120 Ambulances have always been a scarce emergency medical and ambulance resource. In order to standardize the development of the industry and use limited resources to the most urgently needed places, local health administrative departments have been exploring scientific development models. Last year, Nantong City , our province, issued relevant management measures, using public 120 for pre-hospital emergency, using private 120 for non-hospital emergency, supplementing scarce resources, and formulating a unified charging standard. However, nearly a year has passed. Although this practice has effectively curbed the existence of "black rescue" and regulated the industry order, Nantong Ruidi Emergency Station Co., Ltd., as the first private 120 emergency company in Nantong, has been to the outside world for the first time Express your voice: It is difficult for them to survive.
Citizens questioned the high charges for private ambulances
In February 2016, Mr. Zhou, a citizen of Nantong, transferred from Nantong University Affiliated Hospital to Shanghai for medical treatment due to pneumonia. Due to the multiple fractures in the lumbar spine, he could only lie flat. Under the unified dispatch of the Nantong 120 Emergency Management Center, a professional ambulance from the private Ruidi Emergency Station undertakes this task.
Nantong is about 120 kilometers away from Shanghai. At first, the agreed price between the two parties was 2,500 yuan, and the patients took care of the toll. However, the family learned later that since April 2015, Nantong City has unified the charging standards for pre-hospital and non-pre-hospital ambulances, with the fare being 40 yuan within 5 kilometers, 8 yuan per kilometer for the excess, and the medical fee being 90 yuan. . After the family complained to the competent department about the random charges of private ambulances, the price was cut in half to 1,300 yuan.
The more Mr. Zhou thought about it, the more wrong he felt. He felt that the charge was unreasonable. Didn’t it be said that the maximum is 10 yuan per kilometer? Either don’t contract or just the government comes. This is a welfare for citizens after all.
Private emergency enterprises are struggling to make progress
It is reported that in 2013, the National Health and Family Planning Commission stipulated that emergency centers (stations) and emergency network hospitals shall not use ambulances for non-pre-hospital medical emergency services. Based on this, the Nantong Municipal Health and Family Planning Commission has carried out industry reforms on the management system of 120 emergency stations in the local pre-hospital and non-pre-hospital areas. uses scarce public 120 resources to ensure pre-hospital first aid in various hospitals, and the government finances "guaranteed" ; Hand over non-pre-hospital ambulances to market-oriented private enterprises, and the enterprises bear their own profits and losses in the form of "public management and private"; Currently, there are two private emergency stations in the local area, and 8 ambulances have been approved for approval and included in Nantong City's 120 emergency rescue Central scheduling management.
Nantong Ruidi Emergency Station Co., Ltd. is the first private emergency company in the local area. Company head Li Weilin felt unfair about the current pricing regulations. He did some calculations for the reporter. The three ambulances under the company's name had a monthly turnover of about 130,000 yuan. Excluding operating costs, the monthly profit was only about 10,000 yuan, and the annual income was 120,000 yuan, which did not include vehicles and equipment. depreciation fees. According to this calculation, the company's investment of more than 2 million yuan will take more than 20 years to recover the cost. In addition, the method of billing one-way according to the actual number of kilometers makes them even worse. If there is no hospital to receive patients in a timely manner when transferring to a hospital in another place, no kilometers will be generated, and even the dual billing mode of taxis will earn much more than ambulances.
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Li Weilin: "To be honest, I have tried to turn it off many times, and I admit that I failed to invest. But the leaders told me that I hope I can see the future of the industry is still full of hope. Now I am just facing some crux of the problem, and there is no problem with the big framework. So I said, OK, I will continue to do it. "
Jiangsu News and Radio Reporter Zhu Liang (right) is interviewing
Price limit limit scope does not include private first aid enterprises
Reporter learned from Jiangsu Provincial Price Bureau that the price limit scope issued by provinces does not include private first aid enterprises , so if Nantong Ruidi First Aid Station is a private enterprise, it can negotiate pricing with users.
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Price Bureau staff: "Our policy is very clear. For non-pre-hospital emergency, if it is within the scope of 120 management , is the government-managed emergency center, so we have made it clear that 8 yuan per kilometer, and the floating up and down of each city cannot exceed 25 (%); we have no mandatory regulations for the private sector." ”
From this point of view, Nantong Ruidi emergency station The initial agreement price charge does not seem to violate the regulations of the Price Bureau.So, why has the Nantong Municipal Health and Family Planning Commission not relaxed the charging prices for non-pre-hospital emergency aid in private enterprises?
Nantong Municipal Health and Family Planning Commission is the administrative department of the local 120 emergency station. Kang Ning, deputy director of the Medical Administration Department, said that the current pricing standard for private 120 in Nantong is indeed relatively low, but in the price regulations of the Provincial Price Bureau, there are only two ambulances. Nature: public and private. They hope that the price limit policy will be more flexible, so that Nantong-style "publicly managed and private" ambulances can also increase the charging standards.
However, he believes that this does not mean that the people will pay more. Under the current circumstances, we can solve the problem from the following two aspects: First, the price increase is subsidized by the government's finance, because private rescue stations also undertake social welfare services. , The second is to include the ambulance medical expenses that are not pre-hospital emergency treatment in the scope of medical insurance reimbursement for ordinary people.
Internal facilities of first aid vehicles
Expert opinions
reporter learned from the Jiangsu Provincial Health and Family Planning Commission that the operating models of the 120 first aid industries in 13 prefecture-level cities in our province are different, and all regions are exploring scientific development models. The Provincial Health and Family Planning Commission supports all regions Through exploration, social management of non-first aid business can effectively alleviate the situation of lack of resources. Regarding the charging prices for socialized operation of non-pre-hospital emergency services, relevant staff from the Medical Administration Department said that relevant companies can apply for registration from the local price department. , however, the reporter did not understand the feasibility of the operating method.
Provincial People's Congress representative and Nanjing Chest Hospital Chief physician of the Department of Cardiac Thoracic Surgery of Nanjing Chest Hospital first affirmed the reform direction of Nantong. He also believes that this practice can effectively alleviate the current situation of insufficient public 120 first aid resources. However, he pointed out that if the government wants to "subsidize" non-pre-hospital private emergency enterprises, the first thing to do is to find out whether the enterprise is responsible for the government's affairs.
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Tang Jin: "The competent department needs to measure it. One is to have public welfare and subsidies. If it is not public welfare, it will be completely handed over to the market. Public welfare subsidies must calculate the cost to ensure that they have at least small profits. If you make contributions at full cost, you will not be able to persist in the long run. "
internal first aid kit
Nanjing University Law School Civil and Commercial Law Professor Qiu Lufeng believes that government fiscal revenue comes from taxpayers, and subsidized enterprises must also have the awareness of saving expenses. If the government cannot afford public products other than basic guarantees , it can be solved through a thorough market-oriented model, allowing more private capital to enter the industry to compete fairly, and the prices will naturally drop. Government departments only need to fulfill their regulatory responsibilities.
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Qiu Lufeng: "Because this is If you have this kind of taxpayer awareness, you will be very restrained in what public products you provide. You must provide what you should provide, and you do not have the right to provide what you should not provide. Then the shortage will be included in the next part. Market demand, you are open. The government’s function is to supervise the order after opening up. Don’t let cheating and unqualified cars get in. As long as those who meet the standards (ambulances) have the right to participate in the competition, but they do not meet all the ones that do not meet. banned." During the interview with
, the reporter provided the views of experts and scholars to Kang Ning, deputy director of the Medical Affairs Department of Nantong Municipal Health and Family Planning Commission. He was very moved that if it was completely marketized in a "one-size-fits-all" form in the short term, it would instead It will cause chaos in the non-hospital ambulance market and people's discomfort with price increases. He believes that the early stages of the reform of the private ambulance industry in Nantong still require policy guidance and encouragement. As long as the original intention and direction of the policy makers are correct, marketization under certain administrative intervention is more conducive to social harmony and stability.
Jiangsu News Broadcast
Reporter Zhu Liang Qian Yiming (intern)
Nantong Taiwan Reporter Fang Yue
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