桌上签字能否阻止桌下“交易”？ The table below the sign would prevent“trading”？

——卫生部拟规定医患双向签字不送“红包”引发关注 -health plans to sign not to deliver the doctor-patient two-way provisions“Red envelopes”Cause concern

　　卫生部日前就《加强公立医院廉洁风险防控》征求意见，规定“患者入院时进行医生不收‘红包’、患者不送‘红包’双向签字，协议书纳入病案管理”。此举引发社会热议，一纸协议能否根治屡禁不止的“红包”痼疾？“红包”现象，患者有怨言却要送，医生不情愿却在收，到底何时才能跳出这一怪圈？

It's ministry of health has《Strengthening public hospital clean risk prevention and control》For advice，provisions“When admission with doctors don't‘Red envelopes’、Patients do not send‘Red envelopes’Two-way signature，Agreement into the medical records management”。The move triggered social hot debate，A paper agreement can effect a radical cure the long-standing“Red envelopes”Chronic illness？“Red envelopes”phenomenon，Patients have complaints but to send，The doctor reluctant but in charge，Exactly when will the circle jump out？

“红包”原本在桌下，桌面签字无意义？ “Red envelopes”Originally under，Desktop signature meaningless？

　　对于卫生部此举，中华医学会党委书记饶克勤说，用明文规定告诉患者和医生，送“红包”和收“红包”都是不可取的，对于规范医疗行业从业人员行为是必要的。

The move to the health ministry，Association of party committee secretary RaoKeQin said，Use expressly tell patients and doctors，send“Red envelopes”And receive“Red envelopes”All is not advisable，For regulating medical industry practitioners behavior is necessary。

　　然而，北京市人大代表、隆安律师事务所合伙人强磊表示，约定虽可起到震慑和警示作用，但实际意义不大。“红包”本身就是暗箱操作的，怎么会写在书面上呢，这是道德问题，应该靠良心去做。“桌上签协议，只是走形式而已。”

however，The Beijing National People's Congress、This law firm partners strong lei said，Though agreement can have stunned and warning effect，But the actual meaning is not big。“Red envelopes”Itself is rigged，How can write on paper，This is a moral issue，Should depend on the conscience to do。“The table to sign an agreement，Just gone through the formality。”

　　记者在北京、深圳等地采访了一些医生，他们表示，中国是人情社会，人们习惯了办事给人家一些好处，实际上很少有医生主动向病人索要“红包”，病人大都是自愿的，因此这与违法犯罪是两回事。

Reporters in Beijing、Shenzhen interviewed some doctors，They say，China is human society，People get used to the somebody else do some good，In fact there are few doctors to voluntarily for patients“Red envelopes”，Most patients are voluntary，So this and illegal crime are two different things。

　　中华医学会肝病学会分会主任委员、北京友谊医院肝病中心主任贾继东则认为，患者发自内心尊重医生的医术、医德、人品表达感激送“红包”的数量不会太多。更多的患者是“从众心理，不送‘红包’不放心，怕不送得不到好的服务”。另外一种可能是，患者想得到额外更好地服务，比如提前住院、提前手术等。

Association of liver disease society branch the chairman of the committee、Beijing friendship hospital liver disease, director of the center JiaJiDong is considered，Heart patients with respect the skill of his doctors、Medical ethics、Character to express their gratitude“Red envelopes”The number of not too much。More patients is“Conformity psychological，Don't send‘Red envelopes’Don't trust，Don't be afraid to get good service”。Another possibility is，Patients want to get extra better service，For example in hospital in advance、Early surgery。

　　来自山东省的陈峰对记者说，去年他父亲患心脏病住院手术治疗，有朋友提醒一定要给医生送‘红包’，否则不好好给治。陈峰不好意思地趁医生一个人在屋时，塞了2000元的信封在医生口袋里，也给住院处的护士长送了同样的数额。

In shandong province from the ChenFeng told reporters，Last year his father heart disease surgical treatment in hospital，Has a friend reminded must give the doctor sent‘Red envelopes’，Otherwise not good to cure。ChenFeng embarrassedly while the doctor a person in the house，Filled 2000 dollars envelope in the doctor in my pocket，Also the head nurse ZhuYuanChu sent the same amount。

　　“还好我送了。”陈峰后来发现和他父亲同病房的其他人也送了。“因为医生到底会不会认真手术和治疗，患者没法检验。”陈峰说。

“Also good I send。”ChenFeng found out later and with the rest of the ward his father also send。“Because the doctor what will never seriously operation and treatment，Patients can't test。”ChenFeng said。

服务不好、医生待遇低，岂能靠“红包”解决？ Bad service、The doctor low salary，By can“Red envelopes”solve？

　　记者在医院采访时，有医生表示，医生是个高风险、高门槛、高强度的工作，收入并不高，“红包”是劳动价值的扭曲体现。

Reporters in the hospital in an interview，A doctor said，The doctor is a high risk、High threshold、The high strength work，Income is not high，“Red envelopes”Is the distortion of the labor value embodiment。

　　贾继东认为，医生的劳务价值没得到体现确实是问题，要改革，但是不能通过收“红包”来改。如果依靠收“红包”弥补劳务价值不足的损失，无异于饮鸩止渴。“医生收‘红包’本身就是不合法的行为，而且还有损医生的尊严。”

JiaJiDong think，The doctor's labor value didn't get really is reflected，To reform the，But not through the charge“Red envelopes”To change。If rely on the“Red envelopes”Make up for the loss of the value of labor shortage，The remedy is worse than the as。“The doctor‘Red envelopes’Itself is illegal behavior，But beneath the dignity of the doctor。”

　　如果对医生不能依靠政策规定获得体面的收入，用“红包”形式提高收入，最直接的是损坏了医患关系。“如果有患者治疗效果不理想，他可能会想，我为什么没有得到好的治疗，因为我没有送钱，或者说送的不够多。”贾继东说。

If the doctor can't rely on policy provisions decent income，with“Red envelopes”Form to raise revenue，The most direct is damaged the doctor-patient relationship。“If a patient treatment effect is not ideal，He may want to，Why didn't I get good treatment，Because I didn't send money，Or send much for it。”JiaJiDong said。

　　解决医生劳务价值不能得到体现的问题，必须靠政策解决。比如现在医药分开，增设医事服务费就是往这方面走的一步。“医生不是不能谈钱，关键是要靠自己的知识、技术、劳动合法、公正、体面地取得应有的报酬和地位。”

Solve the doctor labor value cannot be reflected problem，Must rely on the policy solution。Such as now medicine apart，Add the medical service charge is go to this step。“The doctor is not can't talk about money，The key is to rely on their own knowledge、technology、Labor legal、justice、Decent in reward for and position。”

　　有人担心自己不送红包就可能得不到好的服务？贾继东说，主要是因为医患间缺乏信任。医院的运营体制存在问题，非营利性医院客观上存在趋利性，医院自身的运营、发展全靠自己去挣钱。而医院自己挣钱的来源主要不是靠技术，而是靠卖药和检查费用，因此过渡用药和检查一定程度上存在。目前，医药分开的改革就是要革除这一痼疾。

Anyone worried about not give a red envelope may not get the good service？JiaJiDong said，Mainly because of a lack of trust between patient。The hospital operation system has a problem，Nonprofit hospital QuLiXing objectively，The hospital itself operation、Development go to make money all by themselves。And the hospital main sources of your own money not by technology，But by selling drugs and the inspection fee，So the transition to a certain degree examination administration and existence。At present，Medicine separate reform is to abolish the chronic illness。

　　有医生说：“现在是不拿‘红包’的都很清贫，拿‘红包’的活得反而很滋润，这样下去很可怕。”贾继东认为，在当前这个体制下，医术越高超，医德越高尚，挣钱越少的问题确实存在。

A doctor said：“It is now take‘Red envelopes’Are very poor，take‘Red envelopes’Instead of live very moist，Go on like this is terrible。”JiaJiDong think，In the present system，The superb medical，Medical ethics the more noble，The less money problems do exist。

　　国务院医改专家咨询委委员、北京大学光华管理学院经济学教授刘国恩说，患者找不到好的医生，或者做一个手术要等很久，因此送“红包”成了解决稀缺资源的手段。尽管“红包”确实起到了补偿医生收入的作用，但医生待遇问题不应该通过“红包”来解决。

Cure of the state council changes a expert consultation committee members、Beijing guanghua school of management (university economics professor LiuGuoEn said，Patients can't find a good doctor，Or do a surgery have to wait a long time，So send“Red envelopes”Become scarce resources to solve the means。although“Red envelopes”Really played the compensation of the doctor income effect，But doctors treatment problems should not pass“Red envelopes”To solve。

桌上协议与桌下改革并举，杜绝“红包”或可期 The table under the agreement with the reform simultaneously，Put an end to“Red envelopes”Or can be expected

　　多位专家表示，必须从制度上保证医生不收“红包”，有更高的合法收入，拿“红包”的医生承担相应的法律责任。

Several experts said，Must guarantee the system from the doctor not to receive“Red envelopes”，Have higher legal income，take“Red envelopes”Doctor bear the corresponding legal responsibility。

　　强磊等一些法律界人士指出，医务人员收红包，相当于利用职务之便收受贿赂，触犯了刑法，是犯罪行为；送红包也是行贿行为；如果有医务人员表现出“不给红包就不好好手术”的态度，就是罪上加罪，变成“索贿”。

Strong lei and so on some legal professionals said，Medical personnel receive red packets，Equivalent to use their position and take bribes，Breaking the criminal law，Is the crime；A red envelope is also bribery behavior；If there are medical personnel show“Don't give the red envelope is not good operation”attitude，Sin is a sin，into“sacked”。

　　但实际上，在司法实践中，很少有医生因为收受“红包”被追究法律责任的，即便被查处，也至多是做违纪处理。许多地方出台了规定，一旦发现医生收受红包将予以开除，但业内人士表示，收“红包”较多的基本都是医院业务骨干，医院怎么可能开除这些人呢？所以很多“禁令”最终沦为一纸空文。

But in fact，In judicial practice，There are few doctors for accepting“Red envelopes”Be shall be investigated for legal responsibility，And even if it is，Also at most do deal with discipline。Many local issued a regulation，Once found the doctor from red envelope will be dismissed，But people in the industry say，accept“Red envelopes”More basic is the hospital business backbone，How can these people expelled from the hospital？So many“ban”Finally, a dead letter。

　　贾继东、北京儿童医院血液病中心主任医师郑胡镛等认为，仅仅是原则性的规定缺乏约束力，行之有效的是严格的法律约束和监管机制。在欧美等法律体系发达的国家，医生和律师、教师等都是高社会责任的职业，对这些职业的监督体系非常敏锐，一旦发现违规行为，严格处罚，才能起到震慑作用。

JiaJiDong、Beijing children's hospital, director of the center ZhengHuYong physicians, would think，Only the provisions of the principle of binding upon both parties，Effective is strict legal constraints, and supervision mechanism。In Europe and America and other legal system developed country，Doctors and lawyers、The teacher is high social responsibility of occupation，These classes of supervision system is very sharp，Once found irregularities，Strict penalties，To play a deterrent effect。

　　郑胡镛认为，调整现行的医生收入体系，正确评价医生的劳动价值是解决医生“收红包”和根除医疗领域商业贿赂的关键所在。贾继东等医务人员认为，政府在进行制度安排时，必须充分考虑医生的收入，保证医生在接诊某个具体病人时，在具体的医疗行为时，不一味地想自己的收入。这才是合理的制度安排。

ZhengHuYong think，Adjust the current doctor income system，Evaluation of the doctor's labor value is to solve the doctor“Accept red envelopes”And eradicate the medical field is the key to the commercial bribery。JiaJiDong and medical personnel think，In the government for system arrangement，Must consider the doctor's income，Ensure that the doctor sees in a specific patient，In specific medical behavior，Not blindly to their income。This is the reasonable arrangement of system。

　　贾继东、刘国恩认为，从更深层次来看，还是需要解决医疗供给不足的问题。卫生部门要想办法开放医疗市场，解放医生，为其提供有效的平台，同时引入社会力量，加大医疗服务供给量。

JiaJiDong、LiuGuoEn think，From beneath the surface，Still need to solve the problem of shortage of medical supplies。The health department must think of a way to open the medical market，Liberation doctor，Provide the effective platform，At the same time introducing social power，Increasing the supply of medical service。

　　还有专家指出，除了医疗系统内部的改革外，还需要社会大环境的改善。(记者李亚红、赵仁伟、郭宇靖、郭沛然)

And experts say，In addition to medical system of internal reform outside，Still need social environment improvement。(Reporter LiYaGong、ZhaoRenWei、GuoYuJing、GuoPeiRan)