2009年8月26日星期三

The Beijing News: Medical information disclosure is not only a matter for the hospital

Of course, it must be recognized that information disclosure is only to solve medical and health information technology, asymmetric means to belong to a stopgap policy, the fundamental solution lies in the supply and demand of medical services at two levels scheme.



Recently, the Ministry of Health on "medical and health institutions to implement information disclosure approach" (hereinafter referred to as "methods"), extensively solicit public views. "Procedures" specify that hospitals should focus on public health service prices, seven categories of information. ( "Beijing News" August 25)



Medical and health institutions as a medical and health system, one of the terminals, to provide true and reliable public source of information is supposed to its statutory responsibility.



The implementation of the medical and health information disclosure, an important reason is that this industry has a serious information asymmetry. Medical services was concentrated expertise: good health or not, the severity of the disease need to take medicine disposal, the patient has no ability to distinguish, everything depends on the doctor's look Smelling cut. It is a monopoly of information by virtue of this technology, the patient's medical consumer behavior have complete control over the hands of a doctor's prescription --- big red envelope kickbacks and excessive medical and other strange status quo, are the source for this.



And other goods and services are different, medicine consumption is often difficult to pre-determined price. While China's medical services and drugs are already being implemented strict price controls, but this means that a lower nominal prices, however, the actual price is another matter. Whether to buy a TV, or enjoy the travel agency services, there were not clearly marked in advance, the customer has a price before the full right to choose. Medical services are not, a pre-agreed standards for fees and medicines can not be the actual cost of a fixed limit. As the complexity of disease and individual differences, the doctor may have different treatment options, the prices are also nominal He also goes to be hundreds of combinations of the cost difference is heaven and on earth. With a cold, ranging from two hundred to spend, while in a thousand dollars, is hardly new.



Is for this reason alone, the open medicine prices and fees, for the people, but more than mere symbolic significance. Proposed "measures" might be more in-depth step, the actual cost of medical services to include, such as in-patient public hospital out-patient meeting all costs, the average cost of medicines in different disease, and other information, and different hospitals in different diseases, the average costs of comparison, the public will see a doctor prior to the actual price of the medicine a relatively clear-cut judgments can be made "shop around" and rational choice, but also conducive to promoting competition in the hospital. Of course, this price information platform is not only a hospital can to whom the health sector should assume the information collection, analysis, comparison and release functions.



In fact, the price of in-depth medical and health services open, Beijing has been trying. From the second half of 2002, the Beijing Municipal Health Bureau to the public some hospitals in Beijing, "acute appendicitis, nodular goiter, benign ovarian tumors, uterine fibroids, ectopic pregnancy, cesarean section" and six kinds of single disease The average cost of hospitalization and hospital stay of indicators. This measure has achieved good social effects. However, such disclosure of the diseases covered by little, excluding only for hospital out-patient clinic, and the range is only part of Beijing's hospitals, there is much room for improvement.



Of course, it must be recognized that information disclosure is only to solve medical and health information technology, asymmetric means to belong to a stopgap policy, the fundamental solution lies in the supply and demand of medical services at two levels scheme. Some experts believe that, because health care information asymmetry, so the Government can not open up the medical services market, otherwise there will be more supply-induced demand, medical expenses will be accelerated. The logic and practical experience poles apart, may I ask: compare the full competition and monopolies, under conditions in which unscrupulous business practices and will be less? The correct logic with these experts, advocates the opposite: the regional health planning and tax policies to encourage access, should make significant policy adjustments, to mobilize all the resources can be mobilized supply, through full competition to restrain supply-side behavior to reduce their information monopoly advantage.



In addition to supply-side constraints, the demand-side constraints are also essential. With only the individual patient, it is difficult with the hospital the doctor's professional knowledge and skill to compete. Health insurance institutions as the purchaser of the concentration of agent, can be professional and technical strength and service management tools to make up for this deficiency. Similarly, the district where the limited power of individual owners, but once the group transformed into owners associations negotiating power, the property situation of one party dominance probably should have been balanced. (This article Source: The Beijing News)



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