Abstract: With the rapid development of China's economy and the reform and development of medical system, it is the most prominent problem in current medical and health services that it is difficult and expensive to see a doctor, which has become a hot issue of general concern throughout the country. Difficult and expensive medical treatment is not only a livelihood issue, but also a comprehensive and institutional social issue. This paper focuses on the main contradiction of difficult and expensive medical treatment, analyzes its causes and reveals the countermeasures to solve it.
Keywords: medical system reform; Medical and health care; medical insurance
1 analysis of the causes of the problem of difficult and expensive medical treatment.
With the rapid development of various fields in the country, it is more and more obvious that it is difficult and expensive to see a doctor. This problem can be analyzed from several aspects:
The first is to analyze from the patient's perspective. The vast majority of patients without medical insurance in China are farmers, accounting for about 37%. Because of this, I think they lack laws and regulations on medical insurance and have no correct understanding and foresight on medical insurance. So when they go to the hospital, they always find it difficult and expensive to see a doctor. Those patients were frightened by this fact and had a mental breakdown because of this expensive medical expense. So things like this are still happening.
Secondly, from a national perspective, there are not only policy reasons, but also the reasons why the state and the government are not strict enough in market supervision and lack of financial investment. In terms of policy, there are still many defects in China's medical legislation, such as imperfect legislation and imperfect legal supervision. Therefore, when patients go to the hospital for treatment, they can only feel that the price is high and cannot be guaranteed by law. Moreover, hospitals and some health centers or clinics belong to public institutions and are profitable, so patients are more likely to be deceived. At the same time, the state's supervision of the medical market is not strict, and it has not really been implemented on everyone, so this has greatly opened up the bad situation of difficult and expensive medical treatment. In terms of financial input, in 2007, China's financial input in medical assistance at all levels reached 765.438+0.2 billion yuan, of which the central government subsidized local urban and rural medical assistance funds of 3.34 billion yuan, an increase of 654.38+0.4 billion yuan over 2006, and local financial budgets at all levels arranged urban and rural medical assistance funds of 3.78 billion yuan, an increase of 2.7 billion yuan over 2006. Among them, local governments in Jiangxi, Shanghai, Liaoning, Zhejiang, Jiangsu and other places invested more than 200 million yuan in urban and rural medical assistance, and provincial governments in Jiangxi, Shanghai and Henan invested more than 6,543.8+billion yuan. The financial input of Guangxi, Anhui, Chongqing and other places has more than tripled this year compared with 2006. We can see that this is still not enough. Such a big country has invested so little, which not only makes it difficult for our people to see a doctor, but also can't solve their practical problems. In addition, China's medical and health investment accounts for only 2% of the world's total population, while China's total population accounts for about 22% of the world's total population. Using 2% medical expenses to solve the health problems of 22% population will definitely find it difficult and expensive to see a doctor. According to the data of the statistics department a few years ago, about 49.2% people in China were sick and didn't go to see a doctor. This figure is really surprising. Faced with this pressure, I think the state and the government should attach great importance to it and not let this situation continue to develop.
With regard to medical insurance, the coverage of medical insurance in China is particularly narrow at present. Structurally, the basic medical insurance mainly covers the staff of government agencies and institutions. Farmers, urban informal employees and vulnerable groups (low-income or laid-off workers) are not covered by the insurance system, and the fairness and superiority of the medical insurance system are not fully reflected. In some rural areas, we can obviously see many phenomena of returning to poverty due to illness, and the new rural cooperative medical system has not been fully highlighted, so we can often see from the motorcycle screen that migrant workers have no money to treat diseases because of work-related injuries or accidental injuries, even if they are insured, they are still not enough. The main reasons are as follows: First, the rural cooperative medical insurance is short of funds. With the decline of the collective economic strength of grass-roots communities, raising funds from farmers has become an important source of funds for establishing cooperative medical care. However, the difficulty of investing in farmers depends on their satisfaction with medical care. However, the state has invested little in medical care. Then the rural cooperative medical care policy is unstable. Because most countries adopt a laissez-faire attitude towards medical cooperation. However, for the sake of their own interests, local government administrators greatly reduced their initiative in implementing the policy and failed to promote the implementation of the cooperative medical care policy. In addition, the state has recently implemented some policies to benefit the people and cancelled cooperative medical care projects, which conflicts with the state policy of supporting the development of rural cooperative medical care and increases the difficulty of the development of national medical policy. Then the rural health system is difficult to adapt to farmers' requirements for health care. The level of economic development in China is extremely unbalanced. Due to the sharp differentiation of rural labor force and large-scale non-agricultural and employee-oriented, farmers have different requirements for medical security, which constitutes an obstacle to the establishment of a unified rural medical security system, that is, the subject, direction and management mode of rural security. Finally, the uneven distribution of medical and health resources makes it difficult to maximize benefits. First, the business of health care outlets set up in rural administrative areas is insufficient. In many places, farmers can basically stay at home for minor illnesses, and go directly to county or township hospitals for serious illnesses. Therefore, the county or township medical layout can not adapt to the new situation. Second, overlapping health institutions and overstaffed personnel have caused great waste of health resources. In addition, the distribution of health workers is very uncoordinated. In short, these are the main reasons for the serious shortage of medical insurance coverage. After the shortage, it is natural for patients to see a doctor difficultly and expensively.
The public welfare of public medical institutions is weakened, which brings troubles to patients. First of all, medical institutions do not fully guarantee that everyone can get basic health services and improve people's living standards. Secondly, the county economy is difficult, especially in many counties in the west, so this may lead to public doctors.