院长下令:不得采购进口药、新特药和高价药!

2017-04-11 持平 健识局

今年,院长给全院下了新命令:无论何种原因不得购进进口药、新特药,原则上不采购高价药,医生不得用辅助药,约谈要占比超过30%的医生,有的外科医生因为药占比超过了30%,内科医生只要月药占比超过40%的停止工作。对一些高值耗材或高价药品必须院外药店购买。中成药的数量也大大减少,有段时间,中成药在该医院都不见了踪影。上面这些现象出现的原因是降低药占比和药品零加成政策全面执行,医院面临的压力正越来越大。医


今年,院长给全院下了新命令:无论何种原因不得购进进口药、新特药,原则上不采购高价药,医生不得用辅助药,约谈要占比超过30%的医生,有的外科医生因为药占比超过了30%,内科医生只要月药占比超过40%的停止工作。对一些高值耗材或高价药品必须院外药店购买。中成药的数量也大大减少,有段时间,中成药在该医院都不见了踪影。

上面这些现象出现的原因是降低药占比和药品零加成政策全面执行,医院面临的压力正越来越大。

医院这样应对药占比和零加成政策

上面涉及的医院是豫北一家县医院,在当地也数一数二,占一半以上的医疗市场。

2015年这里就开始严格执行药占比制度,县级医院绩效考核将县级医院药占比指标定为40%以下,而该院之前年度药占比为50%以上,如果超过考核指标将拿政府财政预算的退休工人资金兑现。

怎么办?于是该院院长就使出“扩大分母压分子”的做法,在职工会上要求医生少开药、不用高价药而多开检查化验,比如将血型检验也作为所有住院病人的常规检查项目,CT、核磁及彩超成了该院的重要收入来源。于是该院的年度药占比仅仅19.89%,是全省综合医院药占比最低的医院。但实际上药品总销量并没有减少,全年业务收入1.4亿,其中药品销售近4800万元,仍是一笔不小的收入。

2015年末该院开始实行药品零加价制度,按照国家有关政策,县政府需要对医院的零加价药品一定比例补贴,但半年过去却未见政府补贴款的踪影。怎么办?于是院长找县长“要账”,然而壮着胆子去却灰心丧气归,为什么?

原来该县是省级贫困县,县财政紧张,补贴的确有困难,县长看院长“一心为公”要账,于是就用“请你想办法解决,如果的确有困难,我就让别的同志去试试看”,一句话让院长灰溜溜返回。

所以,只能自身想办法。要减少损失,只有两个途径:少卖药和多开检查。多开检查之后, 影像检查成了收入主要途径,但是国家也开始意识到这一点,检查、检验机构要开始独立设置了,按病种付费也开始逐步推行,多开检查的路子已经愈走愈窄。

于是,这家医院开始走剩下来的一条路径:少开药。有人的或许说,医院也可以二次议价,对于县医院来说,这无异于痴人说梦。

按照药品年销售额,县医院规模有限,在和药企的谈判中处于弱势,药企其实并不在乎一家县医院。国家政策虽然强调大病不出县,要提高县医院的能力和水平,并且要和三甲结成联盟,但是,目前并无任何三甲医院联盟。

在药品销售额不高的情况下,少用药就成了唯一的选择。

于是该医院想方设法减少药品进购及销售——不进购进口药、新特药、高价药,医生不用辅助药,有段时间该院中药房的中成药也几乎是不见踪影。

2017年该院换了院长,又采取其他办法来进一步压低药占比,减少减轻政府财政负担。比如引进开展介入、微创等外科项目,另外出台新的“制约”政策,对药占比过高医生进行约谈,内科医生只要月药占比超过40%的停止工作。对一些必须高值耗材或高价药品院外药店购买。

医改政策推行需要有改革

“三医联动”是医改核心的措施之一,三医假若真的能够联动的话,医改就有成功的可能。但是在现实中,新医改降低减少病人医疗消费的主要靶向是医药,从集中招标采购到二次议价和“两票制”,从限制公立医院药品销售指标(药占比)到干脆药品零加价销售等,这些措施都是为了保证医保基金不透支,减轻政府的财政负担或压力。

但是,零加成、药占比在执行中往往变了味,没有减轻或变相加重了病人负担。

笔者认为,要想真正实现缓解百姓“看病难看病贵”目的目标,就必须在病人的医疗消费项目组成上动脑筋,比如实行按病种付费,比如政府零加价补贴必须准时到位,比如将药占比、诊疗效果及病人平均消费与绩效考核挂钩,而不能单纯讲药占比。

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    2017-12-08 雕雕
  2. 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    2017-06-09 rjchwd

    太难了

    0

  3. 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createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLANEL7Sww3HicKsN9aribicAmGGWXOIMEiaZ1iadgZg9RibjqSwIKUS8gSPib2NwTVg2zVvVJhdP3BkuDIl/0, createdBy=944d1605392, createdName=shaosai, createdTime=Wed Apr 12 09:44:23 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186849, encodeId=8095186849ab, content=签到学习了很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/A3E53E62691178E2F18D7B999FD22131/100, createdBy=f44d2003846, createdName=Chongyang Zhang, createdTime=Wed Apr 12 09:43:10 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186828, encodeId=ccf3186828b7, content=医改是个大工程!, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kym1A9qicflExZYSdibSZBHDyicKZZj37w4jR44fPa9DI3mVLObHAxzntpTAbwxeHvviclcw8coNrDge/0, createdBy=6dc22001775, createdName=春暖花开8785, createdTime=Wed Apr 12 08:47:10 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186816, encodeId=3c7a1868166c, content=难啦!都是钱的问题。, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdicLmdJEK9VoiaDianY6fzHNN9iaGv80m39pMHU3eSnNN0kn1o0rdQ7Bz2f03Qibcf1ia7rKvxIt4UVlErF2d4gCmDC5/0, createdBy=98e31740255, createdName=cqykthl, createdTime=Wed Apr 12 08:33:42 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186809, encodeId=e60f18680987, content=过犹不及, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Wed Apr 12 08:06:10 CST 2017, time=2017-04-12, status=1, ipAttribution=)]
  4. 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topicName=采购)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9bb312387914, createdName=wolongzxh, createdTime=Thu Apr 13 12:33:00 CST 2017, time=2017-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186859, encodeId=8472186859a8, content=赞一个,赞一个!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160914/IMG57D82E721DB581755.jpg, createdBy=4fc81933929, createdName=明天会更好!, createdTime=Wed Apr 12 10:10:47 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186851, encodeId=1334186851c5, content=好好学习,涨知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLANEL7Sww3HicKsN9aribicAmGGWXOIMEiaZ1iadgZg9RibjqSwIKUS8gSPib2NwTVg2zVvVJhdP3BkuDIl/0, createdBy=944d1605392, createdName=shaosai, createdTime=Wed Apr 12 09:44:23 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186849, encodeId=8095186849ab, content=签到学习了很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/A3E53E62691178E2F18D7B999FD22131/100, createdBy=f44d2003846, createdName=Chongyang Zhang, createdTime=Wed Apr 12 09:43:10 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186828, encodeId=ccf3186828b7, content=医改是个大工程!, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kym1A9qicflExZYSdibSZBHDyicKZZj37w4jR44fPa9DI3mVLObHAxzntpTAbwxeHvviclcw8coNrDge/0, createdBy=6dc22001775, createdName=春暖花开8785, createdTime=Wed Apr 12 08:47:10 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186816, encodeId=3c7a1868166c, content=难啦!都是钱的问题。, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdicLmdJEK9VoiaDianY6fzHNN9iaGv80m39pMHU3eSnNN0kn1o0rdQ7Bz2f03Qibcf1ia7rKvxIt4UVlErF2d4gCmDC5/0, createdBy=98e31740255, createdName=cqykthl, createdTime=Wed Apr 12 08:33:42 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186809, encodeId=e60f18680987, content=过犹不及, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Wed Apr 12 08:06:10 CST 2017, time=2017-04-12, status=1, ipAttribution=)]
    2017-04-13 wolongzxh
  5. 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createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLANEL7Sww3HicKsN9aribicAmGGWXOIMEiaZ1iadgZg9RibjqSwIKUS8gSPib2NwTVg2zVvVJhdP3BkuDIl/0, createdBy=944d1605392, createdName=shaosai, createdTime=Wed Apr 12 09:44:23 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186849, encodeId=8095186849ab, content=签到学习了很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/A3E53E62691178E2F18D7B999FD22131/100, createdBy=f44d2003846, createdName=Chongyang Zhang, createdTime=Wed Apr 12 09:43:10 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186828, encodeId=ccf3186828b7, content=医改是个大工程!, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kym1A9qicflExZYSdibSZBHDyicKZZj37w4jR44fPa9DI3mVLObHAxzntpTAbwxeHvviclcw8coNrDge/0, createdBy=6dc22001775, createdName=春暖花开8785, createdTime=Wed Apr 12 08:47:10 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186816, encodeId=3c7a1868166c, content=难啦!都是钱的问题。, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdicLmdJEK9VoiaDianY6fzHNN9iaGv80m39pMHU3eSnNN0kn1o0rdQ7Bz2f03Qibcf1ia7rKvxIt4UVlErF2d4gCmDC5/0, createdBy=98e31740255, createdName=cqykthl, createdTime=Wed Apr 12 08:33:42 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186809, encodeId=e60f18680987, content=过犹不及, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Wed Apr 12 08:06:10 CST 2017, time=2017-04-12, status=1, ipAttribution=)]
    2017-04-12 明天会更好!

    赞一个,赞一个!!!!

    0

  6. 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topicName=采购)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9bb312387914, createdName=wolongzxh, createdTime=Thu Apr 13 12:33:00 CST 2017, time=2017-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186859, encodeId=8472186859a8, content=赞一个,赞一个!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160914/IMG57D82E721DB581755.jpg, createdBy=4fc81933929, createdName=明天会更好!, createdTime=Wed Apr 12 10:10:47 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186851, encodeId=1334186851c5, content=好好学习,涨知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLANEL7Sww3HicKsN9aribicAmGGWXOIMEiaZ1iadgZg9RibjqSwIKUS8gSPib2NwTVg2zVvVJhdP3BkuDIl/0, createdBy=944d1605392, createdName=shaosai, createdTime=Wed Apr 12 09:44:23 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186849, encodeId=8095186849ab, content=签到学习了很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/A3E53E62691178E2F18D7B999FD22131/100, createdBy=f44d2003846, createdName=Chongyang Zhang, createdTime=Wed Apr 12 09:43:10 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186828, encodeId=ccf3186828b7, content=医改是个大工程!, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kym1A9qicflExZYSdibSZBHDyicKZZj37w4jR44fPa9DI3mVLObHAxzntpTAbwxeHvviclcw8coNrDge/0, createdBy=6dc22001775, createdName=春暖花开8785, createdTime=Wed Apr 12 08:47:10 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186816, encodeId=3c7a1868166c, content=难啦!都是钱的问题。, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdicLmdJEK9VoiaDianY6fzHNN9iaGv80m39pMHU3eSnNN0kn1o0rdQ7Bz2f03Qibcf1ia7rKvxIt4UVlErF2d4gCmDC5/0, createdBy=98e31740255, createdName=cqykthl, createdTime=Wed Apr 12 08:33:42 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186809, encodeId=e60f18680987, content=过犹不及, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Wed Apr 12 08:06:10 CST 2017, time=2017-04-12, status=1, ipAttribution=)]
    2017-04-12 shaosai

    好好学习,涨知识

    0

  7. 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createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLANEL7Sww3HicKsN9aribicAmGGWXOIMEiaZ1iadgZg9RibjqSwIKUS8gSPib2NwTVg2zVvVJhdP3BkuDIl/0, createdBy=944d1605392, createdName=shaosai, createdTime=Wed Apr 12 09:44:23 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186849, encodeId=8095186849ab, content=签到学习了很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/A3E53E62691178E2F18D7B999FD22131/100, createdBy=f44d2003846, createdName=Chongyang Zhang, createdTime=Wed Apr 12 09:43:10 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186828, encodeId=ccf3186828b7, content=医改是个大工程!, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kym1A9qicflExZYSdibSZBHDyicKZZj37w4jR44fPa9DI3mVLObHAxzntpTAbwxeHvviclcw8coNrDge/0, createdBy=6dc22001775, createdName=春暖花开8785, createdTime=Wed Apr 12 08:47:10 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186816, encodeId=3c7a1868166c, content=难啦!都是钱的问题。, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdicLmdJEK9VoiaDianY6fzHNN9iaGv80m39pMHU3eSnNN0kn1o0rdQ7Bz2f03Qibcf1ia7rKvxIt4UVlErF2d4gCmDC5/0, createdBy=98e31740255, createdName=cqykthl, createdTime=Wed Apr 12 08:33:42 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186809, encodeId=e60f18680987, content=过犹不及, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Wed Apr 12 08:06:10 CST 2017, time=2017-04-12, status=1, ipAttribution=)]
    2017-04-12 Chongyang Zhang

    签到学习了很多

    0

  8. 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createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLANEL7Sww3HicKsN9aribicAmGGWXOIMEiaZ1iadgZg9RibjqSwIKUS8gSPib2NwTVg2zVvVJhdP3BkuDIl/0, createdBy=944d1605392, createdName=shaosai, createdTime=Wed Apr 12 09:44:23 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186849, encodeId=8095186849ab, content=签到学习了很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/A3E53E62691178E2F18D7B999FD22131/100, createdBy=f44d2003846, createdName=Chongyang Zhang, createdTime=Wed Apr 12 09:43:10 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186828, encodeId=ccf3186828b7, content=医改是个大工程!, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kym1A9qicflExZYSdibSZBHDyicKZZj37w4jR44fPa9DI3mVLObHAxzntpTAbwxeHvviclcw8coNrDge/0, createdBy=6dc22001775, createdName=春暖花开8785, createdTime=Wed Apr 12 08:47:10 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186816, encodeId=3c7a1868166c, content=难啦!都是钱的问题。, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdicLmdJEK9VoiaDianY6fzHNN9iaGv80m39pMHU3eSnNN0kn1o0rdQ7Bz2f03Qibcf1ia7rKvxIt4UVlErF2d4gCmDC5/0, createdBy=98e31740255, createdName=cqykthl, createdTime=Wed Apr 12 08:33:42 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186809, encodeId=e60f18680987, content=过犹不及, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Wed Apr 12 08:06:10 CST 2017, time=2017-04-12, status=1, ipAttribution=)]
    2017-04-12 春暖花开8785

    医改是个大工程!

    0

  9. 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attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kym1A9qicflExZYSdibSZBHDyicKZZj37w4jR44fPa9DI3mVLObHAxzntpTAbwxeHvviclcw8coNrDge/0, createdBy=6dc22001775, createdName=春暖花开8785, createdTime=Wed Apr 12 08:47:10 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186816, encodeId=3c7a1868166c, content=难啦!都是钱的问题。, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdicLmdJEK9VoiaDianY6fzHNN9iaGv80m39pMHU3eSnNN0kn1o0rdQ7Bz2f03Qibcf1ia7rKvxIt4UVlErF2d4gCmDC5/0, createdBy=98e31740255, createdName=cqykthl, createdTime=Wed Apr 12 08:33:42 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186809, encodeId=e60f18680987, content=过犹不及, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Wed Apr 12 08:06:10 CST 2017, time=2017-04-12, status=1, ipAttribution=)]
    2017-04-12 cqykthl

    难啦!都是钱的问题。

    0

  10. 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attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kym1A9qicflExZYSdibSZBHDyicKZZj37w4jR44fPa9DI3mVLObHAxzntpTAbwxeHvviclcw8coNrDge/0, createdBy=6dc22001775, createdName=春暖花开8785, createdTime=Wed Apr 12 08:47:10 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186816, encodeId=3c7a1868166c, content=难啦!都是钱的问题。, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdicLmdJEK9VoiaDianY6fzHNN9iaGv80m39pMHU3eSnNN0kn1o0rdQ7Bz2f03Qibcf1ia7rKvxIt4UVlErF2d4gCmDC5/0, createdBy=98e31740255, createdName=cqykthl, createdTime=Wed Apr 12 08:33:42 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186809, encodeId=e60f18680987, content=过犹不及, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Wed Apr 12 08:06:10 CST 2017, time=2017-04-12, status=1, ipAttribution=)]
    2017-04-12 smartxiuxiu

    过犹不及

    0

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