This article is machine-translated by Google.
Since last night, eating too fast, too hard to chew, accidentally bite his tongue, suddenly bloody, almost gushing. I immediately buy a point cold ice cream in an attempt to stop the bleeding cold. He started well, but after a while, began to bleed, and more and more, bleeding. Not long after feeling swallowed a stomach blood. I want to go to the hospital, but look at the table ten o'clock, for fear that the school can not see the hospital emergency room, or go the next morning. After a while, feeling throat swallow too much blood, a little uncomfortable. Looked in the mirror tongue, bleeding speed that startled me, could have nearly 0.2 milliliters per second. Qiazhiyisuan an hour is 720 ml, sleep on several rose. Think this incredibly soft legs, then immediately go to the hospital.
Sure enough, the university hospital emergency room can not see, so I went Weigongcun near Peking University Dental Hospital. I took a taxi to the Dental Hospital, walked into the emergency room, when it is already a little late. It took me five bucks to hang a number, wait in line for a while on the go. Beautiful young female doctor asked me how, I said about my condition, the doctor told me to lie down and asked if I usually have no symptoms. I thought, said, "I should have Hypoglycemia it," smiled the doctor, let me open your mouth and begin treatment of wounds. My doctor saw the wound position is strange indeed, turned out to be in the middle of the tongue, or on end. Just because a bite of small blood vessels, so only bleeding. When dealing with doctor kept asking me in pain, although a little sore before, but I do not know how the doctors treated even when It does not hurt anymore, probably because it beautiful young female doctor. Not a moment, the wound handled well, half an hour no more bleeding.
Payment time for me very surprised, cost a total of 8.2 yuan, my first reaction is good cheap ah. Although as a student of the medical expenses can be reimbursed, but it was so cheap I'm too lazy to go reimbursed (as a rational person, but I'm still going to be reimbursed, not to small not for profit thing). After paid the fees doctors also warned me attention, do not eat hot stuff and so on, that attitude just makes me feel grateful.
Compare US and European medical institutions, in which ailment or go to a public hospital queue to die or go private dental clinics, and mentally prepared to receive a huge bill, and midnight to people also may not care about you. Only heavenly empire have this inexpensive 24-hour pick-watching medical services.
Why I can enjoy it all
Although the medical experience very pleasant, but I'm still a clear understanding that there is no free lunch. China this high-quality low-cost medical services, at the expense of public hospital doctors, especially the press interest. Such medical services where there is not, but is concentrated in a few large cities like Beijing and Shanghai, it was coveted by the whole nation. Do not you see the major hospitals in Beijing entrance twenty-four hours were full of people from all over the doctor's inquiry, why they come to Beijing? Because only Beijing have such quality medical service ah.
But always limited public resources, no amount of medical resources will be patient endless full. For how to resolve the situation enough to go round this, nothing more queuing, and lottery market. Queuing is the most common way that most public hospitals, as well as the Spring Festival ticket queue that have adopted the "fair" way. Ballot is not uncommon, for example, Beijing car license plate lottery, high-quality primary and secondary schools enrollment lottery, this approach also seems to be fair. The way the market is competitive auction, this approach was also used a lot, but quite far away from ordinary people, such as government land to the highest bidder, it can be considered fair (not consider the issue of corruption). These three ways difficult, "who is more equitable," he says only "to whom more favorable," it said. Queuing is clearly beneficial for the poor, because of the high cost of time rich. The auction is, in turn, benefit the rich. The ballot is the same for everyone, so some people think that the lottery is fair. For example, ancient Greece Athens democratic system, developed later in pursuit of absolute fairness on the use of lottery.
But the market is pervasive, queuing, and drawing lots can be passed on the market, such as queuing hire, hire ballot initiative reselling or someone discharged or pumped resources. Like military service during the American Civil War, although conscription is mandatory random draw, but if you can find recruits instead of a person, you can let others exempted from military service in place, which makes most of the wealthy have chosen to replace their own mercenary. For hospitals, often see cattle reselling registered, the number of experts hundreds of dollars Scoop registration fee can be thousands of dollars are common. I will not speak of this Daomaidaomai Meets morally such behavior at least to solve a problem, that is the real value of high-quality resources. If there are no cattle Daomaidaomai, it is difficult to know a number of experts in the end worth, this is where the significance of the secondary market.
I believe no one would think five dollars registration fee is expensive, but also because of the interests of this, hospitals and doctors are denied. Medical service itself is a kind of professional services, market demand or moral needs, a professional doctor (moral) deserve proper economic returns and social respect both of its. However, due to state-controlled price of medical expenses, the hospital could hardly earned from the above funds to maintain operations, rely on other means, that is, we often say that the "drug dependent doctors." As for the state-subsidized public hospitals, I do not know the specific figures, but estimates difficult to maintain hospital operations. Therefore, hospitals and doctors became the scapegoat, as if the doctor kickbacks become "expensive" is the culprit, not knowing the cost of expensive medical services itself.
Because of my illness really is not, and the doctor did not mean to get kickbacks from me, so what is useless to expensive drugs. After all, in today's tense doctor-patient relationship, the doctor went to get a rebate or to think twice. I was able to enjoy this service is completely based on the interests of hospitals and doctors to be sacrificed on. So I after reading the patient, the doctor could not help but say a few good "thank you."
Medical costly culprit - access system
Health care costs into the cost of medical services and medical costs, and the two parts of your reasons are different. In China, the former is artificially low, making the former hospital had to use the latter subsidies. In western countries, especially the United States, why the medical frighteningly expensive it? I think it has its roots in the harsh practice access system. If you've seen the film "Beijing encounter Seattle", you might notice a detail, the story finally Frank after years of efforts finally passed the American doctor's license, then into the high-income class. However, Frank itself is Beijing Fu Wai Hospital doctors practicing medicine for many years ah! This detail reflects how difficult a doctor in the United States, and this is difficult to entirely man-made.
United States Medical Licensing issued by the Medical Council of each state, must pass the exam, "American Institute of Certified USMLE (United States Medical Licensing Examination, USMLE)" and other assessment. Usually a physician before beginning practice, we need to learn more than ten years, and through internships. Due to the harsh access system, the number of doctors in the US health care market is strictly limited, resulting in an artificial shortage, the doctor's revenue will naturally increase.
Since the United States is also the problem of expensive medical expenses, why maintain this system? The reason is simple, to "public safety." Unqualified doctor you see a doctor, you will be assured it? The reason seems to make sense, but only one side of the speech. Such harsh access system is to ensure the quality of the doctors, but the expense of the interests of patients and are not licensed doctors. Not everyone needs a very high standard of care, some people just need a general level, but low-cost medical services. However, doctors in order to maintain their high income and social status, using a variety of political forces lobbying authorities, kidnapped by the public interest to ensure that the method of self-interest.
China past barefoot doctors, providing cheap medical services in the country. Hong Kong Kowloon Walled City before the split, since the Hong Kong government for its lack of jurisdiction has become an unlicensed dentists and concentrated Chinese medicine clinics (British Hong Kong government does not recognize Chinese medicine practice qualification). Wherein the clinic, although in different ways, but to solve the problem of a considerable part of the doctor of the poor. Now, only the poor go to public hospitals in Hong Kong line, is a row of small disease may be six months.
Similar examples expensive due to the access system as well as London and New York due to taxi prices. In London, the access threshold taxi driver was surprisingly high, applicants for all taxi drivers will take three to four years of study at The Knowledge (this name sounds very powerful light), which requires drivers to keep in mind not only knowledge 25000 cities streets and 30-50 suburban street, but also on London's history, culture, attractions by heart. Therefore, very few people pass the exam, he became a London taxi driver "high-income profession." For consumers, the result is a London taxi is very expensive, I once again from Heathrow Airport to the City of London taxi took 105 pounds, also without tips. The access system is reflected in the New York taxi license in 2013, a New York taxi license auction price of $ 1.3 million. In fact, in the past is not the case, a total of 30,000 former New York taxi margin (the population is far less than today), but later the mayor of New York signed the "Haas Act," so that the number of taxis dropped to 16,900, and now New York 830 million people, only 13,336 taxis, more than double the population compared to Beijing than New York, but there are more than 69,000 taxis. Because of this disparity in the number of differences, the price of a taxi in New York is very expensive (and there are reasons for the labor market, do not press), but also because of this, it gave like Uber companies such profit space.
Compared to the price of medical services, medicine prices either in America or China are very high, which is what causes it? R & D is the direct cause of the high cost of medicine (even though the marginal cost of production is very low), a new drug research and development costs as high as hundreds of millions to billions of dollars and ten years time. But the reasons behind the FDA demanding listed pharmaceutical regulatory system, resulting in a sharp increase in the cost of drug development. Why is this so? The reason is that drugs meet the FDA requirements for the listing of a series of standards, and the need to do a complete clinical trials, which gives pharmaceutical R & D enterprise has brought huge economic costs and time expenditures, such companies have to spend huge amounts passed on to consumers. Although FDA purpose of public safety (and public safety ......), but do not know how much hinder development of new drugs, so that could have saved more people tragically died. As for China, in fact, there are few self-developed drugs, most of which are imported patent, the US pharmaceutical R & D expensive Chinese medicines can also cause expensive. At the same time China also emulate the United States to develop a more rigorous drug GMP certification. FDA now has been extended tentacles medical mobile applications, or even result in the Silicon Valley start-ups to survive the difficulties related to hinder the progress of medical technology.
Ideal health care system
I think the talk about the ideal health care system. I think the ideal health care system should be fully market-oriented, all doctors access system, the drug should be canceled if a mandatory audit system. But not completely abandoned, or can be retained as a reference. Anyone with the will, you can practice medicine, the patient can choose whether to trust. If the doctor is willing to obtain a license, you can increase the confidence of the patient, the equivalent of a professional certificate only (false fraudulent, is another issue). At the same way a doctor licensed institutions should break the monopoly, any organization can issue certificates, which admitted the difficulty of its gold content, the number of decisions issued similar certificates financial or IT sector. Like the financial sector practitioners not a CFA certificate to purchase or sell securities, IT industry practitioners can not have a MCSA certification program, as to whether the company you hire, the certificate is only a reference, other experiences are also an important part of the experience.
Similarly FDA drug access system should be abolished in favor of the drug by a third party rating agencies (public or private) to evaluate the drug, similar securities rating agencies. Note that this problem of fraud and non-normal way does not resolve bribery and other causes, but there are also FDA can not solve, how to solve another problem.
In such an ideal situation, the necessity of the existence of public hospitals is not much, because the market can provide all levels of medical care, poor choice of cheap, rich choice of quality, like any other goods or services. I think there is no requirement is "rigid" and insisted the government should not intervene, including health care, housing, education, can be effectively regulated by the market (in the case of cancellation of administrative intervention premise).
Some people think that there is a market to provide complete medical services is contrary to ethics, an example of the poor is seriously ill, he can not afford the expensive medical costs, does it mean that it should die? This is indeed a very controversial issue. In fact, I think it relates to people's "right to life" of a problem than medical, including food and clothing, natural disasters. About food and clothing, even in developed countries but also in the last one hundred years, gradually eliminated, not because of any egalitarian political movement, but a substantial increase in productivity, resulting in food, textile prices become very cheap, just let everybody burden affordable food and clothing. Even if someone could not afford it, through government subsidy method, so that a person can not eat too much money to spend. The health is still a very scarce resource, in any case can not satisfy everyone always allocated, and then you face a lot of money even if the disease can not do anything. It is entirely restricted to human medical technology, there is no perfect way to solve. Government boasted responsible for each individual medical behavior is extremely irresponsible, because there is a "sarcastic." Therefore, the ultimate solution is to improve medical technology, rather than any political movement. In this context, in order to ensure the development of medical research, its funding is essential, so the optimal allocation of resources is the way distribution market, so as to make effective capital flows into the medical field, to stimulate its development.
Finally, explain the title, Chinese medical system does have many problems, but there are many problems in the United States, compared with China's health care system to the patient is not bad, at the expense of the interests of doctors (indirect damage the interests of patients, resulting in a lose-lose situation). While the United States at the expense of the interests of patients, doctors fattened.