How far can the new model of “pay first after seeing sickness” go?

Yesterday (14th), there were two news stories about the same thing - seeing the doctor first and then paying the money. One was the “Dahe” report that the patient was not required to pay a deposit before being hospitalized, but paid only to pay for it. The measures were implemented for a hundred days. Nearly 2,000 patients enjoyed the convenience service and there was no case of malicious evasion. The other is the "Shangshan Business Daily" report: From February 15 onwards, Jining City's medical institutions at all levels will fully launch the implementation of the first-after-pay medical treatment service model. According to reports, since last year Jining took the lead in promoting the first-ever post-payment visit service model in the country, more than 180,000 patients have enjoyed this policy of benefiting and facilitating the public, effectively relieving the problem of “difficult access to doctors, expensive medical services, and inconvenient medical services.” .

In Luoyang City, the “first visit to the doctor and pay later” was implemented for 100 days. There was no case of malicious evasion. After the Jining pilot, it alleviated the problems of “difficult to see a doctor, expensive to see a doctor, and inconvenient for a doctor”. It is worth mentioning that this measure not only facilitates people, but also increases hospital outpatient visits, hospitalizations, and business income. This is a win-win good. Jining City Medical Reform Office Ma Zhengyao also said that this move won the recognition of the majority of patients, and objectively increased the public welfare of the hospital. This "recognition" and "public welfare" will obviously increase the credibility of the hospital.

There are many benefits to “seeing a doctor first and paying later”. First, some patients cannot afford to be turned away because they cannot pay for the moment. The patient’s illness can be treated promptly; the second is to reduce disputes and doctors’ troubles. Many patients have been dismissed for medical reasons because they did not pay medical fees at one time. As a result, the illness was aggravated. As a result, disputes were caused, and some of them even died. The families of the deceased rushed to the hospital; the third was to solve the problem of difficulty in seeing a doctor. There is money and money to cure the illness first, which truly reflects the spirit of "rescuing death and rehabilitating the wounded."

At present, the contradiction between doctors and patients has become increasingly prominent in some localities, and there are more and more doctors. Doctors complain that patients are intractable, and patients and their families complain about the doctor's indifference. This is clearly a lack of a good medical insurance system. Some local governments dumping stalls are not trying every means to solve medical problems. Instead, they transfer the contradictions to hospitals, causing ordinary people to concentrate on hospitals. This is not conducive to resolving contradictions, but also affects the stability and harmony of the society. Judging from the experience of Luoyang and Jining, it is not difficult to implement the measures of “seeing a doctor first and paying later”. The key is to improve the medical security system, increase the coverage of new rural cooperative medical insurance, medical insurance for urban residents, and medical treatment for urban employees. Coverage of insurance.

The government should take the initiative to assume its responsibilities. The medical expenses of patients with “three no” patients, low-assurance patients, and “five-guarantee households” should be paid financially instead of being passed on to the hospital. In fact, the amount of money is not much. Every place can solve the problem by reducing the cost of "three public servants." In addition, the government should make hospitals as little as possible, and pay them to hospitals in advance according to one-third or one-half of the total medical expenses last month, so as to reduce the pressure on hospital advances. Chen Muqing, dean of the People's Hospital of Xin'an County, said that in the past three months, the hospital had paid a total of 8.47 million yuan to patients. Because the NCMS and the medical insurance department implemented the system of once-a-year write-offs, the hospital has faced certain economic pressures. If paid in advance, it can obviously ease the economic pressure of the hospital. Moreover, the money paid by the peasants to the New Rural Cooperatives was paid at one time at the beginning of the year and was paid to the government “in advance”.

As the saying goes, people are long meat. You are good to me, I am good to you, the hospital can be anxious for patients, think patients think, patients and their families will think for the hospital, which is a case of Luoyang did not appear a cause of malicious evasion. Of course, we do not rule out that in the future there are malicious evaders, the world's largest, and what kind of people exist. To prevent malicious evaders, it is obviously not enough from the moral level to constrain, but it still needs to be implemented in the system. For example, Jining has already started the “first visit after paying” bad record early warning module. For patients who enjoy the “first visit, pay later” medical service model but maliciously owed the hospitalization fee, the relevant staff of the clinic hospital will enter the information about the arrears of the visit to the system. , After the verification of the information by the superior health bureau, the formal inclusion of bad records management information base. In the course of hospitalization, patients will no longer enjoy the "look first and pay later" preferential policies. Of course, other measures can also be taken to jointly stop malicious evasion.

For the public, how far the new model can go is perhaps their most concerned topic. In my opinion, the key to how far we can go is to see if the government is truly people-oriented, concerned about the people's livelihood, and good for the people. Is there anything more important than the people's life and health?