China's health care system has made great progress. Officials from the World Health Organization said in an interview in Beijing on November 1 that there is no completely free medical care in the world. Any type of health care system needs to find various resources to raise funds, such as taxes, social security or Personal payment, etc. to support the provision of services. The government has the responsibility to establish a medical and health service system, but individuals also have responsibilities, and free will cause huge waste of resources.
Shi Hede, representative of WHO in China, said that the establishment of a medical and health service system in all countries needs to follow several common principles: First, the government must take responsibility so that people can get basic medical and health services when they need it; Individuals must take responsibility for their own health and avoid health risks. Third is to encourage prepaid insurance mechanisms to ensure that people do not have to pay large sums of money when they are ill; fourth is to ensure that poor residents can also see the disease.
He said that in order to support the provision of medical services, countries have established three funding systems: a system based on national taxation, such as the United Kingdom; a system based on the social medical insurance system, such as Germany; a system based on personal payment capacity, such as the United States. There are many ways to raise funds and WHO does not recommend them. In addition, there is no one-size-fits-all healthcare system, especially in countries with unbalanced development in areas like China.
How to evaluate the performance of a country's health care system? According to Lin Guangwen, head of health system development at the WHO Western Pacific Regional Office, there are three main areas that can guarantee that all people can enjoy equal services, and that the provision of medical services meets the needs of everyone, medical insurance. Whether the funding and distribution is fair. Before the medical reform in China, there was a problem with the entire system and the largest medical reform in the world is now under way. It has made great progress compared to the past.
Schröder said that China’s medical reform is fast, government spending on health expenditures is increasing, and personal spending is decreasing. This is an important milestone in access to basic medical services for all, while medical insurance covers 95% of residents. Very important. Next, China still needs to continue to improve in areas where everyone enjoys fair services, expands the scope of medicines and services, provides primary health care with a high quantity and quality standards.
Martin Taylor, a health system development officer at the WHO Representative Office in China, said that Russia mentioned that free medical care should be introduced some time ago. However, in reality, both the government and individuals need to pay a certain percentage of the cost. Many of China’s indicators are even better than Russia. "Each country's service system is good in some respects, and in some cases it is almost a point where there is no perfect medical system in the world."
"Free medical care" can only guarantee that patients enjoy the lowest possible medical services. According to Ren Minghui, head of the International Cooperation Department of the National Health and Family Planning Commission, there is no "free lunch" in the world in terms of health care services. Free, not free, refers to whether the patient pays for services. Even in countries that claim to have implemented free medical care, patients may be free at the time of the doctor's visit, but in fact medical expenses are already reflected in various taxes for individuals and businesses, or insurance payments. The so-called free medical treatment does not exist at all.
It is understood that Russia has not implemented a new medical security policy. Russia’s existing medical security system follows the Soviet public health system. Every Russian citizen can enjoy free basic medical services included in the national social security system. The funds are mainly derived from medical social insurance funds. Don't pay for doctors, but you need to pay for it. The queuing of public hospitals is serious, and patients have to wait for a long time. "Free medical care" can only guarantee that patients have the lowest medical services.
Ren Minghui believes that the reform of the medical system is a worldwide problem. The key point is to deal with fairness and efficiency. This is a difficult project in any country. Ensuring that all people are able to access medical services in an equal and convenient manner and controlling the reasonable increase in costs is the basic idea for the reform of the medical system in all countries. For China, a large developing country with a population of 1.3 billion, the situation is even more complicated.
Free medical theory is not established and will not work in practice. Fu Wei, deputy director of the Department of System Reform of the National Health and Family Planning Commission, believes that China is a developing country, the vast majority of them are rural populations, and there are large differences between urban and rural areas. Limited amount. In 2012, the total national health expenditure was 2891.444 billion yuan, the per capita health expenditure was 2135.8 yuan, and the total health expenditure was 5.15% of GDP. As the population ages, the health needs increase rapidly. It is unrealistic for medical services to be solely funded by the government.
Fu Wei said that the new medical reform proposes to provide the basic medical and health system as a public product to all citizens. Medical and health services can be divided into basic and non-essential. The basic part should be mainly provided by the government, and the non-essential part should mainly be provided by the market. Only by adhering to the combination of government-led and market mechanisms can China adapt to the needs of medical and health reform.
Liang Wannian, director of the National Health and Family Planning Commission’s Department of Structural Reform, pointed out that no country is completely free of medical and health services. Even if individual countries implement so-called "free medical care," not all of them are free, but there are limited items and categories. Medical services are free, not only does not meet the medical and health laws, but also causes waste of medical resources.
The expert from the Health Development Research Center of the Ministry of Health, Ying Ying, said that one of the features of medical services is the high demand elasticity and high sensitivity to price. Once free, it is easy to overuse. If universal free medical care is implemented, there are two consequences: First, medical insurance funds cannot bear, and free medical care cannot be sustained. Second, medical resources cannot be sustained. Hospitals are overcrowded and residents wait in line. Instead, people with genuine needs cannot receive treatment. When medical services are all free, individuals no longer care about medical expenses, and excessive consumption will occur. According to international research, in the medical expenses expenditure, the proportion of personal self-payment is between 20% and 30%, which is the most reasonable and is most conducive to saving resources. Free medical treatment is theoretically not established and will not work in practice.
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