For the problem of difficult and expensive medical treatment, many people put the responsibility on hospitals and doctors, but Peng Jianming believes that this should actually be a system problem. And because doctors are too professional, it is difficult for ordinary government departments to deal with these problems to the point.

Nowadays, many people complain that the cost of various examinations and laboratory tests in the hospital is increasing, and it turns out that when you go to the hospital to see a doctor, you only need to see a doctor from the doctor, and then you can go directly to get the medicine. But now, register with the doctor, regardless of 3721, the first thing is to prescribe a few examination sheets or laboratory tests for you, and wait until the results come out, and then prescribe medicine.

Many people think that such an examination or laboratory test is actually unnecessary, because with the doctor's experience, he should basically be diagnosed at that time Chapter 1273 Medical Separation (ask for a monthly ticket). But why do doctors insist on lab tests or tests? Mainly because once a doctor-patient dispute arises, there is no neutral structure that can be agreed upon by both parties to deal with it. And the evidence presented by both sides is even more risky for doctors.

For example, for a common cold, you only need to prescribe some medicine and go back to take it. But now, if the patient goes home and does not drink more water according to the doctor's instructions, especially the older patients, once there is fever and sweating, the blood will thicken, and once a myocardial infarction occurs, the doctor must come up with evidence to prove that there was no myocardial infarction at that time, so an electrocardiogram should be done.

Can this not be expensive? If there is an infection, use some antibiotics first, or if there is a secondary infection in the future, and then ask the doctor to prove that there was no infection at that time, wouldn't it be very troublesome? In order to avoid trouble, it is natural to consider all kinds of possibilities in advance, only the tests and tests that need to be done, and no one can be missing, and no one can be missing.

Speaking of doctors' salaries, it should be said that the vast majority of doctors are still conscientious, which Peng Jianming deeply understands. But if everyone is made selfless, this is also unrealistic. No matter who is going to be profitable, the same two kinds of medicines, prescribing high-priced drugs, Chapter 1273 Medicine Separation (Asking for a Monthly Pass) He can get a bonus to prescribe low-cost drugs every month, not only does he not receive a bonus, but he also has to be criticized by the leader. It may not matter once or twice, but if it goes on like this for a long time, I'm afraid it will not be a question of bonuses, but a question of whether you can keep your job.

Attentive patients will find that chloramphenicol eye drops that used to cost 1 a piece are now difficult to find. Erythromycin for injection is out of stock nationwide, and one is hard to find. The lack of some first-aid cheap drugs makes patients worry and doctors have headaches. The relevant departments once made a statistic that the shortage of cheap drugs in hospitals was as high as 342. Why are cheap drugs disappearing? Pharmaceutical companies say that doctors don't like to use and have no market, while doctors say that pharmaceutical companies don't make profits and don't want to produce. Who is to blame for the shortage of cheap drugs in hospitals?

Peng Jianming believes that if the hospital is made a for-profit structure, if the doctor's salary is linked to his performance, such problems will always arise. Even if the hospital earns all the money of the heart booster for more than a dollar, it will be more than a dollar. But a booster of more than 200 yuan, no matter what, is also fifty or sixty times the profit of the booster.

Peng Jianming slowly made his views clear to Zhu Daidong. He analyzed such things from the perspective of a doctor, the hospital, and the cadres of the health department, increasing doctors' salaries, reducing the profitability of hospitals, and having the municipal government come forward to purchase national essential drugs alone.

"Comrade Jianming, I am greatly inspired by your views, can you combine your views and form a textual thing? In addition, is there really such a big difference in the price of drugs with the same efficacy? Zhu Daidong still has some problems of disbelief, you get what you pay for, if the price is too expensive, how can it be accepted by the market? This is obviously not in line with the laws of the economy. Although Zhu Daidong does not know much about the health system, as long as it is related to the economy, he still knows it.

"I'll do my best to write everything out and report back to you when the time comes. As for the difference in the price of drugs with similar efficacy, let me give you an example. Cediran is a kind of cardiac agent, which is very commonly used in clinical practice, although in the treatment of heart failure, there are drugs such as "poison hair K", "milrinone", etc. can be replaced, but "poison hair K", the side effects are larger, and the price of "milrinone" is as high as one or two hundred yuan. In addition, cediran can also treat other diseases such as heart tremor, which is irreplaceable. If there is a shortage of this medicine, the consequences for patients in the intensive care unit are very fearful. But now in many hospitals, there are very few cediran, if there are really patients who need first aid, they can only use milrinone, and the amount of money is more than 100 yuan, the difference is more than 100 times.

In addition, bicodone, which is used to treat asthma, sulfadiazine sodium injection for meningitis caused by N. meningitidis caused by sensitive meningitis, and cyclophosphamide injection, which is used for cancer treatment, are all difficult to find in hospitals. There are also chloramphenicol eye drops for 1 yuan and 1 stick, haloperic acid for a few yuan a box, periodontal spirit tablets for 8 yuan and 100 tablets, etc., and some commonly used drugs that were very familiar have almost disappeared from the doctor's prescription.

This is the case with these medicines, and other medicines are similar, and many drugs that cost a few cents or a few dollars are now becoming more and more difficult to trace. The original intention of China's medical company was to benefit patients, but because of loopholes in the policy, hospitals and pharmaceutical companies are now mainly benefited, and even patients with medical insurance pay a great price. Peng Jianming sighed and said.

"Actually, I understand what you mean, medicine is not separated, and it is difficult for drug prices to fall." Zhu Daidong said helplessly, in fact, it is impossible to have cheap drugs in China now, under the premise that public hospitals are not compensated, the price of drugs actually includes the labor costs of some medical staff, and if public hospitals want to be subsidized, this requires a lot of financial investment, but according to the current situation, Zhu Daidong feels that it is better to subsidize hospitals than to let them earn the difference in drug prices. If all the medical workers in all public hospitals in the city were included in the budget, how much would this burden increase the city's finances? If Kikawa wants to provide free medical care for all, it is imperative to include medical workers in public hospitals in the budget again.

As for the construction of hospitals, if it is infrastructure, it is easy to do, and there are urban investment companies. If equipment is needed, now hospital equipment, especially some large equipment, still needs to be imported. Zhu Daidong suddenly thought that if Zhang Tianrui's Hengtian Foreign Trade Company introduced the medical equipment of all public hospitals in Muchuan and handed it over to Hengtian Foreign Trade Company, would it be much stronger for the hospital to purchase it by itself, or let the government departments purchase it?

Nowadays, if a hospital wants to import a set of equipment, in addition to the price of the equipment itself, it will also incur a lot of additional costs. For example, in some places, an inspection team will even be sent to visit foreign countries first. After returning, if the proposed plan does not pass guò, you need to send someone out to investigate again. After repeated inspections, the final cost will naturally be calculated on the head of the medical equipment. And these costs are ultimately borne by patients.

In addition to letting Hengtian Foreign Trade Company be responsible for imports, in fact, a supervision agency should be added, otherwise, people will always be exploited.

Some people in the government don't have much to do every day, and all they think about all day long is how to find loopholes in existing policies to make things easier for them.

Mayor Zhu said it. In other words, in addition to the price of the medicine itself, the doctor's prescription to the patient also includes the hospital's operating costs, the doctor's compensation for the doctor's low salary, the nurse's salary, and so on. Peng Jianming said that the mechanism of public hospitals to support medicine remains unchanged, and high-priced drugs are always more popular than low-cost drugs. This point is not subject to human will. Even if Zhu Daidong is as strong as a man, he can't change it if he wants to rely on a few texts.

But if you start with the system, things are much simpler. Otherwise, according to the normal market rules and low prices, they tend to sell quickly, but in China, the higher the price, the better it sells. The formation of this deformity phenomenon is an important factor in the addition mechanism of hospital drugs. According to the regulations, hospitals can increase the purchase price of drugs to patients by 1% on the basis of the purchase price, and hospitals can earn 5 yuan for purchasing drugs for KC yuan, but can only earn 15 yuan for purchasing drugs for 0 yuan. Therefore, hospitals are willing to give preference to expensive drugs in drug procurement, so that they can earn more profits.

In recent years, the National Development and Reform Commission has repeatedly lowered drug prices, and cheap drugs often become the target of price reductions, and after each price reduction, there will always be a batch of cheap drugs missing. Because the maximum retail price is set low, the operating space in the middle is reduced, and the rebate that doctors have to take is naturally smaller.

It is precisely because of the above reasons that in the drug bidding, if there are foreign-funded and domestic enterprises winning the bid for the same variety of drugs, the hospital often purchases a foreign-funded drug (one product and two regulations: that is, the same drug and the same dosage form can only be purchased with two specifications), and the other chooses a company from the domestic pharmaceutical factory to procure, or even does not purchase domestic drugs. However, the drugs of foreign-funded pharmaceutical companies with the same specifications and dosage forms are often more expensive than those made in China.

"Comrade Jianming, you have been working in the health system for a long time, and now you are in charge of the work of the Civil Affairs Bureau, this time the free medical care is a rehearsal of the city's free hospitals, I hope that the Civil Affairs Bureau can actively cooperate with the Health Bureau and the Finance Bureau, and work together to practice this work for a long time." Zhu Daidong said solemnly.

"Please rest assured that Mayor Zhu will cooperate well with the Health Bureau and the Finance Bureau, and under the correct leadership of the municipal government, we will unswervingly implement the issue of free medical care and free education for the subsistence allowance." Peng Jianming said.

"If you have such an attitude, I believe that the system of free medical care will be well implemented." Zhu Daidong said firmly.

"The main reason is that we have Mayor Zhu in Muchuan, otherwise I don't think this system will ever be implemented." When Qin Xiaojuan was adding water to Zhu Daidong, she heard their conversation and said a word.

Of course, Mayor Zhu is not only the youngest mayor in the province, but also the most courageous mayor. In my life, I am really fortunate to be able to work under the leadership of a cadre like Mayor Zhu. Peng Jianming glanced at Qin Xiaojuan with annoyance, he was talking to Zhu Daidong, what qualifications did Qin Xiaojuan have to interject? Although Qin Xiaojuan can be the master of the house at home, but now that Zhu Daidong is here, it is working time.

"Premier Hong often says, as long as we are not selfish in our work, and we are honest and self-disciplined in our work style, I believe that you will also become better leading cadres in the future." Zhu Daidong said solemnly, Gong Shengming, Lian Shengwei, just six words, it is easy to say, but it is so difficult to do. Some cadres have practiced all their lives, but they have not been able to control themselves in the last step.

Qin Xiaojuan's face was overjoyed, she wanted to say something, but Peng Jianming gently pinched her hand, on such an occasion, she made a speech, which was already against common sense, if she spoke again, I am afraid that even if Zhu Daidong's equipment is good, she will be dissatisfied.

"Comrade Jianming, Director Qin wants to speak, you can't deprive others of their right to speak. Our party has always advocated democracy and freedom, but today is not a formal meeting, so we can speak our minds freely. Zhu Daidong said with a smile.

"Mayor Zhu, I promise you that in the future, I will definitely think that you will learn from the example, and you will be my goal and motivation to move forward." Qin Xiaojuan said firmly, she now has a punishment on her body, and she has been demoted by half a level at the same time. Although her current working environment is even better than when she was the director, after all, she is only a deputy section-level cadre now, and now Zhu Daidong personally visits her door, how many cadres in Muchuan City can enjoy such an opportunity?

"Comrade Qin Xiaojuan, your essence is actually good. In fact, there is no need to take the punishment you received before. As long as you remember what I just said, and use it as a motto for a lifetime, I believe that you will definitely make progress. Zhu Daidong said solemnly, he actually knew very well what kind of mood Qin Xiaojuan was in when facing him.

I think that when I was in Yuhua County, I was also very excited to see the leaders of the city. A word of encouragement from a leader, a motivating look in his eyes, can make him full of strength. Now because of Peng Jianming's relationship, Zhu Daidong can be said to have encouraged Qin Xiaojuan very well, and he believes that as long as Qin Xiaojuan is self-motivated, there is still a lot of room for improvement.

"Thank you, Mayor Zhu, please look at my watch in the future, I will definitely not disappoint you!" Zhu Daidong said with a smile.

"Okay, Comrade Jianming, in the future, Comrade Xiaojuan's personnel transfer, you remember to inform me, and I will come back to congratulate you and your husband and wife at that time, goodbye." Zhu Daidong said. !!