The medical website on June 9 was deployed by the national health and family planning commission, and in the end of September 2017, the national public hospitals will eliminate all drugs. What followed was a discussion of how public hospitals could survive the financial crisis after the drug's zero rate. 

 

In recent days, a move by the anshan family planning commission has reignited the industry's deep meditation on these issues. On May 27, anshan who planning commission in 2017 "anshan city public hospital pharmaceutical circulation enterprises bidding scheme selection of the bid-winning enterprises to pay the 5% - 25% service charge to the public hospital. Drug manufacturers and drug companies are required to pay a certain amount of service fee to public hospitals in accordance with the actual cost of the drug purchase. 

 

According to the interpretation of the anshan health development planning commission, the service fee refers to public hospitals to provide production and circulation enterprises "platform of information integration services, Banks, financial settlement services, inventory sharing query service, hospital logistics support service", realize the modern logistics process reengineering, and to charge service circulation enterprises, the service fee shall be borne by the production and circulation enterprises. The cost of the service, including the service cost of the settlement system, the cost of hospital financing, the cost of the hospital inventory logistics service, etc. 

 

"Is it not more than 15 percent of the drug added to the service?" The original inspector who planning commission of guangdong province, the venture capital association argue that the new wave big health club, executive chairman of liao, the practice of anshan health development planning commission fees, on the one hand is to cancel the risk of drug addition after gradually transferred to drug firms; On the other hand, it is easy for the public to think that this is another form of "medicine for medicine". 

 

Shanghai maritime law firm partner, liu also believe that this behavior is another form of drug addition, and the state development planning commission demand the cancellation of drug addition of policy direction. "The anshan family planning commission does this, does it show that the hospital has a financial problem after the state requires the hospital to cancel the drug?" Liu believes that if the hospital operating difficulties due to cancel the drug addition, who planning commission as the competent administrative department for public hospital, may be targeted to take some measures. 

 

Charging for a service charge is equivalent to the addition of a drug 

 

The anshan health and family planning commission requires drug companies to pay a service fee to the hospital in the opposite direction of the national health and family planning policy. Or is it a helpless thing to get rid of the drug? Riau said the elimination of the drug added to the problems of public hospital administrators, and that it is difficult to rely on hospitals to do more. "Therefore, the solution that the bidding platform and its relevant departments have come up with is a service charge, which would be a waiver of the government's commitment." 

 

"According to the proportion of 25% of pay service fee is more high than drug addition, and the proportion of 5% while on the surface show in public hospital to provide pharmaceutical services need to cost, but who will responsible for this part of the cost need? How to calculate cost of hospital pharmacy practice? Overkill to cancel 15% of drug addition? This kind of practice is not according to the market rule to handle affairs?" Liao's question is the beginning of a series of downsides to the elimination of drugs. 

 

"First, the government should allocate the appropriate fiscal subsidy to hospitals in time, rather than passing them on to drug companies and doctors." Mr. Liao told the health community that there is no legal basis for charging fees to the winning companies, and whether the service fee will not be determined by the bidding platform. Liao new wave, the practice will lead to all the participants in the tender drug firms will service as part of the costs of the drugs, cancel the drug addition reforms with useless. 

 

Is it legal for hospitals to charge companies for service charges? Liu said it is difficult to define the legality of the practice legally. "Who's planning commission as a public hospital administrative unit, its dispatch required to pay the service fee is a kind of administrative behavior. But in fact, the bidding procurement should be public hospitals and drug companies on both sides of the things, whether to charge a service fee, should also be kept in public hospitals and drug companies to direct negotiations." 

 

The practice of anshan is a transfer of risk, and the problem of "taking medicine for medicine" is not solved, liao concluded. "Whatever" pharmacy trusteeship "or" to the winning drug firms mandatory levies a 5% - 5% service charge, 'there is no legal basis, is' medicine for medical alternative performance." Mr. Liao said that only a comprehensive cost accounting can solve the problem of removing the drug, and that it would be impossible to use the unwise practice. 

 

The elimination of drugs is only the beginning 

 

To break the "medicine for medicine" mechanism, the national health and family planning commission requires all public hospitals across the country to eliminate the drugs by the end of September 2017. This means that public hospital income from drug addition, medical service fees and subsidies on three legs into medical service fees and subsidies on two legs. 

 

Liao new wave wrote in its microblog: with the deepening of the reform, together with departments of various policies have different time, a variety of policy proposals, problems are by no means accidental, the contradiction of both sides of Labour and capital in the future will emerge in endlessly and deteriorating. After all, the deans had nothing to do with the problem. 

 

The first step in public hospitals, he suggests, is to recognize what the 15 percent of drugs are originally intended to be. "This is a policy of compensation for hospital, is through another way to make up the finance shortage; if now cancel 15% of the drug addition, just fill in the fiscal subsidies already should be put into the part." 

 

Liao new wave of thought, in addition to the government should grant subsidies under a hospital in time, should also be careful not to transfer the contradiction to doctors, patients, drug companies, such as the parties. By adjusting the medical service price make up for the loss due to cancel the drug addition to hospital, liao new wave that have gone in some places, such as Beijing, Some places are smaller, mainly because they worry that if they move too big, there will be problems with chongqing health reform, which will arouse public opposition. 

 

Can health care play an important role? In the eyes of patients, it is a personal account, even if the reimbursement rate is 80 per cent, liao said. Some people will choose to community health service center to prescribe medicine, this is the policy play a positive role, but at the same time the problem is the community health service center of drug directory cannot be achieved with big hospital. "Through the reform, the patient does not reduce spending, but increased, only increase the degree of different, to the community clinic increased spending is relatively less." Liao said new wave.