly drug dealers to mess up the medical treatment, now a stent from 10,000 yuan down to 700 yuan, before the drug dealers in the manipulation of the inside, the pitfalls of a large number of patients.

6⃣️ practice has proved that only the public system can eliminate the disputes between doctors and patients, the people enjoy the agricultural insurance, employees enjoy the medical insurance, to find out the reasons why it costs a lot of money to go to the doctor, to eliminate the waste of nearly half of the unnecessary funds, in fact, the reform of the health insurance system is not difficult!

Thanks for reading 🙏!