According to Guangming Daily, in recent days, such a news disclosed by the media has attracted people's attention. A must-have drug, "protamine," used for heart surgery, has been out of stock in many cities in the country for nearly a month. Nanjing Children's Hospital has even started to suffer from the beginning of March this year; in Beijing, where the demand is relatively large, the hospital has to strictly control the amount of “protamine†and use “protamine†for approval. There are no substitutes for this drug, so it is difficult to break the experts of major hospitals. Due to the lack of "protamine", many hospitals have been forced to stop heart surgery. At the same time, we have read such an equally worrying news. "The number of advanced instruments in China far exceeds that of other countries, and technological abuse has aggravated the contradiction between doctors and patients." According to reports, at present, the large-scale state-of-the-art instruments such as CT, MRI and PET/CT in China's urban hospitals far exceed the number of large hospitals in developed countries. Take Nanjing as an example. There are more than 50 secondary hospitals in the city, almost all of which have CT, but there are only more than 70 CTs in Germany. The medical conditions have improved, the technology is advanced, and the disputes between doctors and patients have increased year by year. The annual disputes between doctors and patients in major hospitals in Nanjing are about 2000, and they are increasing at an annual rate of about 20%.
Relevant media also explored this chaos. The reason why "protamine" is out of stock is because only three companies in the country have approved the production of the drug, but only one company has been producing it for a long time. Related people said that a "protamine" injection sold for more than ten yuan, this price has been maintained for several decades, raw material prices, labor costs, distribution costs, etc., all prices have not risen, the drug has not increased prices . Due to low profits, pharmaceutical companies lack production enthusiasm. Undoubtedly, the reason why many hospitals are keen on the configuration and use of sophisticated medical equipment is that this can greatly increase the profit margin, small investment, large output, and quick results.
In fact, every person who has seen a doctor at a hospital will have a personal feeling about the above situation. In the past, we looked at Western medicine. The stethoscope that the doctor did not leave should always swim on your body, supplemented by the touch and inspection of your body with your palms and fingers. Now, these have long since disappeared - not waiting for you to finish the disease, the doctor has already prescribed a large number of drugs, and then it is recommended to do inspections, CT, MRI and so on. If such a situation is taken for granted and repeated, we can't help but ask: Before the doctor advises you to check, is it really impossible to judge the condition with a doctor's mind, knowledge, experience, or to use expensive because of profit-driven? The instrument is inspected for its own purpose? Thus, how can patients not be deceived? And a doctor, how can you set aside the professional ethics of disregard, focus on the money, and criticize the people to dig the pits?
I can't afford to ask for a lot of medicines that we got. Recently, there have been some cases of "one dime prescription" and "eight cents of medicine to cure the disease with a price of 100,000 yuan." The high price of medicines and the waste of medicines have indeed reached a point where we feel heavy! In the past, cheap and easy-to-use penicillin, stomach Shuping, berberine, and skin relaxing ointment have quietly faded people's horizons and replaced them with many "innovative" and expensive new drugs. The aforementioned shortage of "protamine" is a concentrated reflection of this situation.
Of course, we should condemn the infinite profit-seeking behavior of the manufacturers and the hospital’s fortunes. However, we need to sort out from the source – the import, procurement and use of high-precision medical equipment . The superior authorities of major hospitals will not be ignorant, or even approved by relevant departments. The equipment was admitted to the hospitals. What is still fresh in people's memory is that as early as 2006, the Ministry of Health announced that the procurement of medical equipment will be implemented. The medical institutions of different scales and grades must be subject to centralized bidding and procurement through the government under the guidance of the corresponding medical assembly specifications. Moderate and appropriate medical equipment such as CT, MRI, and pacemaker. According to the Ministry of Health, medical equipment that has not undergone technical evaluation and ladder selection by the Ministry of Health cannot participate in centralized bidding and procurement, and cannot be imported or applied by medical institutions. Centralized procurement of medical equipment is organized and implemented by provincial and municipal health administrative departments; public medical institutions must participate in centralized procurement of medical equipment.
In the future, the technical evaluation and selection of medical equipment will be incorporated into routine work, and it will serve as the basis for the standard allocation of equipment for public hospitals at the central and local levels and for governments at all levels to carry out centralized bidding for medical equipment.
Such regulatory requirements seem scientific, rigorous, and comprehensive. But unfortunately, now, five years later, the blind purchase, deployment, and use of medical devices have not only been curbed, but have become more and more fierce. The CT ownership of a large city hospital is roughly equivalent to the ownership of the whole of Germany. The amount has already explained everything. In the face of such a glamorous and expensive mess, I would like to ask, the relevant localities and departments have closed their eyes on the above-mentioned norms, or have they not put them in their eyes? The department that issued the specification, how to ensure the implementation and implementation of the specification?
The same is true of the shortage and disappearance of "protamine" and cheap drugs. On the one hand, the relevant examination and approval departments have given a green light to the replacement of cheap drugs by “innovative†drugs, which has caused the reality that patients can only choose high-priced drugs in hospitals. Among them, there are a few “catsâ€, a few black curtains, and a large number of rebates, perhaps only relevant. On the other hand, the drugs that are "card neck", such as "protamine", do not care, do not respect the laws of the market, do not consider the profits of manufacturers, and there is no drug reserve mechanism at all. Allow them to be self-sufficient and self-defeating. Some experts pointed out that drugs such as "protamine" should establish a linkage mechanism, an early warning mechanism, a shutdown report mechanism, and a special drug subsidy mechanism to prevent irreparable damage caused by a shortage of drugs. In fact, the shortage of "protamine" has already sounded the alarm for the daily management and supervision of relevant parties.
Letting the administration go back to the administration and letting the market return to the market is easy to say, but it is difficult to implement it! Perhaps, the administrative can not be returned to the administration, the market can not be returned to the market, it is in this "gray zone" where there is no sunshine, it is perfunctory, sloppy, and too many people have gone through everything. At the moment when all parties call for open and transparent sunshine and administrative affairs, we hope that such a "grey zone" will be less and less. This is the blessing of patients, the welfare of the public, and the welfare of the society. Responsibility, courage, prohibition, supervision, and supervision are not accommodating. In fact, this is only the basic requirement for standard management and scientific management.
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