Under the current medical insurance system, the strategy of hospital management is to make money from medical insurance as much as possible. If the amount of a disease is 15,000 yuan, the hospital will use 16,000 yuan, although it is deducted because it exceeds the reimbursement amount. One thousand yuan, but still earned, otherwise you save two thousand dollars is not yours, nor is it a patient. This kind of medical payment does not actually start from the perspective of cost saving. The "super use" medical insurance quota will inevitably bring insecurity factors...
The key to hospital management is quality and safety. Simply put, doctors should not think too much about economic and administrative matters, only focusing on treating diseases. The safety of the medical field is more rigorous than that of any industry, and the doctor is facing an "examination" for every patient. If the TV is broken, you can change parts or throw it, and the human organs are not so easy to change. If pure economic thinking is used to guide the reform of the medical field, it will inevitably lead to a mess.
How is the operating cost of the hospital reflected and calculated? At present, the pricing of hospital services is a mess. The current reforms are carried out in the state of the government in the past planned economy, and the full-cost accounting has not been carried out in accordance with the laws of the market. Now, the government does not provide funds to hospitals, but also public hospitals to survive in the market. With the idea of ​​planning economy, the hospital is called "selling services" in the market, which leads to the current public hospitals being "unworthy," which should not be The government's will, the government must correct it!
From another perspective, since the reform and opening up, public hospitals have developed rapidly, but the government has spent very little money. However, the results were unsatisfactory. The hospitals and doctors did not receive favorable comments. Instead, they had many complaints from the people and the relationship between doctors and patients became more and more tense.
In this contradiction, the government wants to return to its responsibility, how to provide fair and effective medical services for all people, that is, the direction proposed by the new medical reform - to provide basic medical services as public goods to the people of the country? I guess there is still a long way to go. On the surface, our medical insurance coverage is full, but under the “full coverageâ€, the proportion of self-pay is still very high, and the absolute value of personal payment is much more than before. Although the content of the service is different, the quality of medical services is also affected, and the over-medical and medical care is becoming more and more serious.
For example, some diseases are expensive, many are not reimbursed, and there is a threshold for payment, and then there is a maximum cap, and finally the patient still has to pay a lot of medical expenses. In this case, if the patient chooses to abandon treatment, is the quality of the medical treatment affected? At the same time, some medical insurance costs are abused, and abuse is also an unsafe performance. For example, the inspection of large equipment, the abuse of antibiotics, the abuse of auxiliary drugs, the shortage of medical staff, the high labor intensity, the inability to control the hospital, etc., there are many unsafe factors, which are not for everyone's attention; in the "small profits but quick turnover" Driven by the obvious, hidden and hidden security risks. Under the current medical insurance system, the strategy of hospital management is to make money from medical insurance as much as possible. If the amount of a disease is 15,000 yuan, the hospital will use 16,000 yuan, although it is deducted because it exceeds the reimbursement amount. One thousand yuan, but still earned, otherwise you save two thousand dollars is not yours, nor is it a patient. In fact, this kind of medical payment does not start from the perspective of cost saving. The "super use" medical insurance quota will inevitably bring about unsafe factors.
In summary, there is a very abnormal situation: the doctor's salary is absolutely linked to the hospital's income, the department's income, the doctor's behavior is linked to "income income", and the relationship with medical quality is "doing best" .
Looking at foreign countries, MD Anderson, Mayo, Cleveland and other medical institutions, in terms of scale, they are not large, the scale of China's county-level hospitals far exceeds them, but they are based on community medical care, outpatient medical care. why? Because in the United States, every bed does not mean that you can make money, you may lose money. Because a patient is hospitalized, hospital hospitalization costs are very expensive, especially for labor costs, which account for more than 70% of hospitalization expenses. Their doctors are very dignified, they cannot be "small profits but quick turnover", and they must spend a certain amount of time on the patients. This is respect for medicine and respect for patients.
However, the value of foreign doctors is far from being "seven dollars" and "five dollars" like China, but it accounts for the majority of the hospital's income. Take the outpatient clinic as an example, the medical expenses are paid by the insurance company, and it is paid by the sub-account. How much is the doctor's service? How much is the doctor's service? The total cost of the hospital service (the total expenditure of the hospital's logistical support system) is one day, the insurance company and the hospital. Settlement; inspection, inspection, medicine, etc. are all paid by sub-ledger.
In the United States, drugs are not the main source of income for hospitals, so hospitals simply do not want to “operate†drugs. This is the separation of medicine in the true sense. From a business perspective, drugs, inspections, etc. are cost centers. In this case, the hospital can only obtain more income by creating services and more safer services to maintain the development of the hospital. Therefore, the system determines the behavior of doctors, and different systems produce different behaviors.
Plant extraction process
1. Select plants/herbs. No more than ancient prescriptions, prescriptions, folk herbs to find. At present, common and uncommon herbs have been studied. At present, it is mostly to increase the amount of medicinal materials to extract and separate components with low content, or to find medicinal plants that have never been studied from miao medicine, Tibetan medicine, Mongolian medicine, Africa, Latin America and other places.
2. The extraction. Solvent petroleum ether, n-hexane, cyclohexane, benzene, chloroform, ethyl acetate, n-butanol, acetone, ethanol, methanol, water (low polarity → high polarity). Daily medicine decoction effective, water and ethanol and other solvents with large polarity, such as artemisinin boiling ineffective extraction with petroleum ether and other solvents with small polarity. Common medicinal materials water/alcohol/ether to go through, separation and identification of more compounds.
3. The separation. This is the most important work. In the solution extracted from the second step, there are dozens of compounds, usually by column chromatography, which is often referred to as the column flushing. It's a lot of work, it's boring, it's low tech. A master's student might do this every day for two years. The column for separating compounds, as shown below, is as large as 2 meters high and as small as 10 centimeters. Change the solvent condition of mobile phase, change the material of column, different conditions and different separation principles of column repeatedly punching, can be separated from the monomer compound.
Herbal Medicine,Ginger Extract Powder,Hawthorn Berry Extract,Lycium Berry Fruit Extract
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