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医改再辩:政府or市场

来源: 南方日报网络版     时间: 2019年05月23日 02:57:39
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(的)(所)(谓)(世)(纪)(难)(题)(。坚)(持)(市)(场)(主)(导)(的)(市)(场)(派)(又)(非)(常)(推)(崇)(商)(业)(化)(程)(度)(较)(高)(的)(美)(国)(模)(式)(,积)(极)(推)(行)(公)(立)(医)(院)(民)(营)(化)(。  但)(是)(即)(使)(是)(市)(场)(主)(导)(派)(也)(只)(关)(注)(医)(疗)(服)(务)(市)(场)(的)(服)(务)(提)(供)(方)(,而)(往)(往)(忽)(视)(了)(医)(疗)(服)(务)(市)(场)(中)(最)(重)(要)(的)(因)(素)(,即)(医)(疗)(服)(务)(的)(接)(受)(方)(和)(费)(用)(支)(付)(方)(,还)(更)(忽)(视)(了)(二)(十)(一)(世)(纪)(现)(代)(社)(会)(的)(医)(疗)(服)(务)(不)(是)(资)(本)(主)(义)(初)(期)(丛)(林)(法)(则)(主)(导)(下)(的)(市)(场)(体)(系)(,而)(是)(一)(种)(各)(方)(利)(益)(相)(互)(制)(约)(的)(体)(系)(。  无)(论)(政)(府)(主)(导)(派)(还)(是)(市)(场)(主)(导)(派)(都)(不)(能)(忽)(视)(这)(样)(一)(个)(事)(实)(,一)(方)(面)(为)(了)(要)(保)(证)(医)(疗)(服)(务)(可)(及)(和)(公)(平)(,医)(疗)(卫)(生)(服)(务)(必)(须)(坚)(持)(公)(益)(性)(,另)(一)(方)(面)(医)(疗)(卫)(生)(服)(务)(的)(所)(有)(资)(源)(都)(必)(须)(从)(市)(场)(上)(获)(取)(,在)(市)(场)(经)(济)(环)(境)(下)(医)(疗)(服)(务)(自)(然)(还)(具)(备)(市)(场)(属)(性)(。即)(,医)(疗)(卫)(生)(服)(务)(是)(具)(有)(公)(益)(性)(和)(市)(场)(性)(双)(重)(属)(性)(的)(体)(系)(。  医)(疗)(服)(务)(的)(公)(益)(性)(体)(现)(了)(现)(代)(社)(会)(公)(民)(的)(健)(康)(权)(是)(人)(权)(的)(基)(本)(内)(容)(,就)(像)(俄)(罗)(斯)(总)(统)(普)(京)(讲)(的)(那)(样)(,医)(疗)(与)(教)(育)(就)(像)(空)(气)(那)(样)(人)(人)(有)(享)(受)(的)(权)(利)(。同)(时)(还)(表)(现)(在)(医)(疗)(服)(务)(的)(可)(及)(性)(和)(公)(平)(性)(。  医)(疗)(服)(务)(的)(市)(场)(性)(体)(现)(了)(医)(疗)(服)(务)(所)(需)(的)(人)(、财)(、物)(等)(资)(源)(必)(须)(按)(照)(市)(场)(原)(则)(进)(行)(配)(置)(。例)(如)(;医)(生)(和)(护)(士)(的)(收)(入)(过)(低)(职)(场)(风)(险)(高)(,就)(会)(有)(大)(量)(医)(学)(院)(校)(的)(毕)(业)(生)(不)(去)(医)(院)(工)(作)(而)(转)(向)(其)(他)(行)(业)(就)(职)(,据)(统)(计)(去)(年)(上)(海)(交)(通)(大)(学)(系)(列)(医)(学)(院)(校)(的)(临)(床)(医)(学)(毕)(业)(生)(只)(有)(30%选)(择)(去)(医)(院)(就)(职)(。  即)(使)(在)(医)(院)(工)(作)(多)(年)(的)(医)(生)(也)(会)(由)(于)(工)(作)(强)(度)(高)(/待)(遇)(低)(/承)(受)(压)(力)(风)(险)(高)(而)(离)(开)(医)(疗)(第)(一)(线)(跳)(槽)(转)(行)(。近)(期)(上)(海)(第)(一)(财)(经)(频)(道)(播)(出)(的)(深)(度)(报)(道)(节)(目)(“医)(疗)(价)(格)(背)(后)(的)(秘)(密)(”中)(披)(露)(,即)(使)(是)(三)(甲)(医)(院)(的)(上)(海)(中)(山)(医)(院)(三)(年)(前)(的)(医)(生)(人)(数)(是)(380人)(,尽)(管)(三)(年)(来)(的)(医)(院)(的)(门)(诊)(量)(巨)(增)(,几)(乎)(翻)(了)(一)(番)(达)(150万)(人)(次)(,人)(力)(资)(源)(补)(充)(上)(也)(不)(断)(的)(招)(聘)(新)(人)(,但)(是)(还)(是)(不)(断)(有)(优)(秀)(的)(中)(坚)(医)(生)(离)(开)(,其)(结)(果)(跳)(槽)(离)(职)(的)(大)(于)(招)(聘)(补)(充)(进)(来)(的)(,现)(在)(只)(剩)(下)(370人)(。  医)(院)(用)(药)(采)(取)(零)(差)(价)(或)(低)(价)(招)(标)(,药)(厂)(就)(不)(愿)(意)(生)(产)(低)(价)(药)(等)(,其)(结)(果)(政)(府)(不)(得)(不)(采)(取)(政)(府)(定)(价)(采)(购)(保)(证)(医)(疗)(机)(构)(用)(药)(。2012年)(12月)(25日)(济)(南)(时)(报)(报)(道)(“大)(医)(院)(难)(觅)(1元)(红)(霉)(素)(针)(剂)(国)(产)(廉)(价)(药)(再)(现)(缺)(货)(门)(”,其)(背)(景)(就)(医)(保)(对)(红)(霉)(素)(针)(剂)(定)(价)(过)(低)(,导)(致)(医)(药)(生)(产)(厂)(商)(无)(利)(可)(图)(只)(得)(放)(弃)(生)(产)(,其)(结)(果)(百)(姓)(无)(药)(可)(用)(。  医)(疗)(卫)(生)(服)(务)(市)(场)(与)(所)(有)(行)(业)(的)(市)(场)(一)(样)(,都)(由)(服)(务)(提)(供)(方)(和)(服)(务)(需)(求)(方)(两)(大)(基)(本)(要)(素)(构)(成)(的)(。  但)(是)(,医)(疗)(服)(务)(市)(场)(又)(有)(区)(别)(于)(其)(它)(消)(费)(品)(服)(务)(市)(场)(的)(特)(殊)(性)(,由)(于)(大)(部)(分)(的)(患)(者)(对)(疾)(病)(及)(治)(疗)(缺)(乏)(知)(识)(,在)(偶)(然)(性)(患)(病)(就)(医)(时)(的)(情)(绪)(不)(安)(,以)(及)(与)(医)(疗)(机)(构)(间)(的)(掌)(握)(信)(息)(的)(严)(重)(不)(对)(称)(性)(,使)(得)(患)(者)(个)(人)(不)(具)(备)(与)(相)(对)(强)(大)(的)(医)(疗)(机)(构)(进)(行)(博)(弈)(的)(能)(力)(,而)(通)(常)(是)(通)(过)(代)(表)(患)(者)(利)(益)(的)(保)(险)(机)(构)(来)(应)(对)(医)(疗)(服)(务)(机)(构)(。  所)(以)(,在)(医)(疗)(服)(务)(市)(场)(上)(的)(供)(需)(双)(方)(主)(要)(是)(医)(疗)(服)(务)(方)(和)(患)(者)(利)(益)(代)(表)(的)(保)(险)(支)(付)(方)(。一)(个)(可)(以)(制)(约)(服)(务)(提)(供)(方)(的)(医)(疗)(保)(险)(是)(平)(衡)(市)(场)(各)(方)(利)(益)(关)(系)(和)(构)(筑)(健)(全)(的)(医)(疗)(卫)(生)(服)(务)(体)(系)(的)(关)(键)(要)(素)(。目)(前)(以)(改)(革)(医)(疗)(卫)(生)(服)(务)(提)(供)(方)(为)(目)(的)(的)(医)(改)(方)(案)(并)(不)(能)(真)(正)(改)(变)(患)(者)(及)(公)(众)(在)(医)(疗)(服)(务)(市)(场)(上)(的)(弱)(势)(地)(位)(。深)(化)(医)(药)(卫)(生)(体)(系)(改)(革)(要)(着)(眼)(于)(提)(高)(患)(者)(及)(公)(众)(在)(医)(疗)(服)(务)(市)(场)(的)(竞)(争)(优)(势)(,要)(从)(社)(会)(医)(疗)(保)(险)(转)(型)(开)(始)(。  (作)(者)(简)(介)(:毕)(业)(于)(日)(本)(东)(京)(大)(学)(研)(究)(生)(院)(,现)(任)(东)(软)(集)(团)(战)(略)(咨)(询)(部)(首)(席)(咨)(询)(顾)(问)(。日)(本)(光)(电)(工)(业)((株)()高)(级)(工)(程)(师)(,日)(本)(医)(疗)(情)(报)(学)(会)(资)(深)(会)(员)(。欢)(迎)(有)(兴)(趣)(参)(与)(此)(话)(题)(讨)(论)(或)(有)(医)(疗)(健)(康)(投)(资)(、政)(策)(相)(关)(见)(解)(,请)(发)(邮)(箱)(:jiankangzhihui001@163.com)(编)(辑)(王)(世)(玲)()  作)(者)(:杨)(金)(宇)(点)(击)(进)(入)(【股)(友)(会)(】参)(与)(讨)(论)(
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