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Buy and sell, namely business concern is a requirement that makes the market, but not be sufficient condition, do not have the market namely, can have business concern likewise. Below the circumstance that does not have the market, business concern can be a kind of content that is a foundation with interest exchange authority changes a relationship.
Clear what doing is the market, do not have what meaning it seems that, actually otherwise. A lot of errors come from a definition to not be clear about.
Lin Hang stops in " economic lintel " in one book piece for " doctor and economist " in have a word: "... doctor and disease person the person that the relation makes deal, the doctor sells medical skill holds medicaments bagman part-time at the same time, buy its to serve the person that reach drug to be a patient, although medical affairs market is free competition, for the circumstance with Hong Kong, it is all the freedom between the doctor that suffers education and training in country of big the British Commonwealth competes, but when disease person when facing a doctor, the doctor already became the monopolist of cure patient or monopolist; The patient serves as consumer, to the demand of medicines and chemical reagents and doctor service, be not take the place of by the doctor however by him consumer he makes a decision, a lot of ‘ pecuniary problem ‘ from this and unripe. A lot of ‘ pecuniary problem ‘ from this and unripe..
This shows, the market that alleged medical services, suffer from than doctor and disease between hospital and hospital, doctor and doctor between competition wants some more sufficient, and between the consumable manufacturer such as home appliance, between the businessman, between businessman and consumer, than the competition between hospital and hospital, doctor and doctor more sufficient. If we reach complete market,complete blame differentiates between the market for 5 grade: Complete market; More complete market; Follow the market; Relatively not complete market; Complete blame market.
This shows, from participate in competitor to look, a complete market, the freedom that must be the requirement of limitation of nature of no more than that including two above competes: One is congener product many generator (or sell a supplier) the competition between; Another is to not have specific the free choice that the much person that consume demand faces the blame of many suppliers to limit a condition naturally. Before one each reduces utmost ground cost by competition, improve quality, stimulative efficiency; One each will form the direct award to the winner by the choice after, make free competition can continue thereby, this kind of award can be integrated also can be one-way. The integrated generation that will lead dimensions to turn a company, and the one-way progress that lays hurried professional fractionize enterprise.
And medical services, be relatively not complete market.
Above all, the before 1997 Hong Kong that whereaboutsing exemple of forest of no less than lifts, there is some kind of competition between hospital, doctor, but when the patient faces a doctor, basically be a doctor " sell " what, patient " buy " what. And to the mainland, should face possibly still appoint a hospital, perhaps wait as a result of district condition limitation, identity limitation, cannot select a hospital. This is similar be appointed the product that can buy a certain brand only, do not have so that use otherwise. How do this call medical services market? Next, a lot of countries of the plan or district are ensured in cure of real practise medicine, give money to buy only medical services to ensure a service by the government, often be supplied the influence of shortage, and make the sale Fang Jiang that medical services changed what serve to medical services to buy carry out to be controlled just. For example, want to become an operation in Hong Kong, need queues up for a long time, of course the reason of high-sounding is to cannot make operation doctor too fatigue, will fall otherwise operation character, also be right the doctor rests the encroachment of authority... , but on the other hand, because this is planted,also be operation to hospital, doctor it is " take running water " sale, gain is very small very low. No less than can risk the risk of decapitate for the profit of 300% ; For 100% can risk be punished by the danger of put in prison; For the profit of 50% OK and screwy conscience abandons self-respect; For the profit of 20% can work from dawn to night; Do not have the energy that anyone is willing to take up more than 10 minutes for the profit of 1% . Then people says or state with certainty according to last kinds of circumstance only public-operated lacks efficiency, privately owned ability is businesslike, this is be a kind of misunderstanding. The 3rd, medical services has two dualism, make commercialize difficult think afterwards. The first dualism is it since is exalted is lay. Depend on saving human life loftily, tell what also should not do to money from some kind of angle, perhaps say how many money to also can‘t grab those who answer a lot; Depending on it after the flesh must want to spend money again, it is to cannot continue otherwise exalted. In this dualism, basically did not commercialize a space naturally. The 2nd dualism is a complete medical services needs software to need hardware again already, namely the doctor can contract what disease through the technology judges a patient well and truly, how to treat, can cure, rehabilitation arrives what degree, but must achieve cure finally through medicaments, operation. Chinese mainland appears raise cure with medicine, be pair of software deny and the affirmation to hardware, the doctor is forced to cooperate through be being represented with medicine " buy drug " the receivable accrual that will compensate him software to sell. In this dualism, involve the depart that commercializes content.
Pass afore-mentioned analysises, I think: 1, protect means to solve problem of patient go to a doctor with cure, must have done two basic: The first be medical services resource is balanced change; The 2nd it is to be in related appropriate of national full specified amount below money premise, assess quality of diagnosis and services and amount of diagnosis and services strictly. Medical services resource is balanced change majority of utmost ground desalt run-of-mill disease has the concentration to alleged large hospital, and the appropriate of full specified amount of medical services money, should ensure the doctor passes eligible software namely -- of medical services technology " sale " the due pay that can get can is approved, realize the depart of cure, medicine. Make medicine makes a kind of common provision like soy, biscuit, suffer from consumer to be bought quite by disease. And the ability below the premise that rigorous assessment cares about to be able to expect an increase in the person that be assessed only is significant, when the person that if is assessed does not care about this interest, him person that assessment itself can make assess the awkwardness of a loner of be confined to. 2, the buying and selling between the doctors and patients in service of desalt medical services concerns, exist far from between doctors and patients commercialize a problem, the correspondence that is medical ethics of cure the sickness to save the patient and devoir of dialogue garment angelic concerns, so, core of relation of doctors and patients is a doctor censure limits must clear and specific, the duty that the patient must perform is compulsory, about additional disbursement share is cost only, and besides using up sexual defray, other regard updating equipment as charge only door memory, use at updating equipment to transform. Also be to say a hospital namely cannot the in paying fee extraction from the patient a minute of any money, only such ability put an end to a hospital to borrow thoroughly machine the likelihood that seek profit. And the doctor markets any medicaments, instrument to the patient, should inform against only belong to solid, cancel doctor qualification. 3, the service price that pulls open hospital of civilian battalion profitability. This kind of hospital should commercialize structure of diagnosis and services purely to be surely, do not assume cure to defend a service, all prices must not maintain a level under cure, service of all medical services must not bring into cure to protect cancel after verification, the government must not provide any subsidy. The hospital of profitability controls government according to the company, year end profit should decide share out bonus according to the board of directors. But civilian battalion is not profitability hospital, have beneficent quality, should prep according to completely cure protects sexual hospital to begin a service, undertake administrative, enjoy national policy privilege, but cure protects the relevant money outside dealing with cost in order to to be assumed by civilian battalion partner, as encourage, the money that its assume can prep according to charitable contribution enjoys taxation policy privilege.
Anyhow, in China the circumstance with sincere letter extremely low level falls, enrich the people in the country before the reality of deficient, if of medical services system goes commercialize, it is the road of a failure certainly.
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