钟南山称医生工资应由政府负责,被经济学者称“不懂经济”

2015-08-21 MedSci MedSci原创

导读:8月19日,全国人大代表、中国工程院院士钟南山在广州“呛声”广东的医疗卫生体制改革,他表示全世界的公立医院最公益的体现,就是医务人员的工资全部由政府“买单”,但目前中国内地没做到。“我还没看出来广东是‘医改’的排头兵。”8月19日至21日,广东省人大常委会组织广东选出的全国人大代表在广州开展2015年全国人大代表“深化医疗卫生体制改革”专题调研。取消药品加成,医院不再靠“卖药”营收,成了会议

导读:8月19日,全国人大代表、中国工程院院士钟南山在广州“呛声”广东的医疗卫生体制改革,他主张医务人员的工资全部由政府“买单”,并称这是全世界的公立医院最公益的体现,但目前就是中国内地没做到。但钟南山的“政府买单说”遭到经济学者的批评。


8月19日至21日,广东省人大常委会组织广东选出的全国人大代表在广州开展“深化医疗卫生体制改革”专题调研。取消药品加成,医院不再靠“卖药”赚钱,成了会议的焦点。


广东省卫生计生委党组书记骆文智在报告中指出,广东把取消药品加成作为突破口,广州调整了2000多项医疗服务价格,其中药品加成的80%由调整医疗服务价格补偿,10%由各级财政补助,10%由医院自行消化。广东省发改委社会处的报告称,改革后,医疗服务价格补偿了预期应该补偿的八成。


钟南山对此直言“不满意”。他认为,“公立医院改革没有突破”,药品加成取消后,各级财政补助只有10%,“实在是极少”。“(加成的)八成通过调整医疗服务价格来补偿,意味着看病的大部分支出依然由个人承担。还有10%要医院自己想办法解决,那医院就把这个项目的收费转到那个项目。”

全国人大代表、广东省人民医院院长庄建补充道:“实际上,政府给我们医院的钱不到总支出的5%”,这些钱连给离退休人员发工资都不够。

钟南山还表示,“如果医院要靠政府这点钱让医务人员干活我看是不可能,这也使得现在医院收入更多趋向于药费,以及尽量多看病人。”

总而言之,钟南山院士认为:目前公立医院并没有真正实现公益性,改革没有突破,并提出县级公立医院在药品取消加成后,没有建立合理的补偿机制,政府补贴的部分“太少太少”。“所有公立医院最公益的体现就是医务人员的工资全部由政府买单,现在全国都做不到,这个不改革,其他(指改革)都是假的。”

钟南山对医改的这一“呛声”引发了媒体的关注,对此,宏观经济学者胡释之在接受《凤凰财知道》的采访时坚决反对“医生工资由政府买单”,称钟南山“不懂经济”

胡释之认为钟南山院士对于社会经济问题是个门外汉。他开的这个药方,不是改革,而是向旧体制倒退,不是化解问题,而是制造和加剧问题。

胡释之认为:医务人员的工资由政府买单,会使得医生的衣食父母从患者变成官员。损害患者的权益的同时,医生变成了吃铁饭碗的官老爷。让医生变得更不用在乎患者,怎么能叫改革呢?

同时,胡释之认为“医生想挣患者的钱,对患者是好事而不是坏事”。医生越想挣钱反而会越努力提高自己的医技,让患者受益。患者要担忧的不是医生想挣你的钱,而是没有医生想挣你的钱,那就有钱也救不回命了。

最后,胡释之还讲解了医院敞开收费不是问题,重点问题是公立医院到现在还没有真正市场化,这造成了垄断收费。没了垄断特权,医院可以选择漫天要价,但患者也可以选择不在你这看病,而是把钞票投给新的性价比更高的医院。因此,开放的市场,医院自己也不会胡乱要价。

编后:胡释之的批评恐怕能代表相当一部分经济学者的观点。但问题在于,经济学者们在医疗领域简单地套用经济规律,必须有一个前提,那就是医疗的参与各方都是理性经济人。然而现实中显然不是这样,比如说,医生如果单纯追求利益最大化,恐怕早就去做房地产了;又比如,碰到没有钱的病人,单纯追求利益最大化的医生会弃之不救,而这却是与医生的职业伦理相悖的。那么,简单地把经济规律套到医疗这种不完全理性的经济行为上,这样真的好吗?

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    2016-02-20 zexyw01
  2. [GetPortalCommentsPageByObjectIdResponse(id=2058832, encodeId=5acc205883230, content=<a href='/topic/show?id=3481e83445e' target=_blank style='color:#2F92EE;'>#经济学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78344, encryptionId=3481e83445e, topicName=经济学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=362b271, createdName=zexyw01, createdTime=Sat Feb 20 12:53:00 CST 2016, time=2016-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=58825, encodeId=bfe35882542, content=砖家, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuK9CDibOwszLoEBg36ZXqzB5NDasNV9GTfFDmBicM1V8hUS4OtTicG3IiaFIKq4wqD23LUxORRJXqjVs/0, createdBy=00e81647535, createdName=I come, createdTime=Fri Jan 22 22:03:00 CST 2016, time=2016-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=36352, encodeId=3bcf3635242, content=什么经济学家,砖家而已,不懂装懂, beContent=null, objectType=article, channel=null, level=null, likeNumber=183, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49b81389452, createdName=yztzyw, createdTime=Thu Sep 03 00:08:00 CST 2015, time=2015-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=36012, encodeId=a4833601230, content=支持钟院士部分观点,完全反对不懂医疗卫生工作特点所谓〞经济专家〞,搞经济的就是做〞生意〞,也就物物交换而已,而医务人员每天面对是人的生命,还有比生命更要的〝东西〞吗?经济学家能计算出大家都接受的〝价〞吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=97761645014, createdName=1ddb3d02m65(暂无匿称), createdTime=Sun Aug 23 21:43:00 CST 2015, time=2015-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=35978, encodeId=1948359e86f, content=还是天朝的问题, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25b61624599, createdName=xykzfl, createdTime=Sun Aug 23 07:47:00 CST 2015, time=2015-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=35961, encodeId=cd9f3596166, content=支持钟院士, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=62031644720, createdName=青出于蓝, createdTime=Sat Aug 22 22:00:00 CST 2015, time=2015-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=35959, encodeId=27703595935, content=这经济学家如果要看病,估计会被拒诊或者列入黑名单, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48961639713, createdName=Kshine, createdTime=Sat Aug 22 20:36:00 CST 2015, time=2015-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=35957, encodeId=f2ac3595ebd, content=有声音才有改革的需要,为钟教授点赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e73d1605484, createdName=he408015781, createdTime=Sat Aug 22 12:27:00 CST 2015, time=2015-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=35956, encodeId=297835956af, content=不能完全以经济学的角度来看待医疗体系的改革,这是不理性的, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44491644534, createdName=shinian8, createdTime=Sat Aug 22 11:32:00 CST 2015, time=2015-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=35948, encodeId=88b4359488a, content=未来的医疗…需要全体人民的参与,不单单是医生和患者, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=40251618559, createdName=2014lb3, createdTime=Sat Aug 22 10:02:00 CST 2015, time=2015-08-22, status=1, ipAttribution=)]
    2016-01-22 I come

    砖家

    0

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    2015-09-03 yztzyw

    什么经济学家,砖家而已,不懂装懂

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2058832, encodeId=5acc205883230, content=<a href='/topic/show?id=3481e83445e' target=_blank style='color:#2F92EE;'>#经济学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78344, encryptionId=3481e83445e, topicName=经济学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=362b271, createdName=zexyw01, createdTime=Sat Feb 20 12:53:00 CST 2016, time=2016-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=58825, encodeId=bfe35882542, content=砖家, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuK9CDibOwszLoEBg36ZXqzB5NDasNV9GTfFDmBicM1V8hUS4OtTicG3IiaFIKq4wqD23LUxORRJXqjVs/0, createdBy=00e81647535, createdName=I come, createdTime=Fri Jan 22 22:03:00 CST 2016, time=2016-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=36352, encodeId=3bcf3635242, content=什么经济学家,砖家而已,不懂装懂, beContent=null, objectType=article, channel=null, level=null, likeNumber=183, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49b81389452, createdName=yztzyw, createdTime=Thu Sep 03 00:08:00 CST 2015, time=2015-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=36012, encodeId=a4833601230, content=支持钟院士部分观点,完全反对不懂医疗卫生工作特点所谓〞经济专家〞,搞经济的就是做〞生意〞,也就物物交换而已,而医务人员每天面对是人的生命,还有比生命更要的〝东西〞吗?经济学家能计算出大家都接受的〝价〞吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=97761645014, createdName=1ddb3d02m65(暂无匿称), createdTime=Sun Aug 23 21:43:00 CST 2015, time=2015-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=35978, encodeId=1948359e86f, content=还是天朝的问题, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25b61624599, createdName=xykzfl, createdTime=Sun Aug 23 07:47:00 CST 2015, time=2015-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=35961, encodeId=cd9f3596166, content=支持钟院士, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=62031644720, createdName=青出于蓝, createdTime=Sat Aug 22 22:00:00 CST 2015, time=2015-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=35959, encodeId=27703595935, content=这经济学家如果要看病,估计会被拒诊或者列入黑名单, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48961639713, createdName=Kshine, createdTime=Sat Aug 22 20:36:00 CST 2015, time=2015-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=35957, encodeId=f2ac3595ebd, content=有声音才有改革的需要,为钟教授点赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e73d1605484, createdName=he408015781, createdTime=Sat Aug 22 12:27:00 CST 2015, time=2015-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=35956, encodeId=297835956af, content=不能完全以经济学的角度来看待医疗体系的改革,这是不理性的, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44491644534, createdName=shinian8, createdTime=Sat Aug 22 11:32:00 CST 2015, time=2015-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=35948, encodeId=88b4359488a, content=未来的医疗…需要全体人民的参与,不单单是医生和患者, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=40251618559, createdName=2014lb3, createdTime=Sat Aug 22 10:02:00 CST 2015, time=2015-08-22, status=1, ipAttribution=)]
    2015-08-23 1ddb3d02m65(暂无匿称)

    支持钟院士部分观点,完全反对不懂医疗卫生工作特点所谓〞经济专家〞,搞经济的就是做〞生意〞,也就物物交换而已,而医务人员每天面对是人的生命,还有比生命更要的〝东西〞吗?经济学家能计算出大家都接受的〝价〞吗?

    0

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    2015-08-23 xykzfl

    还是天朝的问题

    0

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    2015-08-22 青出于蓝

    支持钟院士

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=2058832, encodeId=5acc205883230, content=<a href='/topic/show?id=3481e83445e' target=_blank style='color:#2F92EE;'>#经济学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78344, encryptionId=3481e83445e, topicName=经济学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=362b271, createdName=zexyw01, createdTime=Sat Feb 20 12:53:00 CST 2016, time=2016-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=58825, encodeId=bfe35882542, content=砖家, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuK9CDibOwszLoEBg36ZXqzB5NDasNV9GTfFDmBicM1V8hUS4OtTicG3IiaFIKq4wqD23LUxORRJXqjVs/0, createdBy=00e81647535, createdName=I come, createdTime=Fri Jan 22 22:03:00 CST 2016, time=2016-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=36352, encodeId=3bcf3635242, content=什么经济学家,砖家而已,不懂装懂, beContent=null, objectType=article, channel=null, level=null, likeNumber=183, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49b81389452, createdName=yztzyw, createdTime=Thu Sep 03 00:08:00 CST 2015, time=2015-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=36012, encodeId=a4833601230, content=支持钟院士部分观点,完全反对不懂医疗卫生工作特点所谓〞经济专家〞,搞经济的就是做〞生意〞,也就物物交换而已,而医务人员每天面对是人的生命,还有比生命更要的〝东西〞吗?经济学家能计算出大家都接受的〝价〞吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=97761645014, createdName=1ddb3d02m65(暂无匿称), createdTime=Sun Aug 23 21:43:00 CST 2015, time=2015-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=35978, encodeId=1948359e86f, content=还是天朝的问题, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25b61624599, createdName=xykzfl, createdTime=Sun Aug 23 07:47:00 CST 2015, time=2015-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=35961, encodeId=cd9f3596166, content=支持钟院士, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=62031644720, createdName=青出于蓝, createdTime=Sat Aug 22 22:00:00 CST 2015, time=2015-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=35959, encodeId=27703595935, content=这经济学家如果要看病,估计会被拒诊或者列入黑名单, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48961639713, createdName=Kshine, createdTime=Sat Aug 22 20:36:00 CST 2015, time=2015-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=35957, encodeId=f2ac3595ebd, content=有声音才有改革的需要,为钟教授点赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e73d1605484, createdName=he408015781, createdTime=Sat Aug 22 12:27:00 CST 2015, time=2015-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=35956, encodeId=297835956af, content=不能完全以经济学的角度来看待医疗体系的改革,这是不理性的, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44491644534, createdName=shinian8, createdTime=Sat Aug 22 11:32:00 CST 2015, time=2015-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=35948, encodeId=88b4359488a, content=未来的医疗…需要全体人民的参与,不单单是医生和患者, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=40251618559, createdName=2014lb3, createdTime=Sat Aug 22 10:02:00 CST 2015, time=2015-08-22, status=1, ipAttribution=)]
    2015-08-22 Kshine

    这经济学家如果要看病,估计会被拒诊或者列入黑名单

    0

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    2015-08-22 he408015781

    有声音才有改革的需要,为钟教授点赞

    0

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    2015-08-22 shinian8

    不能完全以经济学的角度来看待医疗体系的改革,这是不理性的

    0

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    2015-08-22 2014lb3

    未来的医疗…需要全体人民的参与,不单单是医生和患者

    0

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