At present, many people believe that our health care system has been "market" of the, and the area of ??health problems in the health care system due to the "market." So, our health care system in the end is not "market" out? In this regard, it is debated, but no clear answer. I believe that it is necessary to sort out this issue, because clearly the status of the system to determine, is the basis for further reform of institutional policy.
Smoke and mirrors
Many experts say that at home and abroad, the Chinese medical and health fields currently existing problems are solved because the "market" caused.
Back in 2003, the Chinese University of Hong Kong, one scholar has written that the reason why China s public health situation deteriorated, "but the main reason is probably connected with us in a vague general idea of ??reform there are two kinds of superstitions about – one is the superstition of economic growth; the other is blind faith in market. "According to his words," the 1990s after the establishment of a market economy was established as the objectives of the reform, medical and health gradually to the market ", while the final result," China s the area of ??health is probably the world s most market-oriented one of the areas. "
2005, issued by a related group of special research report, China since the reforms, "the basic medical and health system change to a commercial, market-oriented" and its negative consequences, "mainly for the decline in medical services and health equity investment macro-inefficient ", and" root of the problem in the commercial, market-oriented direction of the development contrary to the basic medical and health law. "
In the same year, a Peking University s China Center for Economic Research Scholars also published an article pointed out that China s rapid economic growth "is not directly brought about the improvement of people s health", and the increase in investment conditions, "the worse the performance of health care." The scholars believe that "The main reason is state failure and market failure the Government in the reform process in the development of health care there is no clear direction and goals, blindly health care market."
These indicate that several aspects of Chinese medical and health experts have reached a high degree of status consensus, which is the reform and opening up, China s status of health care system has been completely "market." In view of these scholars, because the special nature of health care, resulting in market-oriented health reform route is bound to fail.
Many issues involved here, but in order to clarify the crux, we should first understand our health care system in the end is not completely "market."
Odds with the fact that
For many people, our health care has entered the market-oriented way is a self-evident reality. Is not it? Now people are to spend their own money to see a doctor (whether direct dig individual pockets to pay, or by social security or tax pays for); a number of public and private hospitals not only "Mo money come in sick", but also the use of information and technology dominance, induced Patients see a doctor to spend more money – such and such a buy, a sell, not the market? Sale of medical services so common, is not "market" what is it?
National health care spending for high-speed increase, is it not the "market" to blame?
However, the capacity of the author to ask, when a lot of purchasing power concentrated in health services, when the supply of medical and public health aspects of what has made a response? Is not difficult to answer this question, of course, is the result of the first hospitals and health services of people engaged in "hair", and overtly or covertly income rolling. So, when the demand for medical institutions and practitioners focused on the growth momentum in the next highly profitable market, the phenomenon of what is destined to come one after another?
If this is conclusive experts chisel words "market" and highly profitable practice, once the news came Daihatsu, stop the world heroes determined to "Breaking and Entering" – set up more hospitals and clinics, mobilize more people to study medicine, adding more health services – until the line of business practice of "excess profits" is averaging down.
This means that, if there really "market" in this world, practice and made their fortunes is the first reaction is to mobilize more resources into the second reaction is inevitable. It is clear that the former is the growth in demand caused by changes in income distribution, which is the re-allocation of resources with the price mechanism.
However, I survey found that: 1. People health
The increase in health costs and expenses, a few times even 100 times higher than the increase in clinic visits, thus the cost of each treatment increased rapidly – "expensive" is also; 2 each medical institutions as well as each health care , the average gain should be in service revenues have been significantly increased; 3 Overall productivity of our health services have not improved (although in different hospitals, there are significant differences between); 4 is the most important people a lot of money on health services, to stimulate the supply side, there s no corresponding increase in resource mobilization.
Where seen in this and other "market" mean?
Since reform and opening up, Chinese people s daily life use, has undergone great changes. In general, everything from the shortage of hard times into the product an adequate supply of services to improve quickly, inexpensive things flooding the market, which tracks the most basic, is that once concentrated demand, the seller made their fortunes, and soon attracted a large number of "backward elements" to invest in factories set up shop, switch to mobilize human, technical management study, and soon form a production capacity of providers to, and then each of its plan, bargain or competition, or innovation of the strange, until the same has the same products and services into the homes of ordinary people.
It is these horizontal experience, the "Chinese health care market" theory has flaws. Again, I want to debate the question is not "market" is good, this should not, but whether the Chinese health care is not already "market." Some experts, government funding accounts for the decline in the proportion of total health expenditure, as health care "market" basis. I believe that it ignores the question: government spending to reduce the proportion of health costs at the same time, there is no access to health services on the door? Another expert said, "various types of capital can enter the field of medical services, basically there is no entry and exit restrictions, the new layout, and services medical institutions targeting depends on market demand conditions." If they are right, why the medical and public health needs to increase so rapidly, the average charges for medical services a few times, a hundred times improved, but did not stimulate the country s medical institutions and a corresponding increase in the number of staff?
Of course, I have no intention to "market" of a unified concept, after all, each on their own which can justify a definition. But I think it is important to pay attention to a real problem, which is China s medical and public health systems, with demand high in the case, why is the ability to mobilize resources to increase the supply so low? I believe that, regardless of what we have argued that this problem is not resolved, to improve health services in China s policy objectives, if not castles in the air, so it is also certain difficulties.