国务院医改办将于近期出台《关于药品流通行业改革发展意见》，“意见”拟将“暗扣”变“明扣”。“暗扣”是指药企给医生个人的提成，“明扣”则是将暗箱操作变成医院与药企之间的讨价还价，医院将这笔收入纳入本单位的绩效考核。

Cure of the state council on do will, in the near future[About drugs circulation industry opinion of reform and development],"opinion"Quasi will"hidden-interlocking"change"Ming button"."hidden-interlocking"Refers to the medicine qi to the doctor personal allowance,"Ming button"Is black case work into hospital pharmacy enterprises and between the bargaining,The hospital will be the income into this unit's performance evaluation.

　　药品价格虚高，是医改意见最为集中、共识最多的领域。其中流通环节过长、食利者太多——医院、医生、药企、销售、广告、官员等等，是药品价格虚高最为重要的幕后推手。“意见”从流通领域入手，鼓励流通企业并购、保护基本药物配送企业利润、限制医院处方保密等等，缩短利益链条，理顺利益关系，给药品价格清理创造空间。

The price of drugs virtual high,Is the most centralized medical opinion/The most common areas.The circulation link is too long/Rentier too much - hospital/The doctor/Medicine enterprises/sales/advertising/Officials and so on,The price of drugs is the most important virtual high behind the hand slap."opinion"Starting from the circulation field,Encourage circulation enterprise mergers and acquisitions/Protection of fundamental drug distribution enterprise profit/Limit the hospital prescription confidentiality, etc,Shorten interests chain,Straighten out the interest relationship,Give the price of drugs cleaning create space.

　　“暗扣”变“明扣”，将医生的灰色收入“洗白”，摆上台面，成为医院收入，并通过绩效考核，进行重新分配。若能顺利实施，药企支付给医院的费用可以实现公开、透明、可控(因为药企或医药代表私下给医生送“回报”是没有底线的，一旦公开化，幅度将变得可控)，或许还能出现一定的降幅，最终传导到药价上，让广大患者受益。

"hidden-interlocking"change"Ming button",Will the doctor's gray income"Wash white",Pendulum on the table,Become hospital income,And through the performance appraisal,redistribute.If the smooth implementation,Medicine to pay the cost of public hospital can be realized/transparent/controlled(Because the medicine enterprises or medicine representative privately to the doctor send"return"There is no bottom line,Once into the open,Amplitude will be controlled),Perhaps also can appear a certain decline,Final transmission to the prices,Let the patients benefit from.

　　将医生的回扣“弃暗投明”，忧虑也是有的。一者，医生收受回扣本来就属于商业贿赂行为，为法律所不允许。管理部门也曾经多次发文明令禁止，甚至采取过专项行动，整治医生收回扣现象。如将“暗扣”变为“明扣”，由医生收变成医院收，从个人独吞到“集体分赃”，是否意味着行为的性质就发生改变呢？至少在法理上，是有商量余地的。

Will the doctor's rebate"Forsake darkness for light",Anxiety is also some.darling,The doctor accepting rake-offs originally belong to commercial bribery,The law does not allow.Management department also once many times dispatch banned,And even take a special action,Regulation doctor receiving kickbacks phenomenon.If the"hidden-interlocking"into"Ming button",By the doctor charge into the hospital,From individual to take"Collective spoils",Does that mean the nature of the action of happens change it?At least in the legal theory,Is the negotiable.

　　二者，将“暗扣”变成“明扣”，结果会不会变成“双扣”——“明扣”出世，“暗扣”不死？毋庸讳言，这种可能性是存在的。一个厂家成功中标，仅意味着他们生产的药品获得进入医院的资格，但具体到某家医院用不用该药，用量大还是小，最终还得听医生的，药企对此不可能置之不理。因此，极有可能出现的情形是：药企既给医院“明扣”，又要派人去“维护”，给医生“暗扣”，因而出现“双扣”。如此一来，药企的“公关”费用难以下降，药价的下降空间也因此受挤压。

both,will"hidden-interlocking"into"Ming button",The results will become"shuangkou"--"Ming button"Was born,"hidden-interlocking"undead?Needless to say,The possibility exists.A manufacturer the success,Only means they are producing drugs get into a hospital qualification,But the specific to a hospital drug use,Dosage big or small,Finally still have to listen to the doctor's,This medicine enterprises could not ignore.therefore,Is very likely scenario is:Medicine enterprises not only to the hospital"Ming button",And sent"maintenance",To the doctor"hidden-interlocking",appear"shuangkou".so,Medicine enterprises of"Public relations"Cost is difficult to fall,Prices drop space also therefore squash.

　　医院收了“明扣”之后，会不会“扣住”自己的医生，不让他们私下再收？可能性也不大。一位业内人士曾撰文指出，医院院长之所以不愿意干涉医生拿回扣，原因有二：医生拿回扣无损甚而有利于增加医院收入；医生拿回扣损害的是患者利益而不是医院利益。如果不是外部力量强力介入，医院也缺乏管束医生的积极性。

Hospital accepted"Ming button"after,will"buckle"Own doctor,Don't let them privately to accept?Possibility is not large also.A personage inside course of study points out that once wrote,The hospital is not willing to interfere with the doctor take kickbacks,Two reasons:The doctor take kickbacks nondestructive even helped to increase the hospital income;The doctor take kickbacks damage is the interest of the industry rather than in patients with hospital interests.If not external forces strong interference,The hospital is also a lack of a bundle the doctor's enthusiasm.

　　药价虚高，根子在于“以药养医”，从药品身上获取巨额利润，以维持医院的正常运转，因此改革要从这里找到突破口。只要医药分家，“以医养医”，取消药品加成制度，实现市场化，药价自然就能降下来。国内有不少地方试水“医药分家”，其效果也证实了这一点。(连海平）

Virtual high drug prices,Source lies in the"To raise the medical medicine",From drug body of high profits,In order to maintain the normal operation of the hospital,So reform from here to find a breakthrough.As long as the medical centre,"To raise the medical medical",Cancel the drug addition system,Realize marketization,Prices natural can drop down.There are many places to test the waters"Medical centre",Its effect also proved this point.(Even the sea level)