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医疗服务质量及价格也要“货比三家”
文章来源:中国医药化工网    添加人:admin    添加时间:2016/12/8 15:45:15
 

  目前我们是如何对医药物质产品确定价格的?那就是政府定价。尽管我们一直在强调用“优质优价”的原则来确定药品价格,可落到最终还是“以成本定价”。但是,同类产品中一些花了高成本的产品,也许是因为企业花了较高的管理成本,而非花了较高的质量成本。对这样的企业生产的产品“以成本定价”,无疑是保护落后。
  
  对医疗技术服务我们是如何核定“费”的?一方面是政府制定收费的标准;另一方面是按不同的医疗服务项目定收费标准,按事业单位的薪酬办法定医生的工资——医生技术劳务的价格。
  
  前者的收费只能是依据医院的级别,但医院的级别与其医生为单个病人提供的技术服务的质量没有任何关系。后者即医生的工资应当是最能反映医生技术服务质量的了,但政府依然只能依据医生的级别来定其工资!因为,即便是功能再强大的政府,也不可能盯得住每年几十亿次医疗服务消费的质量,不可能区别相同级别的医生提供的服务在质量上的差别。
  
  上述这种不能把价格、收费标准、医生工资与质量挂钩的政府定价方式,怎么可能保证质量与价格的正相关关系!常识的问题还是要用常识解决。要保证质量与价格呈正相关关系,就得像老百姓所说的“货比三家”,比质量的同时比价格。有专家肯定要说,这种市场机制是失灵的。
  
  然而,正是因为医疗服务市场存在价格机制失灵,才会在医疗服务市场出现“医疗保险”这个角色,并以此构建了一种新型的医疗市场关系。尽管这个关系比较复杂,但仍然要遵循市场机制,即医疗服务的质量及其相应的价格,要“货比三家”,只不过医疗保险在作为参保病人付费者的同时,也代表参保人作为价格的谈判者,由医疗保险与医药服务的提供者(医疗机构、医生、医药企业)谈付费的方式以及每种付费方式的费用标准。
  
  由此,所谓支付制度的改革,核心问题还是医药服务的“价格”或者“费”的确定方式到底是由政府部门定价还是用市场机制确定。

 

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