Official Ladder [Grassroots Civil Servants]

To live in the vastness of the world, to establish the right position in the world, to walk the way of the world.If you are successful, you will be free with the people; if you are not successful, you will follow your own way.Wealth and honor cannot be promiscuous, poverty and lowliness cannot be moved, and might cannot be subdued. This is called a real man.

Wang Hongtao is the secretary of the municipal party committee, and he is considered to be in a high position. How can he not know the suffering of the people?

On the third day, the special research team came to Shenzhou County to fully understand the development of free medical care in China over the past year, the pros and cons of the gains and losses, and make a final summary.

A year ago, an unknown county in Shenzhou launched free medical care for all, which surprised many people.Medical care is a worldwide problem. Even in the developed United States, the issue of health care reform is troubling the government.The topic of medical reform affects people's hearts every year. The new medical reform plan has been discussed and debated for many years. Experts and scholars have been arguing endlessly about it. However, Shenzhou County, which is located in a remote area, suddenly raised high-rise buildings on the ground and set up free medical care for all.

Over the past year, the free medical care for all in China has also attracted the attention and discussion of the whole society. The question that the outside world is most interested in is whether the free medical care for all is true?Is Shenzhou too rich?How much does the Shenzhou model cost?Will it make it financially unsustainable?How are technical issues resolved?More importantly, can the Shenzhou model be used for reference by more places, and even become a national model?The public is concerned about these issues, scholars are concerned, and many departments are also concerned. After a year of practice, China is destined to become an unavoidable sample for research on medical reform.

No matter what the result is, Wang Hongtao and Shenzhou have already taken a step ahead, and no one can obliterate it, enough to leave a name in history!

In the Shenzhou Second Hospital, Wang Hongtao pointed to something on the bedside and asked a patient, "My fellow, what is this?"

"Stones are eggs, stones in the gallbladder."

"Is it such a big stone?"

"Fifty-eight years."

"Why wait until now to be hospitalized?"

"I don't have any money. I have had benign prostatic hyperplasia for more than [-] years. I have a cerebral infarction. If the disease is not very serious, then I am reluctant to spend money. The county has a free policy, so I dare to come."

The patient next to him said proudly: "Free medical care is our Chinese nationality. Whether it is a rural area or a citizen, as long as you are sick, you can see it."

"We are basically free of charge. Anyway, if you spend 400 yuan, which is a base of [-] yuan, the rest is all for the state."

"There is a good policy for us to see for free. We just lived in the hospital. I didn't expect such a good policy. I didn't believe it at the time, but now it has been realized, and the promise has been fulfilled."

The special research team went to Shenzhou County Hospital, Yingbin Community Health Service Station and County Hospital of Traditional Chinese Medicine successively. Through on-the-spot inspection, listening to reports, exchanges and discussions, etc., they learned in detail about the comprehensive reform and construction of public hospitals in Shenzhou County's comprehensive medical reform and modern hospital management. In terms of system construction and talent team construction, Wang Hongtao affirmed China's achievements in comprehensive medical reform.

The next morning, the special research team held a symposium to learn more about the pros and cons of China's medical reform.

Walking into the meeting room, Wang Hongtao took the chair, smiled and said to Zhang Qiang, secretary of the county party committee: "I'm sorry today, I took the place of you, a real god!"

Zhang Qiang joked: "The secretary is Jiang Ziya, no matter where he goes, the gods will abdicate!"

Wang Hongtao said sternly: "I'm not kidding, comrades are all here, let's have a meeting. Today is a symposium, the main purpose is to summarize the pros and cons of China since the implementation of comprehensive free medical care, sum up the experience, and lay a solid foundation for the city's promotion. So , you have all personally participated in this great livelihood project, and you must have a lot of feelings, opinions, and suggestions. Please speak freely, and it doesn’t matter if you are right or wrong. I will praise you. Secretary Zhang Qiang, please talk about the overall situation first.”

Zhang Qiang opened his notebook and said: "Okay, Secretary, let me talk about it first, and then I will ask comrades to add more. I have been carrying out free medical care for more than a year, and I have a lot of feelings! We have 42 people, one-third of the rich, three One third is in the middle state, and one third is relatively poor. The income gap between the first third and the latter third is huge. Therefore, free education, free medical care, and free support for the elderly There are people with severe disabilities. These things use the leverage of our government's finances to adjust income distribution.

Like I walked through those villages, I found that all poor households or households returning to poverty, without exception, are disaster-stricken households. For example, a family of five has a deposit of 20 to [-] yuan, which is considered very harmonious as a farmer. In a family, one person got a serious illness. He may need [-] yuan to cure the disease. He spent all the money in the family, and his relatives and friends borrowed tens of thousands of yuan. After the money was spent, the disease could not be cured, and he came back to life. It counts your fate, if you can't survive, my family can't do anything.The more serious problem is that the family's confidence in life has been completely lost, so we were thinking at the time that we should basically avoid the hospitalization of ordinary people.

In March last year, under the guidance of the Municipal Party Committee and the Municipal Government, the Shenzhou County Party Committee issued a document to establish a rehabilitation work committee.I serve as the director of the committee. The purpose of setting up this organization is to organize and coordinate research and policy formulation for the implementation of universal free medical care.The director of the Food and Drug Administration was transferred to be the director of the Office of the Rehabilitation Working Committee.

The work of the Rehabilitation Office began with research, and it was determined that about 35 people received free medical care in the county. According to professional standards, the 12 general hospitals in Shenzhou County were scored and ranked, and the top seven were designated as free medical care hospitals.The beds owned by these 7 hospitals can ensure that China has less than 4 beds per thousand people, which exceeds the average level of the province. We have guaranteed medical resources.

According to statistics, the Rehabilitation Office proposed that the total financial investment should be 1.5 million yuan to implement free medical care for all.When I first imagined it, it might be a little more than this amount. At that time, it was estimated to be 1.8 million yuan.In fact, last year's fiscal expenditure on free medical care was only 1.1 million yuan. "

After Zhang Qiang finished his speech, Yang Xiaowei, the county magistrate, began to speak: "Secretary, after a year of exploration, we still found some problems. Although we are optimistic about public morality, we have set up multiple lines of defense in the implementation of free medical care for all. In order to curb the impulse of hospitals to prescribe large prescriptions and raise medical expenses for profit. Drugs should not exceed half of the total medical expenses, and the proportion of self-paid drugs should not exceed 10%. The excess part should be paid by the prescribing doctor. The cost shall not exceed 400 yuan, and the per capita total hospitalization expenses shall not exceed 4000 yuan. The total length of hospitalization shall generally not exceed 12 days, and the positive rate of machine examination shall not be lower than 75%. The limits of various indicators are set on the heads of hospitals and doctors Tightening curse. It also stipulates the reimbursement quota for 30 common diseases. This single-disease payment mechanism is a method commonly used in countries with complete medical systems. In addition, the implementation method of chronic disease outpatient quota is also being formulated to solve the problem of chronic diseases crowding out ward resources Three months after the implementation of free medical care, almost all the designated hospitals have exceeded the standard in terms of per capita and daily hospitalization expenses. The county government urgently introduced new punishment measures, and the top three hospitals with the cost exceeding the standard will be shut down respectively. A fine of 1.5 yuan, 1 yuan, and 0.5 yuan will be imposed. Those who refuse to mend their ways will be suspended or disqualified as a designated hospital. The last one is undoubtedly the most deterrent. Three months later, the government used this trump card. The expenses continued to exceed the standard, and the qualification of the designated hospital was disqualified."

The director of the Rehabilitation Office said: "Secretary, I have the following thoughts: 1. Medical investment needs precise drip irrigation, and flood irrigation should not be avoided. If medical waste is not solved, no matter how much the government invests, it will be in vain; The key to medical waste is to make doctors willing to return to see a doctor. No matter the cost control of a single disease or the total cost of the average case, it is a temporary solution that cannot cure the root cause. It will only unnecessarily distract doctors and lead to greater resistance from doctors; 2. Free for all Medical care will inevitably lead to waste. Either the government will continue to increase investment and drag down the finances; or the medical service will be reduced, resulting in an overall decline in medical quality. This problem is the most difficult to solve; 3. The starting point for medical reform can only be doctors, because doctors and patients are medical care The most basic relationship in service, and solving the problem of doctors' treatment is the key to returning medical care to public welfare!"

What he said was in place and professional, and Wang Hongtao agreed very much.

Some comrades pointed out that many people are often hospitalized for minor illnesses, resulting in a waste of medical resources.

Some comrades pointed out that if the price of medicines can be lowered, the financial investment will be less, maybe tens of millions will be enough.Some medicines can be sold for 1 yuan or 10 yuan. The country has a ceiling price, but its profit margin is too large. If 10 yuan does not exceed the ceiling price, it can only be made to do it. , you can't help it.

Some comrades proposed that the salary of doctors should be improved. The workload in the past year was at least twice the previous workload, and the salary did not increase.Doctors are looking forward to improving the treatment of doctors during the medical reform.

Wait, such comments and suggestions, Wang Hongtao sorted out 35 items, all of which are real problems.If you want the city's "universal free medical care" to go forward and go smoothly, you must have a sound system to escort it, such as the medical service supervision system and the effective allocation of limited resources.

But in terms of fiscal expenditure, some counties may not be able to afford 1.2 million yuan, but Shenzhou County has a large population, and it is converted into an investment of 300-400 yuan per person. At least half of the state-owned areas in the country will think it will be no problem.

And counting the economic accounts, the common people have no worries, no diseases and no disasters, and they are happy. He has created a lot of wealth, and his purchasing power and consumption ability will greatly increase.So providing health care is an investment.It is rewarding, and this reward is quite cost-effective even in terms of economic returns.It not only promotes economic growth, but also expands people's livelihood. Wang Hongtao can't imagine any better governing philosophy than this.

Wang Hongtao is very clear that the most worrying thing for the entire medical industry is the drug guidance plan that Shenzhoukang is formulating. It adjusts the original cost indicators and tries to implement zero price difference and zero markup. It is impossible for it to survive.In terms of the number of private hospitals, it is not a small proportion in the whole country.

As long as one wants to carry out work, there will be difficulties, reforms will be required, and the interests of some people will be touched, and the ability of those in power to govern must be tested.

The symposium was very successful and provided Wang Hongtao with a lot of ideas.