麥肯錫:中國醫療體系痼疾深重
As China's new leaders take up their posts this fall, one of the most critical tasks that faces them will be reforming the country's broken health-care system.
今年秋天中國新一屆領導人上任的時候，擺在他們面前最關鍵的任務之一，將是改革這個國家支離破碎的醫療體系。The Chinese government has spent $125 billion over the past three years to extend insurance coverage to 95% of the population while also improving access to hospitals and clinics. But despite that effort, the country's health-care system still has a long way to go to and the challenges ahead are mounting, according to a new study from consultancy McKinsey & Co.
中國政府在過去三年投入了1,250億美元，將醫保覆蓋範圍提高到佔全國人口95%的水平，同時改善看病難問題。但諮詢公司麥肯錫(McKinsey & Co.)新發表的研究報告顯示，中國的醫療體系改革還有很長的路要走，接下來的挑戰將越來越嚴峻。The report notes that China's health care spending is poised to triple to $1 trillion by 2020 and while the rate of insurance coverage is high, so are the out-of-pocket burdens on consumers. Most of China's insured still don't understand the limits of their coverage plans, which will leave them financially devastated in the case of a catastrophic incident, the report said.
報告指出，到2020年，預計中國的醫療支出將達到1萬億美元，比目前水平高兩倍。報告說，雖然醫保覆蓋率高，居民自繳部分的負擔也不輕。報告說，中國很多參保人員仍不瞭解所繳醫保的限制，如果碰到大病，這些限制將使他們陷入財務困境。
Another problem highlighted in the study: a still yawning disparity in quality of health care between rural and urban regions. The country lacks a sufficient national drug supply to ensure that rural patients are provided the same access to pharmaceuticals as their urban counterparts, the study finds. Meanwhile, hospitals in rural areas are hard to reach and lack high-quality equipment and manpower, leaving many to flock to urban centers for care. The result is overrun, already underfunded city hospitals.
報告還強調了另外一個問題：城鄉醫療質量差距仍然很大。報告發現，全國藥品供應不足，因此無法確保農村病人能像城鎮病人一樣能夠獲得藥品。與此同時，農村地區就醫難，缺乏高質量的設備和人員，所以很多人涌向城市地區看病。這造成缺乏資金的城市醫院超負荷運轉。Even relatively well-off Chinese feel health-care facilities are inadequate, with 31% saying it's difficult to access care in public hospitals, according to a McKinsey survey of 1,000 people with annual incomes greater than 80,000 yuan ($12,600).
甚至相對富裕的中國人也覺得醫療設施不足。麥肯錫調查了1,000名年收入超過8萬元的人士，31%的人表示在公立醫院很難看上病。A crisis between China's chronically underpaid doctors, who look to pad their low pay checks with kickbacks from pricey drug prescriptions, and skeptical patients is well underway, highlighted by a spiking number patient attacks against physicians, the report said. According to McKinsey's survey of nearly 6,000 physicians in 3,300 hospitals, 59% of doctors said they had been verbally assaulted by a patient or a patient's family member. And 6% said they have been physically assaulted by patients.
長期以來，中國醫生工資一直不高，爲彌補低工資，他們通過開高價藥的方式來賺取回扣。報告說，病人對醫生的懷疑情緒與日俱增，病人攻擊醫生的事例越來越多就是這種矛盾的體現。麥肯錫調查了3,300家醫院的近6,000名醫生，59%的人表示被患者或患者家屬罵過，6%的人表示被患者攻擊過。Recent articles from the Economist and the Associated Press cite mistrust and anger over perceived inadequate treatment as reasons for the assaults.
近期《經濟學人》(Economist)和美聯社(Associated Press)刊發的文章認爲，打罵醫生的原因是患者覺得沒有得到足夠的治療，因此不信醫生，心生怨恨。Asked if tensions in the relationships with patients had changed in the last year, 44% of respondents in the McKinsey survey said it had worsened and 51% said it remained the same. McKinsey also found that
在被問到過去一年醫患矛盾有無變化時，麥肯錫調查中44%的受訪者表示矛盾惡化，51%的人表示沒有變化。麥肯錫還發現，中國37%的醫生表示對自己的工作不滿意，5%的人表示正在考慮改行。37% of doctors in China said they were not satisfied with their work and 5% said they were considering a career change.
如何讓這一切得到控制，將是令中國領導人頭疼的一件事。這同樣也曾是美國總統奧巴馬(Barack Obama)等其他國家領導人感到頭疼的事情。但麥肯錫提到，雖然有這些艱鉅挑戰，企業──不管是中國企業還是跨國公司──也將迎來前所未有的機會：從藥品到醫療設備，從私立醫院到私人醫保，所有市場都將擴大。
