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Britain's national health service

2018-12-06 来源: 51due教员组 类别: 更多范文

下面为大家整理一篇优秀的assignment代写范文- Britain's national health service,供大家参考学习,这篇论文讨论了英国的国家卫生服务制度。英国的医疗保险采取的是国家医疗保险模式,这种模式下的社会医疗保险制度最具代表性的应当是国家卫生服务制度。国家卫生服务制度被世界卫生组织认为是欧洲最大的公费医疗机构和世界最好的医疗服务体系之一,其覆盖面非常广泛。现在英国的国家卫生服务制度实行分级保健制,呈金字塔型。

national health service,英国国家卫生服务制度,assignment代写,paper代写,北美作业代写

British medical insurance adopts the mode of national medical insurance, under which the most representative social medical insurance system should be the "national health service system". The NHS is considered by the world health organization to be the largest public health institution in Europe and one of the best medical service systems in the world, covering a wide range of areas. The NHS is funded 82% of the time by government grants, 12. Two percent comes from the national insurance tax and the rest from donations and other income from social and charitable organizations. At present, the NHS in Britain adopts hierarchical health care system, which is pyramidal. The primary health care service is the main body of the NHS medical system, which is mainly provided by general clinics. General practice clinics are private and do not belong to any government department, which manages them according to the region, buys primary health care services from general practice clinics for residents and manages the services provided by them through agreements. A general practice usually consists of a general practitioner, nurse, and receptionist. The NHS requires every resident to designate a general practitioner from a nearby gp to be his or her family doctor, responsible for routine health care. Most patients need to have a general practitioner's referral form before they can be referred to the secondary medical service.

The hospital is responsible for providing secondary medical services. According to the referral list of general practitioners, specialists in the hospital know the patient's medical history and symptomatic treatment. When the patient is discharged from hospital, the hospital doctor will transfer the rehabilitation matters needing attention after discharge to the patient's general practitioner. If the condition of the patient is serious, exceeded hospital diagnose and treat ability, the specialized subject doctor of the hospital can ask this specialized subject the expert inside certain domain helps, enter 3 class medical treatment service category.

Tertiary medical services in the UK refer to the services provided by experts in a clinical specialty to solve special difficult and complicated diseases. What offer 3 class medical treatment service basically is specialized subject hospital, specialized subject hospital is not responsible for general diagnosis and treatment. Some larger hospitals provide both secondary and tertiary medical services.

To sum up, the NHS has many advantages: the pyramidal three-level medical service network makes general practitioners become the first barrier to enter the NHS system, so that most health problems can be identified and distributed at this level, and controlled by means of prevention, so as to make full and reasonable use of medical resources. The broad coverage and basic free nature of primary health care guarantees equal access to primary health care for all. Medical insurance undertakings are directly managed by the government. After tax collection, the government allocates funds to public hospitals, which provide free services to residents directly. Enterprises and individuals basically have no economic burden. This guarantees social equity to a large extent, and also ensures the basic medical insurance for vulnerable groups. This is a unique advantage of the British health insurance model. Due to the budget decided by the government expenditure, the government of machinery and equipment, new technology development and spread of investment control and strict management, keep the total health expenses of the whole society at lower levels, and at the same time because the government has decided to total spending, can concentrate resources to accomplish large undertakings, government departments in the international exchanges to represent the country's health care system can occupy a better advantage. In the face of emergencies, the NHS system can focus a large amount of money and personnel on the handling of emergencies in a short period of time, ensuring the high efficiency of emergency response. At the same time, in the face of a wide range of diseases, rapid response and unified allocation can be carried out to provide timely and effective treatment and health guidance for the national public, which to a large extent reduces the incidence of disease, improves the cure rate, and ensures the safety of the people.

Although the NHS has made great contributions to the British people's medical security in its operation for many years, with the development of social economy, the disadvantages of the NHS have become more and more obvious. It mainly includes: microscopically, with the increasing expenditure and the improvement of the national medical security requirements, a large part of the funds is used to maintain the huge medical system, and the actual cost to patients is less than 25% of the total; free medical care system makes public hospitals almost have no economic benefits. The low salary of medical staff leads to low work enthusiasm and low efficiency, and it is difficult to meet the growing medical needs of residents. To a large extent, the advantages of free medical care are greatly reduced. Macroscopically, due to the neglect of the role of market mechanism, the way of premium collection is relatively simple, excluding the intervention of social capital, only relying on government appropriation, the financial burden is too heavy, therefore, the government's regulation of medical insurance is often inadequate; Moreover, in recent years, NHS expenditure accounts for an increasing proportion of the total government expenditure, which will inevitably squeeze other government expenditures and ultimately affect the socio-economic development.

In the 21st century, Britain began to reform its current NHS health care system, and the focus of reform was mainly on reducing the economic burden. It includes the following aspects: open source, reduce expenditure and reduce unnecessary medical expenses. We will strengthen oversight and inspection of medical institutions. Government health departments or enterprises entrust qualified health economists to review the medical expenses paid by hospitals to determine whether the medical expenses are reasonable, study the reasonable expenditure amount of a certain case, and promote hospitals to improve technology and save money. We will attract private funds to step in to ease the financial burden. The government has called on powerful social forces and individuals to become NHS partners and integrate private hospitals, which have long been the supplement to the NHS, into the national health care project.

According to the white paper "our healthcare, our concerns and our opinions -- a new guide to public services" issued by the British government in February 2006, the British government has clearly proposed the following five aspects of reform: establish humanized medical service institutions, and implement tracking services for patients with better methods and more special funds; To deliver health care to the home through investment in public hospitals, medical facilities and the smooth separation of health care programs from hospitals; Better cooperation with local councils to improve communication channels between doctors and patients; Providing more options and budgeting for people who need door-to-door services and pay for care on the spot basic care institutions must develop systems for patient interviews and investigations; Multiple ways to prevent and control the disease.

The development of medical insurance system in China. Since the founding of the People's Republic of China in 1949, the Chinese government has always attached great importance to the establishment and improvement of the medical insurance system. Starting from the labor insurance regulations of the People's Republic of China issued by the Chinese academy of political affairs in 1951, China's medical insurance system has experienced the following three stages of development: the medical insurance system under the planned economy system from 1951 to 1981. During this period, China has not yet got rid of poverty and backwardness, with low level of security and narrow coverage. 1981-1998 exploration and establishment of new medical insurance system under market economy. The third plenary session of the eleventh announced taking economic construction as the center, enterprise autonomy and vitality to strengthen, the economic level in China has considerable increase, starting from the mid - 80 - s, along with the further reform and opening up, the adaptation of planned economy system at public expense, labor insurance system started by more and more serious impact. After several years of efforts, the medical security system in line with the requirements of the development of the market economy has been basically established, and its operation has become more and more smooth. From 1999 to 2006, the reform of the basic medical insurance system for urban employees was in its infancy. In 1999, the reform of the basic medical insurance system for urban employees, which was unified throughout the country, officially began. The gradual reform of the medical insurance system led by the government in China entered a critical stage after achieving breakthrough system innovation. The key problem that implements insurance of worker primary medical treatment is fund of medical treatment insurance raise money, use and management. It is related to the interests of doctors, patients and insurance, and the smooth implementation of medical insurance reform. The new basic medical insurance fund management system for employees also provides a good opportunity for the establishment of a stable and scientific new medical insurance system and the accumulation of rich experience.

With the further development of reform and opening up and the continuous improvement of the socialist market economy system, the contradictions and problems in the operation of the new system of medical insurance have gradually emerged, and the drawbacks of the medical insurance system in China have also been exposed. Macro aspects are mainly concentrated in the following aspects: the coverage of medical insurance is small, the gap between urban and rural areas and the gap between east and west is large. The current social insurance and commercial insurance only involve the staff of state organs, employees of enterprises in cities and towns, as well as middle and high-income families. The rural areas and low-income families that need medical insurance most are marginalized. Health resources are concentrated in eastern regions, big cities and big hospitals, which focus on medical treatment rather than public health and the vast rural grassroots, resulting in unreasonable distribution of health resources. Financing channels for medical insurance are narrow and government investment lacks universality. In China, apart from individual investment, the government is the only way to invest in medical insurance, and social welfare investment is only a supplement. Although under the guidance of the government, many insurance institutions are also exploring the field of medical insurance. However, due to the greater uncertainty of medical conditions and the profit-making purpose of social insurance institutions, it is quite difficult to adjust this aspect. The proportion of government expenditure on health services is small and has some blindness. There are great regional differences in financial subsidies for health care in China. Over the years, financial investment in health care has been indirect. On the one hand, it has been done by guaranteeing the salaries of medical personnel, the infrastructure construction of medical institutions and the purchase of instruments. On the other hand, it is achieved by controlling medical prices, ignoring the requirements on the direction and quantity of medical institutions' output. Therefore, financial subsidies are somewhat blind, and the effect of capital injection is reflected by the operation of medical institutions rather than the actual application of the public. With the further development of market economy, the health service system and gradually transition to the market, the government investment proportion reduced, in a for-profit medical institutions purpose are often keen to provide highly profitable medical services, and commercial medical insurance fund intervention because of its to profit as the ultimate purpose, often focused on high earners, through commercial medical insurance to achieve wider coverage of basic medical insurance system is not realistic, thanks in large part to weaken the power of the government regulating medical again, at the same time also led to the rising medical costs, certainly for the vast number of groups and increased medical burden, expected results health care cannot be achieved, Further widening the social gap in the distribution of medical security.

In the micro aspect of individual citizens, the current medical insurance system is not enough to achieve the real patient diversion, so that the existing medical resources can not be fully and rationally used. The main performance is: the greater the demand for health groups, the lower the medical insurance coverage, the worse the medical insurance services. Statistics show that in 2001, government expenditure on health accounted for 15 percent of total health financing. 55%, the proportion of total social health expenditure is 24. 00% of the population's personal health expenditure was basically stable at 60 percent. 50%, it can be seen that the proportion of residents' self-paid medical care is relatively high, and the proportion of medical expenses in the total household expenditure is also large, which is easy to lead to poverty due to illness, and the phenomenon of poverty due to illness, in the long run, it will be a great challenge to China's economic and social development, as well as the construction of social equity. The construction of community medical institutions is in the initial stage and the medical level is relatively low. Medical resources are mostly concentrated in large hospitals. Patients do not believe in the level of community medical treatment, and they have to go to large hospitals for treatment of major and minor diseases. Large hospitals have advanced equipment, high doctors' level and high cost of medical treatment. As a result, medical treatment is difficult and expensive, which increases the economic burden of patients and wastes medical resources. Because there is no grade limit on hospitals like NHS in China, each medical institution is essentially parallel to each other. Patients have enough autonomy when choosing hospitals for treatment, and they do not need the certification limit of primary medical care, so the blindness of seeking medical treatment is inevitable. In addition, China's current system stipulates that outpatient treatment cannot participate in medical insurance compensation, so the system excludes primary security from competition, which also affects the enthusiasm of medical staff and cannot encourage patients to choose community hospitals.

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