Source: China Financial Forty Forum
"This huge public health event in the new coronary pneumonia epidemic shows the inadequacy, irrationality, and imbalance of China's existing medical and public health systems. In addition to the inadequate hardware configuration, the configuration of medical personnel is far from enough. On the other hand, fiscal expenditure data shows that China ’s public health investment is obviously insufficient. In this regard, the country needs to vigorously strengthen the supply-side comprehensive reform in the field of public health and the prevention and treatment of infectious diseases to solve the directional problems, systemic problems, and fundamentals in this field. Problems, making this field an important engine for promoting China's social and economic development.
From the perspective of social system governance, every city in China currently lacks a comprehensive public health system, infectious disease prevention system, and ICU severe isolation resource management system. This public health and epidemic prevention system is a strong guarantee for a country in the face of a huge public health disaster. It must be planned by the central government and invested and constructed by governments at all levels. In addition, to solve the problem of insufficient public health and epidemic prevention personnel as soon as possible, the longest and most effective way is to run education. The training of public health and epidemic prevention personnel must expand the scale and improve the quality, and encourage universities to set up public health colleges. At the same time, they should strengthen international cooperation and study and solve this problem from the perspective of all mankind. It is recommended that governments at all levels, when formulating the "Fourteenth Five-Year Plan" this year, must pay full attention to investment and management and operation planning in public health and epidemic prevention infrastructure, operation system, personnel training, etc., spending 200 billion-3000 from the central to the local 100 million yuan will make up for the shortcomings of the entire public health system in China. We must be aware of the high efficiency of the public health infrastructure investment in stimulating GDP-as long as we plan reasonably and implement effectively, this investment will be a sign of China's comprehensive economic development. "
—— Huang Qifan, Academic Advisor of China Financial Forty Forum (CF40) and Vice Chairman of China International Economic Exchange Center
After the outbreak, the Chinese public health system
To spend two or three hundred billion to make up for the shortcomings
Text | Huang Qifan
Does the occurrence and development of the epidemic indicate that there are still many systemic problems in China's existing public health system and the prevention and treatment of infectious diseases? Is it possible to fundamentally prevent the occurrence of major epidemics and eliminate them in the bud? The plague forced us to reflect deeply.
The country needs to vigorously strengthen the comprehensive supply-side reforms in the areas of public health and infectious disease prevention and control, solve the directional, systemic, and fundamental problems in this field, and make this field an important engine for promoting social and economic development in China. Expanding investment in public health facilities and improving the quality of public health supply in the past 40 years of reform and opening up, as an important engine of China's economic growth, has continuously released its consumption potential, with GDP increasing from 367.9 billion yuan in 1978 to 90 trillion yuan in 2018. In 2010, consumption, investment, and net exports each accounted for roughly 1/3 of GDP, but in the last 5 to 10 years, through supply-side structural adjustment, consumption has accounted for about 60% of GDP (2019), while investment And net exports accounted for only about 40%. To be sure, to maintain long-term economic growth, we must maintain and expand the driving force for consumption. Consumption includes two parts: personal and government public consumption. In general, personal consumption has limited room for growth, but government public consumption, including education, health and culture, has great potential. In the past, government infrastructure investment accounted for a large proportion, but public facilities investment and public consumption accounted for a relatively low proportion. For example, the number of hospitals in the country increased from 9,293 in 1978 to 33,009 in 2018, an increase of 3.55 times, but GDP grew by 240 times during the same period. The difference between the growth rates of the two is obvious, which shows that China's public health investment is obviously insufficient. In 2018, China ’s public health expenditure was 1.6 trillion yuan, accounting for only 1.7% of GDP. To this end, it is recommended that after the epidemic, the finance should transfer part of the money invested in planned projects to public health and other public facilities to improve the quality of the national public health supply, and use this government consumption to promote the sustainable and high-quality development of the Chinese economy. Experience shows that only about 30% of the financial investment in railway and highway infrastructure is converted into the GDP of the year; however, investment in public services and facilities such as education, health, and culture can be converted into the GDP of the year by roughly 60% to 70%. Therefore, it is also financial investment, with higher investment efficiency in the field of public health and a greater impact on GDP. At the same time, meet the needs of the people and form a balance of social services.
Medical and public health systems have huge room for "quality investment"
The epidemic showed the problem of insufficient, unreasonable and unbalanced existing medical and public health systems in China. The actual situation is that in addition to the developed cities such as Beijing, Guangzhou, Shenzhen and Hangzhou, many large cities have insufficient number of top three hospitals and inadequate facilities, and the allocation of medical resources at all levels in small and medium-sized cities is incomplete and unreasonable, and medical facilities and treatment levels are uneven. Qi. This is the reason why large cities and large hospitals are often overwhelmed. The existing medical facilities at various levels in small and medium cities differ too much. As a whole, there are situations in which various medical facilities are not yet sound enough, so people go to the big The hospital ran away.
The establishment of a preventive public health and epidemic prevention system is a hundred-year plan with long-term investment benefits
Although the country now has relevant institutions for the prevention and treatment of infectious diseases, from the perspective of social system governance, every city in China is still lacking a complete public health system, infectious disease prevention system, and ICU severe isolation resource management system. You can say that these three concepts can be found in every conventional hospital, but a conventional hospital is a conventional hospital after all, and it often does not have the infrastructure to control infection. Why the SARS in 2003 and the current new coronary pneumonia, a large number of infected people can not be admitted to conventional hospitals, it is because of their infrastructure, such as air conditioning, sewage, etc., there is no way to control the infection, there is no way to treat the infected patients. 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 the control of infection. Many of these investments seem to be a waste, because there may be some facilities that we will not use for ten years. But for a country or a city, with these facilities, it is possible to avoid the devastating blow to the city once every 100 years. Just like the flood control levee of the Huangpu River in Shanghai, we must build it according to the flood standard of once every 300 years and once every 500 years. Otherwise, once there is a major flood, it will be a matter of life and death for tens of millions of people. Therefore, to establish such a public health and epidemic prevention system, it is necessary to prevent accidents before they happen, so we have to treat the once-in-a-year events as realistic things, build the system of high quality, and do a good job of having some idle waste after doing well, such as Spend 100 billion yuan, and its depreciation interest is very high, but this is the improvement of the overall social operation quality and the improvement of social public security capabilities. The entire public health and epidemic prevention system has a set of independent governance systems. This governance system includes three levels. The first level is the emergency response system, which is the reporting system of layers of warnings, layers of early warnings, and emergency action plans and implementation measures. The second level is the management and use of physical facilities for epidemic prevention. For example, those isolation wards can have 10,000 beds concentrated in several designated hospitals, or each hospital can be scattered. In this way, once an epidemic occurs, patients can be immediately quarantined to avoid the spread of infection; the third level is the emergency requisition mechanism during the epidemic. Once an epidemic occurs in a city, it is equivalent to entering a wartime state, and some civil facilities can be used by the government Requisitioned according to the plan, including hotels, stadiums, exhibition halls, and real estate companies' idle properties, etc., is used to isolate a large number of suspected and intimate people, and to control the source of infection by widely isolating people. None of these three levels can be a temporary decision, but a plan and preparation. China has the advanced nature of the system and a strong organizational security system. We have every reason to believe that under the leadership of the Party Central Committee, through the "14th Five-Year Plan" and even longer construction, we will certainly be able to establish a complete set of The national public health and epidemic prevention infrastructure can deal with various epidemic situations calmly and minimize the impact of the epidemic situation on social economy.
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