Research On The Degree Of Equalization Of Basic Medical And Health Services From The Perspective Of Cost Difference

In March 2009,the State Council issued the Opinions on Deepening the Reform of the Medical and Health System,aimed at effectively reducing the burden of medical and health expenses on residents and alleviating the phenomenon of "expensive and difficult medical treatment".In 2012,the State Council issued《the Twelfth Five-Year Plan for the National Basic Public Service System》,which,on the basis of clarifying the financial responsibility of government at all levels for the provision of basic public services,proposed the strategic goal of equalizing the provision of basic public services among regions.The report of the 18 th National Congress further proposes that China should achieve the goal of Equalization of basic public services by 2020,and raise the equalization of basic public services to the level of strategic implementation.In recent years,China has vigorously promoted the development of people’s livelihood.The basic establishment of the National basic public service delivery system and the substantial increase in the level of supply have made great progress in equalizing basic public services and encountered new problems.This paper takes this as the starting point,deeply examines the achievements,present situation and existing problems of the equalization of basic medical and health services in China,and puts forward the concrete ideas and countermeasures to further promote the equalization of basic medical and health services in the region according to the new situation and new requirements.At present,the measurement of the level of Equalization of basic medical and health services in China is based on a unified national level,and the cost of basic medical and health services can vary from province to province due to different physical geography,economic environment and social conditions,resulting in different effect of financial input of basic medical and health services.Therefore,the measurement of Equalization data can take into account the National per capita standard and the cost difference coefficient,the former being the basis,emphasizing fairness;The latter is the key,reflecting efficiency,the two complement each other,both indispensable.In this paper,the author synthesizes the evaluation of each index and gets the score of three factors: environmental factors,economic factors and social factors.Then we divide the financial expenditure of basic medical and health services by the cost difference coefficient of each province and city,and use the Theil index to measure the difference between regions in the equalization of basic medical and health services,so as to get the actual difference of basic medical and health services in each province and city under the consideration of cost.The empirical results show that the cost difference coefficient of basic medical and health services in the East is small.The cost difference coefficient of the West is large,mainly due to the backward natural environment and economy of the West,the government still needs more input.The Thiel index of basic health services,adjusted for the coefficient of cost difference,is smaller,indicating that the level of financial capacity of basic health services in the provinces is slightly lower than expected,and that the cost factor for the financial input of basic health services in the regions is considered;The Theil Index breakdown shows that the differences within the group are greater than the differences between the groups,indicating greater inequality within the East and central regions,with the central regions being the most unequal,requiring government macro-control.Therefore,this paper puts forward some suggestions from the economic,environmental and social aspects,aiming at reducing the economic gap,improving the environment and stabilizing the society,so as to adjust the coefficient of cost difference and finally promote the equalization of basic medical and health services between regions.Specific proposals include: increasing spending on basic health care,providing more assistance to middle-and low-income people,treating the impact of ageing with caution,strengthening environmental awareness,rectifying industries with high pollution and energy consumption,establishing a two-way referral system and a medical separation system,and reforming the household registration system.