This article comes from WeChat public account: Extraordinary Fritters (ID: ffyoutiao) , author: Hu soup

Suqian Medical Reform

When referring to Suqian, Jiangsu, the first impression of Internet people may be Liu Qiangdong ’s hometown; people who are familiar with history may say that this is Xiang Yu ’s hometown; those who love drinking may say that the origin of Yanghe Daqu; Those who are familiar with medical and health undertakings will never forget—Suqian Medical Reform.

Suqian is the youngest prefecture-level city in Jiangsu, with a GDP of 309.9 billion in 2019, which is not bad. However, in 1996, when Suqian built a city on the basis of 4 national poverty-stricken counties, its economic strength ranked first in Jiangsu, and its fiscal revenue ranked first. Civil servants and institutions (Including medical staff and teachers) The issue of wages is a problem. The government cannot afford the burden of the hospital, the health resources are insufficient, and the conditions of the primary medical units are poor and low.

This is the era when the mayor of Suqian, the post-secretary of Suqian City Party Committee, appeared. He initiated the “Suqian Medical Reform” centered on property right reform and market-oriented. From 1999, he carried out property right reform on 135 public hospitals that accounted for 98.8% of the city’s health assets, and introduced social capital into the medical service field. Public hospitals withdrew.

From 2000 to 2005, Suqian ’s medical and health assets increased from 495 million yuan to 1.778 billion yuan; the total number of hospitals increased from 135 to more than 400; the assets of private medical institutions increased from 60 million yuan, accounting for the city ’s medical 1.2% of health assets rose to 1.144 billion yuan, accounting for 64% of the city’s medical and health assets.

However, behind the bright numbers, there are also huge controversies. The medical reform in Suqian was accused of “sold out” medical reform by the outside world, which led to protracted debates between “government leading” and “marketing”.

Let ’s put aside the arguments between the two factions for the time being, let ’s just look at the follow-up development facts of “Suqian Medical Reform”. For a long time, there are many but not strong medical institutions in Suqian. In 2019, the city’s largest private hospital, Suqian People’s Hospital, was ranked among the top three hospitals. As early as 2011, the Suqian government, for some reason, has reopened the construction of the public hospital, Suqian First People’s Hospital, and has been questioned by the outside world as resuming its old path.

Suqian medical reform has certainly reduced the burden of government investment. The introduction of the “social capital” catfish has changed the way hospitals operate, strengthened competition among medical institutions, and increased the enthusiasm of medical staff to a certain extent. But in other cases, private hospitals under market-oriented conditions are for profit-seeking purposes, and are renovated to increase medical expenses, but the lifeblood of total medical expenses is beyond control.

In addition, problems such as disorderly competition between medical institutions, government supervision of private hospitals, and supervision of the drug and medical equipment markets have not been found.

Let the people see and be ill is the ultimate goal of medical and health development. If it is only to reduce the government’s financial burden, it will sell public hospitals and completely “marketize” the medical and health industry. It will not solve the problem, nor will it be truly market-oriented.

With the passing of time, Qiuhe ’s “sell-out” medical reform, and the development model he believes in based on overdrafts of subsequent economic growth drivers, have also fallen into disappointment with him.

Special rules in the field of health care

For ordinary people, seeing a doctor for medical treatment means being ill, going to the hospital, prescribing for a minor illness, performing examinations, surgery, and hospitalization for a major illness. The seemingly simple process hides the special laws of the medical service industry.

During the medical service, the service provider (Doctor) and service requester (Patient) are highly asymmetric In the process of diagnosis and treatment, the doctor not only has the information of the condition, but also decides the choice of diagnosis and treatment methods and medicines, and is responsible for providing the treatment plan; the demanding patient does not have sufficient professional knowledge and information to monitor the doctor’s behavior and conclusions Evaluation, can not judge the quality of technology, can not choose products and services, so patients are usually afraid to violate doctors’ decisions.

Patients themselves know that even if they have some information, they may not be able to make a completely correct understanding. Misjudgment may lead to wrong choices, and the cost of wrong is damage to physical health, or even life. .

Information asymmetry will also cause “supply-induced demand” in the medical service field, that is, the situation where doctors use their information advantages to influence the needs of patients for personal gain. Supply-induced demand embodies a major theory in health economics, and its origins can be traced back to Romer’s Law, which predicts that “as long as beds are created, someone will definitely use them.” In 2019, a professor from the First Affiliated Hospital of the University of Suda was reported by a doctoral student and eventually investigated. This is the naked interest under this law.

Wei Zexi, 22, was suffering from synovial sarcoma. He boarded Baidu when he had no choice but went to the Second Hospital of the Beijing Armed Police Corps. He was informed by Doctor Li that he could be treated and died after receiving 4 treatments. It was later proved that the “Biological Immunotherapy Center” of the hospital was actually a privately contracted Putian Department in the Second Armed Police Hospital. The tragedy of the whole thing lies not only in the connection between the Putian Department and Baidu, but also because Wei Zexi had no choice but to trust the therapeutic effect of Li’s “Doctor”.

Let’s look back further. In 2003, the graduates of Zhejiang University who were carriers of Hepatitis B on Monday, Chao Chao, were found to be “hepatitis B small three positives” because of a civil servant’s physical examination, and were rejected by the employer. In despair on Monday, one person was stabbed to death and wounded, and he was sentenced to death.
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