Huang Qifan: after the epidemic, Chinas public health system needs 200 billion to make up for its shortcomings

category:Hot
 Huang Qifan: after the epidemic, Chinas public health system needs 200 billion to make up for its shortcomings


Expand investment in public health facilities and improve supply quality

In the 40 years of reform and opening up, as an important engine of Chinas economic growth, consumption potential has been constantly released, and GDP has increased from 367.9 billion yuan in 1978 to 90 trillion yuan in 2018. In 2010, consumption, investment and net export accounted for about 1 / 3 of GDP respectively, but in the last five to 10 years, through supply side structural adjustment, consumption has accounted for about 60% of GDP (2019), while investment and net export only accounted for about 40%. We can be sure that to maintain long-term economic growth, we must maintain and expand the pulling force of consumption.

Consumption includes two parts: personal consumption and government public consumption. On the whole, although there is a certain space for personal consumption to rise, it has been limited. However, government public consumption, including education, health and culture, has great potential. In the past, the proportion of government infrastructure investment was relatively large, but the proportion of public facilities investment and public consumption was relatively low. For example, the number of hospitals in China increased from 9293 in 1978 to 33009 in 2018, an increase of 3.55 times, but GDP increased 240 times in the same period. The gap between the two increases is obvious, which shows that the public health investment in China is obviously insufficient. In 2018, Chinas public health expenditure reached 1.6 trillion yuan, accounting for only 1.7% of GDP.

Therefore, it is suggested that after the epidemic, the government should transfer part of the money from the planned investment projects to the public health and other public facilities to improve the quality of the national public health supply, and promote the sustainable and high-quality development of Chinas economy through the government consumption. Experience shows that only about 30% of fiscal investment in infrastructure of railway and highway can be converted into GDP of that year, but about 60% to 70% of investment in public services and facilities such as education, health and culture can be converted into GDP of that year. Therefore, it is the same financial investment, which has a higher investment efficiency in the field of public health and a greater pulling effect on GDP. At the same time, we should meet the needs of the people and form a balance of social services. ,

Huge space for quality improvement investment in medical and public health system

This epidemic situation shows that the existing medical and public health systems in China are inadequate, unreasonable and unbalanced. The actual situation is that, in addition to the developed cities such as Beijing, Guangzhou, Shenzhen and Hangzhou, the number of top three hospitals in many big cities is insufficient and the facilities are not in place, while the allocation of medical resources at all levels in small and medium-sized cities is incomplete and unreasonable, and the medical facilities and treatment level are uneven. This is the reason why large cities and hospitals are often overwhelmed. The existing medical facilities at all levels in small and medium-sized cities are too different. Generally, there are various kinds of medical facilities in small hospitals that are not sound enough, so the common people run to large hospitals.

Compared with the medical system of developed countries, we can see that even small hospitals in the United States and Japan are equipped with the same facilities as large hospitals. Therefore, the completion of the medical and epidemic prevention system and the investment in high-quality equipment in each city are the specific content of the consumption of public facilities, and each equipment invested by the government has become a public service facility for the convenience of the people. Like the construction of Railways and expressways, the state should build infrastructure in the field of public health in China. More than 33000 medical institutions in China may become 50000 and 60000. The high-quality equipment investment of government led medical institutions is a huge incremental market, which can greatly promote economic development.

In addition, in addition to the hardware configuration is not in place, the configuration of medical staff is far from enough. At present, doctors and nurses in many hospitals are generally short of staff. In general, doctors and nurses outside the staff are equal to 50% of the staff inside the staff. That is to say, two thirds of the medical staff in a hospital are in the staff and one third are out of the staff. Then why dont we add 100000 or 200000 staff to let the doctors and nurses outside the staff into the staff?

On the surface, it seems to increase the governments financial expenditure, but in fact, on the one hand, it is to expand the governments public health consumption investment; on the other hand, the governments subsidy to the establishment has a leverage effect. It is necessary to know that the medical staff do not completely eat the royal food. The current doctors treat people in the hospital, and the governments investment in the establishment often only accounts for the medical staff One fifth of the hospitals actual income, so on the whole, the governments input into the establishment is the public investment that should be made, and it also brings huge social benefits.

In more than 2000 counties, 400 cities and prefectures, hospitals at all levels and other medical systems are not perfect and the number of people is not in place. If we improve the system and expand the establishment, we can not only greatly alleviate the shortage of doctors and nurses for 1.4 billion Chinese people, but also stimulate government consumption, which is more efficient than infrastructure investment It led to GDP growth. By the end of 2018, the total number of health workers in China is 12.3 million. According to the total number of 19 million health workers in the United States, there is still a huge development space in our country. If the total number of health workers reaches 60-80 million through government investment, it will greatly promote Chinas future GDP.

The establishment of a preventive public health and epidemic prevention system is a centenary plan with long-term investment benefits

Although the country now also has the relevant institutions of infectious disease prevention and control, from the perspective of social system governance, all cities in China are still lack of a complete set of public health system, infectious disease prevention system, ICU severe isolation resource management system. You can say that these three concepts can be found in every conventional hospital, but after all, a conventional hospital is a conventional hospital, which often does not have the infrastructure to control infection. Novel coronavirus pneumonia in 2003, a large number of infected people can not be treated in regular hospitals, because their infrastructure, such as air conditioning, sewage and so on, can not control infection, what is more, they can not treat patients with infectious diseases.

Therefore, a country and a city need an independent public health and epidemic prevention system, including various hospitals with sufficient number of beds set up according to the standards for the treatment of infectious diseases, as well as other infrastructure related to infection control. Many of these investments may seem like a waste, because there may be some facilities that we wont use for ten years. But for a country or a city, with these facilities, we can avoid the once-in-a-century devastating impact on the city.

Just like the flood control dyke of Huangpu River in Shanghai, we must build it according to the flood standard of 300 year return period and 500 year return period. Otherwise, once there is a flood, it is the life and death of tens of millions of people. Therefore, to establish such a public health and epidemic prevention system, you must take the once-in-a-hundred-year event as a real thing, build the system with high quality, and do well in the future, it would rather have some idle waste, than spend 100 billion yuan, and its depreciation interest is very high, but this is the improvement of the overall operation quality of the society and the social public security capacity Ascension.

This concept is the same reason that we spent hundreds of billions of yuan to do environmental protection, greening and ecological protection. You cant look at the current input-output ratio with quick success and instant benefit, nor that you hope to have a plague every year to make it play a great role if you have this system. But we should see the investment benefit of this system in the long run. It is a strong guarantee for a country to face a huge public health disaster. As such a system of public service, of course, it can not be built entirely by the market, by the people and by the enterprises, but by the public investment of the state and the city. Because public consumption is what the government, especially the central government, should do, especially this year.

This system of the United States is directly under the administration of the president. The public health system reports to the presidents health and safety committee and reports to the president. It has jumped out of the conventional medical and health management system and is an independent system. Therefore, China also needs to establish a complete social emergency response organization system. Once there is an emergency epidemic prevention problem, the emergency response system from one county to one city, to one province, to the whole country will be launched. Its like the national disaster Committee. Once something goes wrong, the emergency response office of the State Council will report it to the first report of several levels. Therefore, the national public health and epidemic prevention system should also rise directly to the national level, and be established by the state and governments at all levels.

The whole public health and epidemic prevention system has a set of independent governance system, which consists of three levels. The first level is the emergency response system, which is the reporting system of pulling alarm, warning and emergency action plan and implementation measures; the second level is the management and use of physical facilities for epidemic prevention, such as those isolation wards, which can be 10000 The beds are centralized in several designated hospitals, and can also be scattered in various hospitals. In this way, once there is an epidemic situation, the patients can be immediately isolated and prevented from spreading; the third level is the emergency expropriation mechanism during the epidemic period. Once there is an epidemic situation in a city, it is equivalent to entering a wartime state. Some civil facilities can be expropriated by the government according to the plan, including hotels, stadiums, exhibition halls, idle real estate of real estate developers, etc In order to control the source of infection, we should isolate a large number of suspected and close contact people and widely isolate people. These three levels cannot be temporary decisions, but have plans and preparations.

This public health and epidemic prevention system can not be built by every citys Health Bureau or any top three hospital. This system is the combat readiness function of social public health events, which is different from the basic demands of the hospital itself, so it must be planned by the central government as a whole and invested by governments at all levels. Through the previous analysis, we can see that this investment is worth all aspects of the government and has a long-term return on investment.

The state should vigorously strengthen the personnel training and basic scientific research of public health and epidemic prevention

From the epidemic situation in Hubei Province, it is not difficult to see how short the public health and epidemic prevention talents are. A layman of Huanggang citys health committee was removed from his post on the hot line. From one point of view, we must solve the problem of shortage of public health and epidemic prevention talents as soon as possible. The most long-term and effective way to solve the problem is to run education.

Among the three thousand colleges and universities of higher education in our country, there are only 80 universities with the major of public health and preventive medicine and the school of public health. But these public health colleges tend to pay more attention to prevention than emergency. When it comes to emergency epidemic prevention, it involves the integration of literature, science, medicine, industry and economy, and the intersection of politics, economy, public management and other disciplines. Therefore, the curriculum of each existing public health college should be greatly adjusted, and the education of emergency epidemic prevention should be emphasized.

The cultivation of public health and epidemic prevention talents must be expanded in scale and improved in quality. Colleges and universities should be encouraged to set up public health colleges, especially traditional strong schools of Arts, science and engineering. The construction of public health colleges should be strengthened. It is learned that even Tsinghua University does not have a School of public health. Only under the school of medicine of Tsinghua University, there is a public health research center of Tsinghua University, many of which are double top universities There is no school of public health.

So the first suggestion is that the Ministry of education should encourage double first-class universities (the original 985 and 211 universities) to set up high-quality public health colleges, rather than only medical colleges to set up this major. The Ministry of finance should have special investment to build this type of public health college, so as to quickly cultivate a group of talents who not only know public health, but also know systematic epidemic prevention and emergency response.

The second suggestion is to build a national key monomer public health and epidemic prevention University, such as China Public Health University, similar to the University of health and public service and NIH of National Institutes of health. The university should attach equal importance to teaching and scientific research, cultivate high-end public health and epidemic prevention talents for the country, concentrate on the establishment of research system and laboratory system of public health and epidemic prevention, gather high-end scientific and technological talents in the world, and undertake the frontier research work in the field of public health in China and even in the world.

In order to build a school of public health and a University of public health, we need to open the door and strengthen international cooperation. We can establish a whole college or university by joint venture or cooperation with internationally renowned institutions, or we can cooperate with foreign public health colleges or research institutions in a laboratory of a school of public health. That is to say, if we want to open up on this issue, all plagues are the common enemies of mankind. We must study and solve this problem from the perspective of all mankind. In this regard, rather than a small pattern, we should break the conspiracy theory from the perspective of the community of shared future of mankind, and truly play Chinas leading role in the field of global public health and epidemic prevention.

In addition, other existing public health and epidemic prevention research institutions should be sorted out to strengthen the system and pertinence of public health and epidemic prevention research, and the government should increase investment in this area. Many existing research institutions, such as some virus institutes, have not been able to really play a role and the research level is relatively low. The new research institutions set up by the government should not only study the viruses in China, but also the viruses in other countries in the world, so that China can lead the world in virus and epidemic prevention research.

When governments at all levels formulate the 14th five year plan, it is suggested to increase the proportion of public health and epidemic prevention

This new epidemic should be a very important lesson for our governments at all levels. We must learn from the past and strengthen our efforts in public health and epidemic prevention infrastructure, operation system, professional personnel training, etc. in the five years of the 14th five year plan, we should spend 200 billion to 300 billion yuan from the central government to the local government to shorten the public health system in China Board to make up, nothing good.

It is suggested that governments at all levels should pay full attention to investment, management and operation planning in public health and epidemic prevention infrastructure, operation system, personnel training and other aspects when formulating the 14th five year plan this year. We need to realize that it is not a loss to make up the short board of public health in the short term or in the long term. We specifically discussed the high-efficiency pulling effect of investment in public health infrastructure on GDP, that is to say, as long as we plan reasonably and implement effectively, this investment will be a sign that Chinas economy will enter into high-quality development in an all-round way.

Novel coronavirus pneumonia affects the hearts of all people and affects the global economy. Chinas economic losses are inevitable. The priority among priorities is to win the battle against epidemic prevention under the leadership of the Party Central Committee. We should try to avoid a great impact on the economy, especially the private sector, through a series of macro and micro policies.

(function() {(window. Slotbydup = window. Slotbydup| []). Push ({ID: u5811557, container: ssp_, async: true});}) (); anyway, we have seen trillions of economic losses brought by such a public health event. Therefore, it is very worthwhile for us to invest hundreds of billions of yuan in 5-10 years to establish and improve a national public health and epidemic prevention system. China should nip in the bud and avoid the novel coronavirus pneumonia and new crown pneumonia in China. The level of civilization of a society is reflected in the level of public infrastructure. In the past, Chinas government invested heavily in housing and transportation. Now its time to increase investment in infrastructure such as health and epidemic prevention. China has advanced long time system and strong organizational guarantee system. We have every reason to believe that under the leadership of the CPC Central Committee, we will be able to establish a sound national public health and epidemic prevention infrastructure through the 14th Five-Year or even longer construction. We should take time for all kinds of epidemic situations to minimize the impact of the epidemic on the socio-economic. Source: China Economic Weekly Author: Huang Qifan editor in charge: Hua Chengyu

In any case, we have seen trillions of economic losses caused by such a public health event. Therefore, it is very worthwhile for us to invest hundreds of billions of yuan in 5-10 years to establish and improve a national public health and epidemic prevention system. China should nip in the bud and avoid the novel coronavirus pneumonia and new crown pneumonia in China.

The level of civilization of a society is reflected in the level of public infrastructure. In the past, Chinas government invested heavily in housing and transportation. Now its time to increase investment in infrastructure such as health and epidemic prevention. China has advanced long time system and strong organizational guarantee system. We have every reason to believe that under the leadership of the CPC Central Committee, we will be able to establish a sound national public health and epidemic prevention infrastructure through the 14th Five-Year or even longer construction. We should take time for all kinds of epidemic situations to minimize the impact of the epidemic on the socio-economic.