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多位知名院长直言:没有药品零加成补贴 医院亏惨了!

2017-05-15 欧阳峰 看医界

据介绍,镇江在2013年就进行了药品零加成改革,取消15%的药品加成改革,具体实施下来情况是怎样的呢?据朱夫院长介绍,第一年政府财政给了,但到了第二年及以后,财政就没再给一分钱。


零加成补贴不到位,医院亏惨了!

2017年药品零价差将全面实施。那么作为较早实施药品零加成的地区,大医院有着怎样的遭遇呢?在5月13日中欧国际工商学院举办行的第十三届中国健康产业高峰论坛上,镇江市第一人民医院(江苏大学附属人民医院)院长朱夫讲述了医院近年来的遭遇。

据介绍,镇江在2013年就进行了药品零加成改革,取消15%的药品加成改革的计划补偿措施是:江苏物价调整承担77%,政府财政承担10%,医院承担13%。

但具体实施下来情况是怎样的呢?据朱夫院长介绍,第一年政府财政给了,但到了第二年及以后,财政就没再给一分钱。

再加上13%本身就需要医院承担的部分,医院总共承担了零加成损失的23%,将近四分之一,对此其坦言医院很难承受。

会上,复旦大学附属中山医院院长樊嘉表示,药品加成取消以后,药品从外面运到医院,医院把它分发到每个病人身上,流通是有成本的。政府有一些支付来补偿,比如说提高其他方面的服务价格,但这些服务价格不是到位的,医院还要再付出,一些经济运营方面就存在很大的问题。

另据南都报道,湖南湘雅医院院长孙虹在一次会议上直言药品零差价政策的配套措施不给力,药品零差价说好的8:1:1,即通过提高医务性服务价格补偿80%药品零差价带来的损失,政府补贴10%,医院自己承担10%,结果是没有收到政府补偿,医院因此承担了近50%的损失,湘雅医院年收入预计减损2个亿。

一下子收入减少2个亿,再大的医院也受不了,孙虹院长无奈地表示,为了保证医务人员待遇不下降,医院决定削减明年的设备购置费用5000万元,医院的发展或受到影响。

朱夫表示,所以今年零加成在全国推广以后,相信会产生很大的问题,并会有很多的附带问题出现。

改革动的就是大医院利益?

关于新一轮医改中,大医院的利益问题,朱夫直言:一系列改革措施这会对我们医院产生很大的影响,而且这些文件大部分都涉及到我们医院,是冲着医院来的。

实际上的情况是怎样的呢?从本轮零差价改革来看,无一例外的都选择了让医院通过提高管理效率“消化一部分”,说白了就是让医院自己承担一部分。

对此一位业内人士表示,相信之所以这样做,应该是有关部门觉得近些年大医院已经赚得盆满钵满,应该为改革牺牲一部分集体利益。因此改革动大医院利益是没跑了。

但一些地方说好的政府补贴却迟迟不给,说好的调整医疗服务价格补偿80%左右却不能实现,这让一些大医院怎肯就范?

对于医药领域仍然具有垄断性控制地位的大医院,面对政策性亏损自然不会一忍了之。以湖南为例,湘雅系医院就强制要求药商返点,不听话就停付药款。

业内人士看来,但随着央视关于回扣门的曝光,湖南一些大医院遭波及,湘雅二院院长下台,关于医院零加成亏损的补偿问题也再无人提起。但很多大医院面临普遍性的政策性问题并未得到解决。

并表示,改革肯定是利益的重新分配,要想实现分级诊疗,取消“以药养医”,大医院的利益必然会被动刀子。大医院的最好的日子也正在成为过去。并建议改革应该充分医疗市场规律,充分尊重医护的劳动价值,在医技性服务价格的回归方面不能拖泥带水,也不能手软。不然想彻底取消“以药养医”就很难实现。

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objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Mon May 15 23:16:55 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198412, encodeId=5f33198412dd, content=举步维艰,利息冲突, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdicLmdJEK9VoiaDianY6fzHNN9iaGv80m39pMHU3eSnNN0kn1o0rdQ7Bz2f03Qibcf1ia7rKvxIt4UVlErF2d4gCmDC5/0, createdBy=98e31740255, createdName=cqykthl, createdTime=Mon May 15 15:19:18 CST 2017, time=2017-05-15, status=1, ipAttribution=), 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createdName=simayunhe, createdTime=Mon May 15 13:52:49 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198383, encodeId=cc41198383c8, content=医改就是胡改。医院就该有志气取消所有门诊药房,自己去外面买药去吧。, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160506/IMG572CA3331EBB12267.jpg, createdBy=5d771696443, createdName=Dr.V, createdTime=Mon May 15 13:50:50 CST 2017, time=2017-05-15, status=1, ipAttribution=)]
    2017-05-16 sillywu

    好不容易收上来的财税怎么可以随便用在尔等平头小老百姓身上呢?人家交税修高速还要给过路费,何况是你们

    0

  4. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5F5JiaKt8tLwAUUH6ejxhvAsyiaic6HXW0KBxzqaPJQO1KHKuxoBl9KFWFhTicx7Y55WmfwziabRoDRbxicybUWTcOUw/0, createdBy=21cc2055669, createdName=kun111, createdTime=Tue May 16 10:11:21 CST 2017, time=2017-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198660, encodeId=ab8219866090, content=一刀切的做法谁都受不了, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151226/IMG567EB873985DE3928.jpg, createdBy=ea941622301, createdName=inter158, createdTime=Tue May 16 06:46:21 CST 2017, time=2017-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198514, encodeId=6ae4198514b0, content=以药养医持续太长时间, beContent=null, 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createdName=simayunhe, createdTime=Mon May 15 13:52:49 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198383, encodeId=cc41198383c8, content=医改就是胡改。医院就该有志气取消所有门诊药房,自己去外面买药去吧。, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160506/IMG572CA3331EBB12267.jpg, createdBy=5d771696443, createdName=Dr.V, createdTime=Mon May 15 13:50:50 CST 2017, time=2017-05-15, status=1, ipAttribution=)]
    2017-05-16 kun111

    院长再不好当,也有人抢着当啊!

    0

  5. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5F5JiaKt8tLwAUUH6ejxhvAsyiaic6HXW0KBxzqaPJQO1KHKuxoBl9KFWFhTicx7Y55WmfwziabRoDRbxicybUWTcOUw/0, createdBy=21cc2055669, createdName=kun111, createdTime=Tue May 16 10:11:21 CST 2017, time=2017-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198660, encodeId=ab8219866090, content=一刀切的做法谁都受不了, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151226/IMG567EB873985DE3928.jpg, createdBy=ea941622301, createdName=inter158, createdTime=Tue May 16 06:46:21 CST 2017, time=2017-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198514, encodeId=6ae4198514b0, content=以药养医持续太长时间, beContent=null, 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createdName=simayunhe, createdTime=Mon May 15 13:52:49 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198383, encodeId=cc41198383c8, content=医改就是胡改。医院就该有志气取消所有门诊药房,自己去外面买药去吧。, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160506/IMG572CA3331EBB12267.jpg, createdBy=5d771696443, createdName=Dr.V, createdTime=Mon May 15 13:50:50 CST 2017, time=2017-05-15, status=1, ipAttribution=)]
    2017-05-16 inter158

    一刀切的做法谁都受不了

    0

  6. 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objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Mon May 15 23:16:55 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198412, encodeId=5f33198412dd, content=举步维艰,利息冲突, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdicLmdJEK9VoiaDianY6fzHNN9iaGv80m39pMHU3eSnNN0kn1o0rdQ7Bz2f03Qibcf1ia7rKvxIt4UVlErF2d4gCmDC5/0, createdBy=98e31740255, createdName=cqykthl, createdTime=Mon May 15 15:19:18 CST 2017, time=2017-05-15, status=1, ipAttribution=), 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createdName=simayunhe, createdTime=Mon May 15 13:52:49 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198383, encodeId=cc41198383c8, content=医改就是胡改。医院就该有志气取消所有门诊药房,自己去外面买药去吧。, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160506/IMG572CA3331EBB12267.jpg, createdBy=5d771696443, createdName=Dr.V, createdTime=Mon May 15 13:50:50 CST 2017, time=2017-05-15, status=1, ipAttribution=)]
    2017-05-15 1ddf0692m34(暂无匿称)

    以药养医持续太长时间

    0

  7. 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    2017-05-15 cqykthl

    举步维艰,利息冲突

    0

  8. 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    2017-05-15 西风染林

    这种事,让人怎么改啊!?现在的分级医疗改革,真的需要再动动这些人的利益,必须在这种时候来一个伟大的人,牺牲自己利益,来给人们谋福利

    0

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createdName=simayunhe, createdTime=Mon May 15 13:52:49 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198383, encodeId=cc41198383c8, content=医改就是胡改。医院就该有志气取消所有门诊药房,自己去外面买药去吧。, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160506/IMG572CA3331EBB12267.jpg, createdBy=5d771696443, createdName=Dr.V, createdTime=Mon May 15 13:50:50 CST 2017, time=2017-05-15, status=1, ipAttribution=)]
    2017-05-15 simayunhe

    早就该这样!这种钱是不应该赚的

    0

  10. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5F5JiaKt8tLwAUUH6ejxhvAsyiaic6HXW0KBxzqaPJQO1KHKuxoBl9KFWFhTicx7Y55WmfwziabRoDRbxicybUWTcOUw/0, createdBy=21cc2055669, createdName=kun111, createdTime=Tue May 16 10:11:21 CST 2017, time=2017-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198660, encodeId=ab8219866090, content=一刀切的做法谁都受不了, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151226/IMG567EB873985DE3928.jpg, createdBy=ea941622301, createdName=inter158, createdTime=Tue May 16 06:46:21 CST 2017, time=2017-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198514, encodeId=6ae4198514b0, content=以药养医持续太长时间, beContent=null, 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createdName=simayunhe, createdTime=Mon May 15 13:52:49 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198383, encodeId=cc41198383c8, content=医改就是胡改。医院就该有志气取消所有门诊药房,自己去外面买药去吧。, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160506/IMG572CA3331EBB12267.jpg, createdBy=5d771696443, createdName=Dr.V, createdTime=Mon May 15 13:50:50 CST 2017, time=2017-05-15, status=1, ipAttribution=)]
    2017-05-15 Dr.V

    医改就是胡改。医院就该有志气取消所有门诊药房,自己去外面买药去吧。

    0

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