.For the problems that are gradually becoming difficult and expensive for medical treatment, many people have put the blame on the hospital and doctors, but Peng Jianming believes that this should actually be a system issue. Moreover, because the doctor's professionalism is too strong, it is difficult for ordinary government departments to deal with these problems to the point.

Nowadays, many people complain that the hospital's various examinations and test costs are increasing. Originally, when you go to the hospital for treatment, you can go directly to get the medicine after you finish the treatment from the doctor. But now, if you sign up for the doctor, no matter how many test forms or test forms are required, you will first prescribe a few test forms or test forms, and you will only prescribe the medicine after the results are released.

Many people believe that such examinations or tests are actually unnecessary, because based on the experience of the doctor, he should have been diagnosed at that time. But why should the doctor insist on the examinations or tests? It is mainly because once a doctor-patient dispute occurs, there is no neutral structure recognized by both parties to deal with it. The evidence provided by both parties is even more risky for the doctor.

For example, for a common cold, you only need to prescribe some medicine and go back and take it. But now if the patient does not drink more water as required by the doctor after returning home, especially older patients, once they develop fever and sweat, their blood will become thicker. Once a myocardial infarction occurs, the doctor must provide evidence to prove that there was no myocardial infarction at that time, so an electrocardiogram is required.

Is this cost not high? If you have an infection, use some antibiotics first. Otherwise, if you have secondary infections in the future, you will have to ask a doctor to prove that there is no infection at that time. Wouldn’t it be very troublesome? In order to avoid trouble, you must naturally take into account all possible possibilities in advance. Only examinations and tests that need to be done can be done, and neither can be missing.

Besides, the salary of doctors is said to be that most doctors are still conscientious and responsible. Peng Jianming has a deep understanding of this. But it is unrealistic to let everyone be unrealistic. No matter whoever is willing to seek profit, the same two drugs, prescribe high-priced drugs, can get bonuses and prescribe low-priced drugs every month, not only does not have bonuses, but also criticized by leaders. It may not matter once or twice, but if this continues, it may not be a bonus issue, but a question of whether one or two can keep his job.

Careful patients will find that chloramphenicol eye drops that used to cost 1 yuan per dose are now difficult to find. Erythromycin for injection is out of stock nationwide and one is hard to find. The lack of some cheap medicines for first aid makes patients even more distressing and a headache for doctors. The relevant departments once conducted a statistics and found that the hospital has a gap of 342 kinds of cheap medicines. Why did cheap medicines disappear? Pharmaceutical factories say that doctors don’t like to use them without markets, while doctors say that pharmaceutical factories are unwilling to produce them without profits. Who is the fault of the shortage of cheap medicines in hospitals?

Peng Jianming believes that if the hospital becomes a profit structure, if the doctor's salary is linked to his performance, such problems will always arise. Even if the hospital makes all the cardiac agents worth more than one yuan, it will only cost more than one yuan. However, the cardiac injection of more than two hundred yuan, no matter what, is fifty or sixty times the profit of the cardiac agent.

Peng Jianming slowly pointed out his point of view to Zhu Daidong. He analyzed such things from the perspective of a doctor, the hospital, and the perspective of a health department cadres, increasing the salary of doctors and reducing the profits of the hospital. The municipal government came forward to purchase national basic drugs separately, and mainly used national basic drugs for low-income households. As long as these points can be achieved, he believes that the fiscal expenditure on free medical care for low-income insurance will drop rapidly.

"Comrade Jianming, your views have given me a lot of inspiration. Can you combine your views and form a text-based thing? In addition, are the prices of drugs with the same efficacy really so different? " Zhu Daidong still has some questions that he doesn't believe. He gets what he pays for. If the price is too expensive, how can he be accepted by the market? This obviously does not conform to economic laws. Although Zhu Daidong doesn't know much about the health system, he still knows it as long as it is related to the economy.

"I will write everything out as soon as possible and report it to you later. As for how much the price difference between drugs with similar efficacy, I'd better give an example. Xidilan is a type of cardiac enhancer and is commonly used in the treatment of heart failure. Although there are 'toxic hair k' and 'milinon' and other drugs that can be replaced, the side effects of 'toxic hair k' and 'milinon' are relatively large, while 'milinon' is as high as 100 or 200 yuan. In addition, Xidilan can also treat other diseases such as heart tremor, which is irreplaceable. If this medicine is short, the consequences will be very scared to the patients in the intensive care unit. But now, there are very few 'milinon's patients. If there are really patients who need first aid, they can only use milinon, which costs more than 100 yuan, and the difference is more than 100 times.

In addition, Bicodone used to treat asthma, sulfadiazine injection for meningitis caused by sensitive Neisseria meningitis, cyclophosphamide injection for cancer treatment are difficult to find in hospitals. There are also chloramphenicol eye drops for 1 yuan, fluphenolic acid for a few yuan per box, periodontal spirit tablets for 8 yuan, etc. Some commonly used drugs that were originally very familiar have almost disappeared from doctors' prescriptions.

This is the case with these drugs, and other drugs are similar. Many drugs cost a few cents or a few dollars, and it is becoming increasingly difficult to find traces. The original intention of our country's doctors was to benefit patients, but because of the loopholes in the policy, the main benefits are hospitals and pharmaceutical factories. Even patients with medical insurance will pay a lot of money." Peng Jianming sighed and said.

"I actually understand what you mean. If medicine is not divided, the price of medicine will not drop." Zhu Daidong said helplessly. In fact, it is impossible for cheap medicines in China now. On the premise that public hospitals cannot receive compensation, the price of medicine actually includes the labor costs of some medical personnel. If public hospitals want to receive subsidies, it requires a lot of financial investment. However, according to the current situation, Zhu Daidong feels that it is better to subsidize hospitals than to let them earn the difference from drug prices. If all medical workers in public hospitals in the city are included in the fiscal budget, how much burden will this add to the city's finances? If Muchuan wants to provide free medical care for all and re-incorporate medical workers in public hospitals into the fiscal budget, it is an imperative step.

As for the construction of hospitals, if it is infrastructure, it is easy to deal with, and there is a city investment company. If equipment is needed, the equipment of hospitals, especially some large equipment, still needs to be imported. This requires good channels in foreign trade. Zhu Daidong suddenly thought that if Zhang Tianrui's Hengtian Foreign Trade Company introduced all the medical equipment of Muchuan's public chambers and handed over to Hengtian Foreign Trade Company, would the hospital be able to purchase it on its own or let the government departments purchase it much better?

Now a hospital wants to import a set of equipment. In addition to the very expensive price of the equipment itself, it will also incur a lot of additional costs. For example, in some places, they will even send an inspection team to visit abroad first. After returning, if the proposed plan is not passed, they will need to send someone out for inspection again. After repeated inspections, the final cost will naturally be calculated on the medical equipment. These costs will ultimately be borne by patients.

In addition to let Hengtian Foreign Trade Company be responsible for imports, it should actually add a supervisory agency, otherwise people will always find loopholes.

Some people from government departments have nothing to do every day. What they think about all day is how to find loopholes from existing policies to make their own actions more convenient.

"Mayor Zhu's words are said. In fact, a doctor's labor costs are borne by two or three hospital employees. In other words, in the prescriptions prescribed by doctors to patients, in addition to the prices of the drugs themselves, there are also the operating costs of the hospital, the compensation for low treatment for doctors, the salary of nurses, etc.." Peng Jianming said that the mechanism of public hospitals to support medicine remains unchanged, and high-priced drugs are always more popular than cheap drugs. This is not a matter of being transferred by human will. Even if Zhu Daidong is so strong, he can't change it if he wants to rely on a few documents.

However, if we start from the system, things will become much simpler. Otherwise, according to normal market rules, low prices will often sell faster, but in my country, the higher the price, the easier it is to sell. In the formation of this abnormal phenomenon, the hospital's drug addition mechanism is an important factor. According to regulations, the hospital can sell it to patients by 1% based on the drug purchase price. The hospital can earn 5 yuan by purchasing kc yuan medicines, but if the hospital purchases 0 yuan medicines, it can only earn 15 yuan. Therefore, in drug purchases, the hospital is willing to choose expensive drugs first, so that it can earn more profits.

In recent years, the National Development and Reform Commission has lowered drug prices many times, and cheap drugs are often targeted at price cuts. After each price cut, a batch of cheap drugs will always disappear. Because the highest retail price is set low, the operating space in the middle will be reduced, and the rebates that doctors have to get will naturally be smaller.

It is precisely because of the above reasons that in drug bidding, if multiple domestic and foreign-funded enterprises win the bid, the hospital often purchases a foreign-funded drug because it is restricted by the "one-grade and double-regulation" (one-grade and double-regulation: that is, the same drug can only purchase two specifications for the same dosage form), and the other chooses a company from a domestic pharmaceutical factory to purchase, or even does not purchase domestic ones. The same specifications and dosage form for the foreign-funded pharmaceutical factory are often more expensive than domestic ones.

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

"Please rest assured that our Civil Affairs Bureau will cooperate with the Health Bureau and Finance Bureau. Under the correct leadership of the municipal government, we will unswervingly promote the issue of free medical care and free education for the minimum living allowance." Peng Jianming said.

"If you have this attitude, I believe that the minimum living allowance free medical system will be implemented well." Zhu Daidong said firmly.

"It is mainly because we have Mayor Zhu in Muchuan, otherwise I don't think this system will be implemented." When Qin Xiaojuan added water to Zhu Daidong, she heard their conversation and said.

"Of course, Mayor Zhu is not only the youngest mayor in the province, but also the most courageous mayor. I have a lifelong honor to be able to work under the leadership of a cadre like Mayor Zhu." Peng Jianming glanced at Qin Xiaojuan angrily. He was talking to Zhu Daidong. What qualifications does Qin Xiaojuan have to interrupt? Although Qin Xiaojuan can be the master of his family at home, now that Zhu Daidong is here, that is working hours.

"Prime Minister Hong often said that Gong Shengming and Lian Shengwei. As long as we have no sensibility when we are working, we are honest and self-disciplined in our work style, we will become better leading cadres in the future." Zhu Daidong said that Gong Shengming and Lian Shengwei, just six short words, are easy to say, but it is so difficult to do. Some cadres have practiced for life, but in the last step, they have not been able to control themselves.

Qin Xiaojuan was happy and she wanted to say something, but Peng Jianming gently pinched her hand. On such an occasion, it was against common sense that she made a speech. If she spoke again, she would probably feel dissatisfied even if Zhu Daidong had good abilities.

"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, and today is not a formal meeting, so you can speak freely." Zhu Daidong said with a smile.

"Mayor Zhu, I promise you that I will think that you will learn from the example in the future and you will be my goal and motivation for progress." Qin Xiaojuan said firmly that she had also been punished and was demoted to half a level at the same time. Although her current working environment is better than when she was the director, she is now just a deputy section-level cadre. Now Zhu Daidong is visiting her in person. How many cadres in Muchuan City can enjoy such an opportunity?

"Comrade Qin Xiaojuan, your essence is actually good. There is no need to take the punishment you have suffered before. If you correct your mistakes, you can correct them. It is great to be good. As long as you remember what I said just now and spend your whole life to treat it as a motto, I believe you will definitely make progress." Zhu Daidong said in a serious manner. He actually knew very well what Qin Xiaojuan felt when facing herself.

I remember when I was in Yuhua County, I was very moved when I saw the city leaders. A word of encouragement and a stimulating look in his body could make him full of strength. Now, because of Peng Jianming, Zhu Daidong can be said to have a good encouragement to Qin Xiaojuan. He believes that as long as Qin Xiaojuan is ambitious, there is still room for improvement.

"Thank you, Mayor Zhu. Please see my performance in the future and you will not disappoint you!" Zhu Daidong said with a smile.

"Have, Comrade Jianming, please remember to notify me of Comrade Xiaojuan's personnel transfer in the future. I will congratulate you again and see you again." Zhu Daidong said.!
Chapter completed!