Introduction:
The corruption of medical domain, already was accepted fact. But, where is corrupt generation germ? However the view with accepted neither one. And the person says person other, it seems that reasonable, do not use up actually like that. We will comb a few kinds of views.
The first kind of view, germ is represented in medicine.
Reason: Medicine represents the person be started directly that is medical domain corruption. Expression is in: Bribery of most medicines and chemical reagents is medical delegate missive; The doctor receives bribery, often be medical delegate apparently " active bewitch " ; Medical representing waits for a variety of corrupt behavior to keep secret to boodle; If the doctor refuses, medical delegate is met ground of leave no stone unturned is done " the thought works " ; If the doctor has discipline law to find out, medical delegate can do it as far as possible cloak; Medical delegate becomes medical bribery to represent on behalf of decay from medical learning, oneself also got bribery bonus.
Medical bound has the whole nation's well-known reform public figure, say " fall medical price must ' encircle and suppress ' medical delegate, the opportunity that allows a doctor to no longer recapture is buckled " .
But, medicine represents the delegate that just expedites medical enterprise. Pay bribery to who, expedite company decision; Pay how many bribery for that medicines and chemical reagents, expedite company business accounting; Pays bribery, expedite an enterprise to give money; The result after bribery is successful, expedite an enterprise to enjoy profit. Medical delegate at best is a person carry out that acts under orders to operate only.
Medical delegate is to include " profession of People's Republic of China classifies grand ceremony " proper profession. Its profession definition is " produce a business on behalf of medicines and chemical reagents, be engaged in drug information delivering, communicate, the professional of feedback. " its job job is " 1, make medical product extend plan and program; 2, the pertinent information that protects personnel to deliver medical product to cure; 3, assist cure to protect personnel reasonable with medicine; 4, collect, feedback medicines and chemical reagents is clinical use circumstance. " medical delegate became bribery delegate now, do not go radically reform, want encircle and suppress to eliminate medical delegate instead, not absurd? If eliminated medicine to represent entirely really, can be the corruption of medical domain eliminated?
Why can medical delegate operate medical corruption? China has more than 2000 years ago " tangerine is south tangerine unripe the Huaihe River, be born at north of the Huaihe River to be trifoliate orange, xie Tu is similar, flavour is actually different. The reason why person why? Natural environment different also. " understanding. If the trifoliate orange north of the Huaihe River is all disroot, move afresh kind of tangerine south the Huaihe River, be afraid have more than is needed how long, tangerine grew trifoliate orange again. Is medical delegate not such also? Fire delegate of 3 million medicine, change newlywed person entirely, still can turn medicine into bribery delegate before long.
Proper way should be the source that lets medicine represent recursive medicine learning, do the information communication between good medical service and medicine and academic promotion work, is not a knock sb. down at one stroke.
The 2nd kind of view, germ is in medical enterprise.
Reason: It is medical enterprise expedited medical delegate, arranged all bribery that medicine represents. Medical enterprise is the architect of medical domain corruption, person that incite, gainer. Had a medical enterprise punish only, restrained, normative, ability effects a radical cure the corruption of medical domain.
Medical enterprise bribery, already was the shift of a kind of sale of oneself, still draped the appearance that collaboration of academic communication, support, alms sponsors sometimes. Compete in congener product acuteness, whether to sell a success to rely on a hospital to purchase the big environment with doctor prescription in, mostly medical enterprise is really run offer a bribe what brought into an enterprise normally in, the charge of bribery of a lot of enterprises is even over normal cost. Why to want much bank note to make hang rely on a ticket? It is for system of avoid finance affairs, "Lawful " the ready money that the ground takes offer a bribe.
so much medicine business is willing to send a person his profit submissively, bearing the risk that is investigated by various government sector and taxation mechanism, censorial mechanism even? Produce this to plant widespread presence, long-standing, ban and the more than, essence that forbids the rake-off bribery appearance that makes repeatedly repeatedly, if drug company does not depreciate,depend on rake-off of case, don't bother to see me out, with respect to the drug that cannot sell oneself, this forces drug company against one's will and firm ground sends a rake-off.
Below existing mechanism, the sale of medicines and chemical reagents basically relies on economic shift. Have publicly: Invite public bidding is seleted compulsive demand a low price, exceed underbid, 2 bargain that in cooperating medical establishment to overthrow, mark a price, promise a province between minimum price linkage. Of underground have: Return a dot to return profit in the dark, rake-off of medicines and chemical reagents boodles. And this 4+7 takes a quantity to purchase centrally can depreciate on average more than 50% , by " take an amount " two words! Saved want formerly " the sales volume that finish " bribery charge.
But, medicine boodles and socially all bribery are same: Have briber already, have bribee bribee again. If pay medical company only, can check bribery, exterminatory corruption, so new what round cure changes to also won't last 10 years is long.
The 3rd kind of view, germ is in doctor.
Reason: The doctor is the person be received directly of bribery; The doctor also is to apply authority of the prescription in the hand to get intention of company of medicine of individual advantage, implementation, caustic to kill patient interest to damage a patient possibly even healthy crucial link.
But, with respect to the doctor, the doctor should live, had wanted decent life, must want to have enough work reward. The doctor has sufferred major to groom, master special adjustment the skill of life, be engaged in since heavy work is intricate work or the medical treatment job that have risk work, natural requirement gets comparative high labor pay. Existing pay system does not do this, so, can oneself try. The doctor should rely on prescription to be in a few kinds to be able to be used only, one kind chooses in inerrable medicines and chemical reagents, feedback bona fide of this kind of choice to drug company, drug company can send rake-off bribery automatically come. Look in the doctor, such doing: Advantageous to the patient, cured ill; Advantageous to the enterprise, sell gave drug; Advantageous to the hospital, finished the job; Advantageous to oneself, got money. What is there not possible? Protect damage, patient economy damage as to cure, owe my just remuneration originally, fill with this photograph! This is psychological balance of the doctor.
It is not certain that this is planted between drug company and hospital doctor face-to-face economy trades, it is our country current and scarce honest be as good as one's word, without fraudulent economic activity.
The 4th kind of view, germ is in a hospital.
Reason: Although the doctor has prescription right, but just be the staff member that in the hospital leadership administration leaves. To the doctor's bribery, hospital not only have leader responsibility, and gave in a lot of respects cooperate: Force protects the prescription inside the courtyard to flow nothing more than; The interconnected system that provides prescription drug square, cooperate to become the business accounting basis of bribery; The relevant prescription of acquiescent doctor becomes the medicines and chemical reagents of the hospital to purchase a foundation, decrease and even do not purchase not the medicines and chemical reagents of bribery; A few hospital asks to share sales commission of medicines and chemical reagents inside section office even in order to make up for the inadequacy of hospital bonus.
But, the hospital also knows rake-off of medicines and chemical reagents is to violate the act that violates discipline to commit a crime even, numerous people socially indicate, so, existing huge psychology kink. The hospital wants to receive bribery to subsidize hospital cost already, be afraid of to duty of administration, law is investigated after be being captured again. So, many hospitals are stuck went out " decline medicine is represented inside " annunciate. Last year, mid hospital of some city people stipulates medical delegate enters a hospital to must want even " inquiry of archives of crime of bribery of mechanism of hold procuratorial work tells letter as a result " ! This is a hospital doing also is not, be not being done also is not the real report of psychological kink.
In this whole bribery bribery process, medical delegate acts under orders to operate; Drug company is known perfectly well violate compasses break the law, avowed however by economic law handle matters; Doctor make use of an opportunity to do sth, inspect had made up for sweated; The hospital increased income of the member that the courtyard mies wife, most welcome. Each psychology is balanced, without ashamed regret feeling, negative blame feeling, how can preserve one's moral integrity?
Then, to germ find out begin to mechanism system development.
The 5th kind of view, germ is raising cure with medicine.
Reason: Raising cure with medicine is before the policy that the country makes public and system. Raise cure to be namely in the open income of medicines and chemical reagents with medicine the inadequacy that extraction compensates a hospital to run cost partly, and can standard its origin and amount, utility. Make public previously lawful raising cure with medicine is addition of medicines and chemical reagents 15% , 0 difference are led now, had done not have this to raise cure with medicine; Make public previously but illegimate raising cure with medicine is to default payment for goods of medicines and chemical reagents, policy already also began to correct now.
Reach the corrupt germ end of medical domain to raise cure with medicine, it is promiscuous mix illegally legal limit; 2 it is promiscuous mix under the counter public dividing line; 3 it is promiscuous the bounds of criminality and undeserved system. Get clear result hard.
19 big later, the country is right raise cure with medicine, already from " do away with " development arrived " cancel in the round " , the volition cannot call not determined. But, raising cure at best with medicine is nevertheless a kind malapropos, ought to forsaken backward system, do not bring about corruption necessarily, it and corruption have nothing to do.
Actually, generation at liberating initial stage with medicine the system that raise cure comes a few years result cannot do not have, it makes the hospital spent the period with republican the most difficult economy. But after building market economic system, the acoustical sparrow that the society oppugns rises. The mainest is a medical price theory tall accusing at raising cure with medicine. Raise cure not to have blunder with medicine actually. Make public the price difference of legal medicines and chemical reagents that raises cure to have 15% only with medicine, although the medicine of the hospital is occupied than be as high as 40% , in see a doctor the proportion of 6% also is held only in total cost, both neither is tall, also be medicine is not divided far from those who cause economy to destroy is main form. And the corruption such as the rake-off bribery of the gray black of underground, complete with raise cure to have nothing to do with medicine. Say honestly, the value that medical use is including medical service necessarily (cure is right ill diagnose and the choice) to medicine, a deal out pays medical service in medical income, be not unreasonable, bringing about the real culprit with medical price tall theory is not this open 15% addition, add however charge of a variety of gray on medicines and chemical reagents, black, normal raise cure to did not cause price of empty expensive drug impossibly also with medicine.
After the nation is rich, carry out finance allowance to cure, cancelled the addition of medicines and chemical reagents of 15% , be helpful for a patient of course. But this and anti-corruption are defeated have nothing to do. Raise cure with medicine, can carry out, also need not carry out. If carry out, also can have the choice of form and amount. After all, below market economy condition, compensation hospital " commonweal " the channel of property has a variety of. Traffic system still is in now carry out " with car maintain a road " policy, although already from asked for foster travelling expenses to change to be in gas price directly collection, the society does not have very big opinion! Why to raise cure to won't do with medicine?
The 6th kind of view, germ is not divided in medicine.
Actually, the germ of medical domain corruption depends on medicine be not being divided, turn over corruption to must want to carry out medicine to part from root. Medicine is to show the hospital opens outpatient service chemist's shop no longer apart, have the capital pass in and out of outpatient service medicine no longer, use medicines and chemical reagents to purchase authority to ask drug company is offerred no longer assistance is expended and return a dot to return profit; The doctor's prescription not demarcate buys drug in hospital pharmacy, drug can be bought in any society drugstore, the doctor uses prescription authority to receive sales commission no longer.
To medical corruption, raised cure to just provide the source of capital merely with medicine, and can carry medical money to cure, need mechanism medium of communication. Medicine is not divided is this mechanism channel.
Each developed country of scan widely world, basically be medical departure mechanism, and social drugstore takes drug retail terminal proportion is very high. Have data exposure, this is occupied comparing the United States is 75% , france is 85% , germany is 84% , japan is 89% , and China has 20% only. Now our country even if the opinion that objects medical departure, the decisive action that also cannot deny medicine to be not divided in high side of medical price theory and the mechanism sex action in medical corruption respect.
Be medicine is not divided, brought about medical price theory price is tall, high marketable, low medicine disappears, medical look forward to develops new drug, entrance drug feebly abuse of flush, antibiotic, big prescription is common, outstanding the doctor is converse fall into disuse, insecurity of relation of doctors and patients, society is dissatisfactory national medical service.
If be err of hospital of a few doctor, minority or crime, OK of course the individual quality of these people mixes ascribe moral character. And if be a lot of doctors, a lot of hospitals,commit a crime in err? This affirmation is the system gave an issue. Although the country is puissant,the rake-off that hits medical field boodles, still ban repeatedly however make repeatedly, make repeatedly ban repeatedly be banned however and incessant, because the mechanism is in,do bad guiding namely.
Doctor prescription is only originally treat a disease cure disease, but do not divide a mechanism to fall in medicine, prescription also has the function of carry out medicine. Add sex of technical nature forestall, medicine did not divide a mechanism to form expedite bribery line, leave from prescription piece, settle accounts of date from of statistic of prescription dispensation, dispensation, dispensation, individual, rake-off reachs the designated position, this circuitry is expedite inside a hospital. The generation of bribery is inevitable almost. On name, the doctor assumed all notoriety, actually, this bribery line included a hospital almost all experience medicine personnel, include statistical personnel even. If patient from dispersive the social drugstore dispensation of much home, form do not dog into bribery those who pay is expedite.
So, the overall train of thought with apart medicine ought to be the join catenary that cuts off doctor prescription and sale of medicines and chemical reagents, drive doctor prescription to need to set out from the illness only; Cut off a hospital to purchase the join chain that sells with medicines and chemical reagents, drive a hospital to do servive routine of good rear service for the doctor in the respect that use drug. And various now holidays " medicine is apart " , often intended innocently evasive this.
Offer social security to look from need, besides seek profits besides the way that sexual hospital takes to decide service, free competition, assume sole responsibility for its profits or losses oneself, seek profits as commonweal sex blame sexual hospital cannot rely on charge of diagnosis and treatment to maintain and develop his only really, need government financial is necessary support, this has no exception all over the world. And how is medicine apart? How to give aid to commonweal sex blame seeks profits sexual hospital? That is another topics.
Wei Zi says cure changes -- of audible Wei Zi, the doctor that sees so that see changes
Cure transforms a group
100 cure change the hall that expert scholar idea hits,
The ground setting out of new journey of open of look forward to of many 6000 medicine,
Hundred thousands of cure changes an architect in all the conference sitting room of business a major programme of lasting importance,
Doctor of 100 much country is not dark from what do not abandon love the ground,
The mental home of hygienists of 11 million medical treatment,
1.39 billion compatriots pays close attention to expectant healthy the Holy land jointly.
