医药“暗扣”要变“明扣”？ medicine"hidden-interlocking"Want to change"Ming button"?

权威人士称子虚乌有，但引出的问题确耐寻味 Authorities say thin air,But the problem of derivation it resistant to ruminate

　　昨天，网上一则消息被热传。该消息称：医改办近期或出台《关于药品流通行业改革发展的意见》，医院药品提成将从“暗扣”变“明扣”。

yesterday,Online news is heat transfer.The news says:Do cure the near future or issued[About drugs circulation industry reform, development and opinion],The hospital drugs from the commission will"hidden-interlocking"change"Ming button".

　　这则消息源于某报17日头版的一则新闻，文中说：“记者从消息人士处了解到，国务院医改办近期将出台对药品流通行业变革发展具有指导性的《关于药品流通行业改革发展的意见》。医院药品提成将从‘暗扣’变‘明扣’。”

The news from the front page of the newspaper playfully 17 news,This paper said:"Reporters from a source place to know,Cure of the state council recently issued will do to the circulation of medicines industry development change with guidance[About drugs circulation industry reform, development and opinion].The hospital drugs from the commission will‘hidden-interlocking’change‘Ming button’."

　　该文进一步说：“该消息人士透露，药价虚高的流通环节还应包括医院中的‘流通’——向医生支付30%左右的药品提成费。据透露，《意见》提出了具体措施解决这一问题，将‘暗扣’变‘明扣’。‘暗扣’是指药品分销企业给医生个人的提成，‘明扣’则是将暗扣这种暗箱操作的做法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。”

This paper further said:"The news sources,Prices virtual high circulation link should also be included in the hospital‘circulation’Payments to doctors - 30% of drug royalties.According to reveal,[opinion]Puts forward the specific measures to solve this problem,will‘hidden-interlocking’change‘Ming button’.‘hidden-interlocking’Refers to drug distribution enterprises to the doctor personal allowance,‘Ming button’Is this dark buckle the black-box approach into the hospital pharmacy enterprises and between the bargaining,The hospital will be the income into this unit's performance evaluation."

　　此消息一出，立即引起社会广泛关注。

This message a,Immediately a widespread social concern is caused.

　　记者昨天向江苏省医改办核实。省医改办相关负责人十分慎重，经与国务院医改办核实后郑重告诉记者：“国务院医改办权威人士说，这个消息子虚乌有！”

Reporters yesterday in jiangsu province to do medical check.Reform the relevant person in charge of provincial do very careful,With the cure of the state council after check do solemnly told reporters:"Cure of the state council do authorities say,The news thin air!"

　　记者昨在江苏省卫生厅和江苏省医学会采访后得到的消息也都是：“目前尚未听说有该文件的调研与征求意见。”

Reporter yesterday in jiangsu province health department and jiangsu province medical association after the interview got the news are also:"At present has not heard about the document investigation and seek advice."

　　中国医药企业家协会顾问、南京大学政府管理学院顾海教授接受本报记者采访时指出：“这是个大笑话。医生的暗扣到底是多少，是个无法统计到的数字。全国大大小小医院的扣率是不一样的，每个厂家每个具体产品，给予不同的扣率。每个医生拿回扣的多少也是根据处方量和药品零售价，这个数据是算不出来的，30%也可能超，也可能还不够。即使这个数据能够统计出来，完全杜绝‘暗扣’，在强大的经济利益惯性下，也会是一个长期的过程，绝对不是哪个政策就能一蹴而就的，更不可能以‘明扣’的形式予以纠正。”

Chinese medicine entrepreneurs association consultant/Nanjing university school of government GuHai professor accepting our newspaper reporter to interview pointed out:"This is a big joke.The doctor's hidden-interlocking exactly is how much,Is a can't statistics to digital.The national greatly small hospital KouLv is different,Each manufacturer each specific product,Give different KouLv.Each doctor how many take kickbacks is according to the prescriptions of and drug retail price,This data is not count out,30% May also super,Also may not be enough.Even if the data can be calculated,Completely prevent‘hidden-interlocking’,In under the powerful economic interests in the inertia,Will is a long-term process,Absolutely not which policy can accomplish in one move of,More impossible to‘Ming button’Form to be correct."

　　顾海教授认为，从来没有哪个政策规定、没有哪个部门认定拿回扣是合法的，纪检部门也一直在介入，但还是成为行业潜规则。现在暗扣的手法也是层出不穷，比如和某医生合作搞科研，给你个十几万的研究费，这个如何被界定和查出是回扣？卫生监管部门如何保证“暗扣”变“明扣”后，“暗扣”就能完全杜绝？搞不好还会成为“地上地下”共存的“二度回扣”。

GuHai professors think that,Never which policies/No department take kickbacks that is legal,Discipline inspection departments also have been involved in,But as an industry latent rules.Now hidden-interlocking technique is also emerge in endlessly,Such as a doctor and research cooperation,Give you a several hundred thousand research fee,This how to be defined and detecting is kickbacks?Health supervision department how to guarantee"hidden-interlocking"change"Ming button"after,"hidden-interlocking"Can completely eliminate?Maybe will become"underground"coexisting"Bis rebate".

　　南京市一位不愿透露姓名的大医院院长对记者坦言，就目前政策来说，如果撇开招标采购价然后再与药企“二次议价格”是严重的违规行为，要做到这一点，首先必须打通政策障碍。

Nanjing, one does not wish to disclose the name of the large hospital dean said to reporters,The policy for example,If put aside the bid for the purchase price and then and medicine enterprises"Secondary negotiate prices"Is a serious violations,To do this,You must get through policy barriers.

　　网络上不少业界人士也纷纷提出异议，一位加V的新浪微博网友@医药纵横在微博中就明确表示了对该“新政”可信度的质疑：“新闻无确切来源，经核不属实，別传了。”记者注意到，他的认证资料显示为北大纵横管理咨询公司医药合伙人。网友@nasa222跟帖道：“我也觉得这条消息不靠谱。”浙江台州市立医院的章雷网友@章雷的微博甚至预言，“不出三天，卫生部就出来辟谣。”

The network many practitioners have to raise an objection,A plus V sina micro bo net friend @ medicine aspect in micro bo, made it clear that for the"New Deal"Credibility question:"News is the exact source,The nuclear not true,Supplementary biography the."Reporter noticed,His the authentication data display for north aspect management consulting company medicine partner.Net friend @ nasa222 reply way:"I also think the news without spectrum."Zhejiang taizhou city hospital ZhangLei net friend @ ZhangLei micro bo even predict,"Less than three days,The ministry of health went out again."

　　向药价开刀，减百姓负担，引起了很多网友的关注，相比专业人士的冷静，公众倒是对这个热传的“或出台政策”的初衷给予肯定，并对“再挤虚高药价水分”给予期待。他们认为，医生开大处方、大检查、用进口手术器材等，根源都在“暗扣”二字。“暗扣”导致医患不信任，关系紧张，还导致医生之间互相攀比收入，处方越开越大，检查越开越多，严重加重了百姓负担，为人们所诟病。不管这个传言是否属实，这个顽疾都应该被政府及早纳入新医改的议事日程中。

To operation prices,Reduce the burden of the people,Caused a lot of net friend's attention,Compared with professional calm,The public is on the heat transfer of"Or policy"To be the original intention,and"Then squeeze virtual high prices moisture"To look forward to.They think,The doctor prescribed DaChuFang/examination/Use imported operation equipment, etc,Roots are in"hidden-interlocking"Two words."hidden-interlocking"Cause the doctor-patient trust,tension,Also led to the each other between the doctor "keep up with the joneses" income,The more the greater the open prescription,Check the more the more open,Serious aggravate the burden of the people,As people have noticed.No matter that rumor is true,This position should be the government as soon as possible into the new medical reform in the agenda.

　　“现在农村乡镇卫生院和城市社区医院都实施了基本药物制度，基药的价格几乎被挤干了水分。医生开药回扣问题主要集中在二级以上大医院，这个现象比较普遍。”省内一家三级医院院长介绍说，现在二级以上大医院虽然也实行了招标购药、集中采购，但中标药品价格仍然比较高，同一种品牌的药，零售药店的价格平均要比大医院低出10%-20%，因此药企仍然有给医生回扣的较大空间。

"Now the rural township health center and urban community hospitals are implemented a system for basic drugs,Base medicine price almost squeezed out the water.The doctor prescribe rebate problem mainly concentrated in the second class above big hospitals,This phenomenon is quite common."Province a tertiary hospital dean said,Now the second class above big hospital although also implemented bidding purchase medicine/Centralized purchasing,But the drug price is still high,The same kind of brand of medicine,The price of retail pharmacy, on average, more than large hospital low out 10% - 20%,Therefore medicine enterprises still have to the doctor the larger space of the commission.

　　南京一家药企销售部经理告诉记者，我国医药企业总盘子与美国差别不大，但我国批发流通企业有1.2 万多家，而美国只有几十家，不少小型药品流通企业运行成本高效率低，缺乏规模效益。目前药品从生产厂家出来流通到百姓手里，经过多少个环节、加了多少利润搞不清楚。

Nanjing a medicine to sales manager told reporters,The medicine enterprises in our country and the United States the total difference,But our country wholesale distribution enterprises more than 12000,And the United States had dozens of,Many small drugs circulation enterprise operation cost high efficiency low,Lack of scale benefit.At present from drug manufacturers to flow out of the hand of the people,How many a link/Add how much profit don't know.

　　他认为，最理想的办法是国家相关部门核实每种药品的成本价，然后分别给药品生产商、批发商、医院一定的合理利润空间，挤掉中间流通环节的水分，这样才能真正让百姓受益。(记者 沈峥嵘 仲崇山 刘艳元 见习记者 孟旭)

He thinks,The ideal way is the national related department to verify the cost price of each drug,Then, the pharmaceutical manufacturer/wholesalers/The hospital must be reasonable profit space,Edge out intermediate circulation of water,In order to truly let the people benefit.(Reporter ShenZhengRong ZhongChongShan LiuYanYuan trainee reporter MengXu)