Research On Chinese Public Medical Treatment And Sanitation Guarantee System

Since the reform and opening policy in China, our medical treatment and sanitation field has developed into the direction of marketability step by step during the course of introducing market mechanism to China. The concerning organiations greatly promote the reform of its system's marketability under the circumstances of vague orientation, the lack of orientation and offside between the government and market. The results are the problems which have become a serious cancer in building a harmonious society: the narrow coverage of public health guarantee and the damage to the equality of medical treatment, the fragility of public health guarantee system and the declining of the government's function, the extraordinary rise of medical cost and unreasonable criteria of evaluating medical efficiency, the high medical expenses and the lack of effective resolution to bad medical ethics and behaviors, the chaos of medical market and the conflict between doctors and patients, the deviations of the government's path to regulate medical organizations, the worsening of exterior environment of citizen's health guarantee,etc. Facing the present troublesome situation of our national public medical treatment and sanitation reform, some people believe that the main cause is the incomplete marketability of medical treatment and sanitation, so we need to speed the reform of marketability and let market mechanism function more completely so as to get out from the present difficult situation. Can the medical treatment and sanitation field get more progress following the idea of the reform? Is marketability is the only solution to solve all the problems which appeared? This dissertation through both the theoretical and the empirical analysis and studies gets a different conclusion.I the general idea and structureThe whole dissertation falls into 5 chapters with the following main ideas and basic viewpoints:Chapter One, theoretical analysis of medical treatment and sanitation and governmental intervention. This chapter is mainly divided into two parts. The first part theoretically demonstrates whether the medical treatment and sanitation can be provided in term of the market rules which include the attribute and classification of medical treatment and sanitation, market failure in medical service and the necessity of the governmental strong intervention. The second part demonstrates the dialectic relationship between the guarantee system of medical treatment and economic and social development.Chapter Two, international comparision and revelation of the reform of public medical treatment and sanitation guarantee system from the international perspective. In the developed countries which carry out market economy,social public medical treatment and sanitation guarantee systems of different ranges and levels have been generally formed from the end of the 19th century to the middle of the 20th century. This chapter probes into the medical treatment guarantee system of western societies and mainly focuses on the guarantee system pattern of Britain's general social medical treatment, part of American medical treatment guarantee and Singapore's health guarantee fund. British and American public sanitations which are paid much importance by the governments have relatively complete law system and operating mechanism. Their concerning government units have quick response, good cooperation and take charge of their own duties.Chapter Three, retrospection and reconsiderations of public medical treatment and sanitation guarantee system since the establishment of the New China. During the 30 years from 1952 to 1982 when our country was still under the condition of poor financial situation and low general investment into medical treatment and sanitation, our people's average life span has increased from 35 years old to 68 years old, and baby's death rate has decreased from 250‰to 40‰and malaria attacks from 5.5% to 0.3%. Before the opening reform, our government-dominated medical treatment and sanitation guarantee system accords with objective rules, and our governmental intervention in choosing the way to develop medical treatment and sanitation career also tallies with objective rules. Since the opening reform, the system has come into the market, resulting in choosing the wrong reform path. Besides, the exterior environment of social public health guarantee is not optimistic, so the public sanitation would face big challenges.Chapter Four, the innovation train of thought of our national public medical treatment and sanitation guarantee system. Facing the trouble situation of our medical treatment and sanitation guarantee system, the central government and theoriticic field attach great importance to it and actively seek new reform ideas and countermeasures. The general thoughts of perfecting our national public medical treatment and sanitation guarantee system are the following two points: one is to reestablsh the government-oriented medical treatment and sanitation guarantee system; another is to separate medical treatment and sanitation. The government would be responsible for public sanitation while medical treatment would continue to move into the direction of maketablity reform. Suqian medical reform embodies a concentrated reflection of the second idea. From both our national and international expericence, we can see that the second reform idea violates the basic development regulations of medical treatment and sanitation and would put our reform into a more troublesome situation.Chapter Five, the research of our national double public medical treatment guarantee system. The realization of the double general medical treatment guarantee system is the aim of the reform. The problem which comes first is how to keep it run effectively and how to guarantee the outlay. It researches the operation of compulsive general social medical treatment. The first is the operation transitional double compulsive general social medical treatment guarantee system; the second one is the compulsive general social medical treatment guarantee system in the harmonious society. The chapter also discusses and designs the operation mechanism of general social medical treatment guarantee's organizing and management and some preconditions of making it function effectively.II the main innovative viewpointsThe dissertation has the following innovative viewpoints:1. Designing our nation's pattern of general social medical treatment guarantee. (1).Double compulsive general social medical treatment guarantee pattern. This pattern consists of Part A and Part B. Part A is the pattern of general social medical treatment guarantee for the town people. Part B is for the country people. In Part B, volunteering taking part in the countryside cooperative medical treatment has been changed into compulsive attendance. (2).compulsive general social medical treatment guarantee pattern in the harmonious society. Under the precondition that dual economic structure and dual social structure have been almost eliminated, all the Chinese citizens should perform social medical treatment guarantee system in the light of the uniform layout and standards and combine the transitional double general Medicare pattern A with pattern B.2. Developing the meaning of public sanitation. The paper puts forward the meaning of public sanitation in a broad sense, including direct and indirect public sanitation and their corresponding policy suggestion.3. International perspective of the reform of public medical treatment guarantee system. Through probes into the medical treatment guarantee system of western societies and mainly focuses on the guarantee system pattern of Britain's general social medical treatment, part of American medical treatment guarantee and Singapore's health guarantee fund. We should lead to establish general social medical treatment guarantee system in our country.4.Innovating the choices of the path to increase financing input to the health guarantee for the population under the poverty. The financing payout items should be put in an order and advanced step by step according to financing situation. The choices of the path of the health guarantee for the population under the poverty are: providing them with government's food ticket→improving quality of drinking water and air and increasing financing support for pubic sanitation prevention→providing them government's medical treatment ticket.5. Designing the special Medicare tax system and innovating managing mechanism of general social medical treatment. The paper designs the special tax system for Medicare. The core of the operation mechanism for management is to manipulate the behaviors of hospitals and doctors to control the cost of medical treatment through general social Medicare. The cost will be supervised by carrying on the budget of total amount for the hospital and government employee system for the doctor. There is no connection between hospitals and doctors'income and medical treatment expenses. Income and expenses become two different lines. Scientific criteria should be set up to evaluate hospital and doctor, and the approach of both qualitative and quantitative analysis should be adapted to scientifically evaluate public hospitals and doctors.