People expect that all doctors can help the world, revitalize their hands and cure all diseases. However, there is a famous saying in clinical medicine, sometimes it is cured, often it is relieved, and always it is comforted. Sometimes it can be cured, often relieved and often comforted. )

Not only is the doctor's ability to face complex diseases limited, but the high medical expenses are not affordable for everyone. A person is seriously ill, and the whole family may return to poverty overnight. I saw a study today. Even in the United States, where the medical level is leading the world, the first reason why people go bankrupt is that they can't afford medical expenses.

American medical technology is very developed. It stands to reason that it should be easier for ordinary people to see a doctor. Why do you see bankruptcy when you see a doctor?

How high is the medical cost in America?

According to estimates, in 20 18, the per capita GDP of the United States was about $62,500, but the per capita medical expenditure was 1000 a year. In China, the per capita GDP is about 9900 dollars, and the per capita medical expenditure is 500 dollars. This means that China people can't earn enough money to see a doctor in one year. Even in proportion, the per capita medical expenditure in the United States accounts for 16% of GDP, which is five times that of China. This is equivalent to creating a GDP of 20,000 yuan every month and getting a monthly income of 654.38+0.000 yuan, but you have to spend1every month. 600 yuan spends nearly 20,000 yuan a year on the original medical care.

In our country, according to common sense, we can feel wrong, because it is almost impossible for a person without major diseases to spend tens of thousands of dollars a year on medical treatment. Generally, it is good to prescribe dozens of medicines for minor illnesses, and with the examination fee, it will cost hundreds of dollars. Suppose a China person spends an average of 300 yuan on each minor illness, and 20,000 yuan is enough for him to see a doctor for 67 times. Only by seeing a doctor every five days a year can he spend so much money.

The sky-high medical expenses that we don't eat or drink for a year are also unbearable for the American people.

Foreign media reported many things about the high medical expenses in the United States. For example, a girl with a broken hand went to the emergency department of a public hospital in San Francisco and later received a bill of $24,000. Although she bought commercial insurance, the insurance was only reimbursed for $3,800. Later, she asked the media for help everywhere, and the hospital was forced to change her mind and only charged her $200.

As soon as the news came out, more than 2,000 readers sent sky-high medical expenses to the media, and all kinds of complaints were jaw-dropping. Someone went to the hospital to see abdominal pain, and the doctor suggested natural therapy (that is, returning to normal life without medical intervention), but backhand sent him a bill of 8 thousand yuan; Parents take their baby to the emergency room. The doctor's treatment content is to let the baby take a nap and drink a bottle of milk, but in the end it will cost 6.5438+0.8 million US dollars. ...

This is not the behavior of some unscrupulous hospitals, because it is very expensive to call an ambulance in the emergency department in the United States, and the pricing of drugs in the United States is not fixed and transparent. Different States, different hospitals and different treatment methods will have different prices, and the gap is very large. It is not unusual for pharmacies to sell only dozens of medicines, nor is it unusual for doctors to charge you thousands of dollars for medicines. As for surgery, without reference, it is even more difficult to compare prices.

Some time ago, I went to a third-class hospital to see an ophthalmologist, and found that the sign on the wall said the pricing of myopia correction surgery, laser treatment and full femtosecond treatment. The price of monocular is very clear. In American hospitals, it is impossible to see a sign indicating the cost of xxx surgery, and the cost is subject to the bill finally received by the patient.

What's more, in the United States, there are also high and low levels of medical care. Those with high-priced commercial insurance can make an appointment with a doctor first, and poor people without commercial insurance often have to wait for several months to make an appointment with a doctor. A minor illness becomes a serious illness, and even if it hurts, they will have to bear more medical expenses in the end.

Differences between Chinese and American medical systems

In our culture, we emphasize morality and always say that doctors are kind; In developed countries, elite doctors are selected and given an average salary of 4-5 times. In any case, the ability and morality of doctors will not be a big problem, so doctors are not the key to difficult and expensive medical treatment.

The crux of the problem actually lies in the medical system.

The medical system is simply the relationship among patients, medical service providers and payers. In China, it is social security and self-funded that pay the bill; In America, commercial insurance is the main way to pay the bill.

The United States has designed an insurance model based on commercial insurance, leaving only a small proportion for patients to pay for themselves. The original intention is actually good. However, the system itself has fatal loopholes. As long as insurance companies and medical institutions join hands, patients can be fooled.

Actually, it's easy to take advantage of loopholes. Insurance companies only need to persuade medical institutions to issue sky-high bills. The original treatment cost of 1000 dollars was set at 20,000 dollars, and then the patient paid 900 dollars at his own expense, and the insurance company paid 100 dollars. The perfect medical expenses were passed on to the patients, and most of the premiums became profits.

Then someone wants to ask, why not just cancel their own fees?

No, if all medical expenses are paid by insurance, the result is that patients overuse medical services and waste medical resources. In order to prevent the price system from getting out of control, the United States tries to separate the insurance company from the payer who finally pays the bill, but it will inevitably lead to a longer process, lower efficiency and higher cost.

However, Obama's four-year medical reform efforts were overthrown by Trump as soon as they came up. It can be seen that it is difficult for the United States to implement universal medical insurance, involving a wide range of interest groups.

So how does China, as the main payer, realize social security?

In the early years, China's medical resources were very backward, and it was the key to let most people see a doctor first, so the unified control of nationalization was reasonably implemented. After the reform and opening up, for the sake of social stability, medical care did not dare to market prices at will, and part of the marketization became the Putian system that we are now criticizing. At the same time, the implementation of commercial insurance is more difficult, because China people are generally unwilling to buy insurance for unknown needs, and without insurance, many people can't stand paying their own expenses. Without social security, the affected groups will be thousands of ordinary people in Qian Qian.

Although social security is a great advantage, China's medical system is not without problems. Blind price limit will make the proportion of labor cost in medical expenses too low, and the registration fee of a few dollars at a time is too meager for doctors, thus giving birth to the phenomenon of "taking medicine to support doctors", which is also commonly known as taking kickbacks.

It is equally difficult to see a doctor all over the world. From an economic point of view, medical price and medical quality are always contradictory. Just like playing mahjong, someone always loses and someone wins, or everyone doesn't make money, but it is impossible for everyone to make money. Cherish the relatively cheap and accessible medical resources. Of course, the most important thing is to take care of yourself and try not to get sick.