Some time ago, a short video set off a wave of followers, calling on hospitals to cancel all examination fees.
Many people’s first impression of the hospital is that the fees are expensive and there are many examinations. someone said. Just went to the hospital and not hospitalized, just checked a bunch of them, costing thousands of dollars. Netizens also expressed many opinions on whether the hospital should cancel the examination fee.
Image source: screenshot of short video platform
Netizen a: After free, there will be an indefinite queue, The gap between rich and poor is obvious.
Netizen b: This is like boasting that medical care in India is free for all, but ordinary people have to wait in line for half a year for CT examinations
Netizen c: The examination fee is indeed expensive, and repeated examinations are expensive It is more expensive and unbearable as a patient.
Why are hospital exams so expensive? What happens if the inspection fee is cancelled in its entirety?
First, India has achieved universal free medical care, why can’t my country?
There are rumors on the Internet that India has achieved universal free medical care. But in fact, India is not free medical care, and India’s annual personal medical expenses account for more than 60% of the total health expenses.
The National Medical Insurance Bureau has responded to this, Our country is not suitable for universal free medical care. Although my country’s basic medical insurance network covers more than 1.36 billion people, and people’s medical insurance coverage rate is stable at more than 95%, my country still lacks sufficient conditions to achieve universal free medical care, because the current level of medical insurance financing is not enough , and the fund support capacity is also insufficient. If the universal free medical care is implemented, it is not conducive to the long-term stable and sustainable development of my country’s medical security system. Therefore, it is still necessary for individuals to bear certain responsibilities for medical and health expenditures.
Second, why is the hospital examination fee expensive?
The reason why the examination fee is expensive is first of all, it has something to do with medical equipment.
Take blood routine examination as an example, the instrument used in the past was cattle and abalone counting board. The inspector mixes the collected blood with diluents of different multiples evenly, and then drops it into the bovine and abalone counting plate, and counts the red blood cells, platelets and white blood cells in the counting pool with a microscope. If white blood cell differentiation is also required, the blood needs to be pushed, stained, and counted cell by cell. Using this method to do blood routine, skilled laboratory personnel can do about 20-30 in a morning.
Now, most of the instruments for checking blood routine have been switched to hemocytometer. The hemocytometer can automatically dilute, stain and count blood, and can easily complete 200-300 blood routines in one morning. analyze.
Increase in inspection speed also means an increase in instrument cost. The cost of cattle and abalone counting plates and supporting diluents is low, while the price of hemocytometer is generally between hundreds of thousands to hundreds of thousands, and some are even as high as millions, and the supporting diluent, hemolysin and cleaning solution, etc. The cost of reagents is not low, from 300 to 500 for cheap, and from 800 to 1,000 for expensive. These costs are evenly spread on a single test specimen, resulting in a high cost.
Secondly, The level of the inspection fee is also related to the inspection item.
If you only check items such as transaminase, urea, cholesterol, etc., because the check method is simple, the check cost will not be particularly high. But now there are many more inspection items, and the content of the inspection will be more detailed.
Take the examination of kidney function as an example, creatinine is usually checked, which can evaluate the glomerular filtration rate, and thus the filtration function of the kidneys. But creatinine levels don’t rise until there’s a certain level of kidney damage, so creatinine alone won’t detect early kidney damage. Therefore, an additional cystatin C test is usually added when examining kidney function, which can detect early kidney damage, but the disadvantage is that the cost is high.
Inspections are expensive, also associated with upgrading inspection methods.
Take the examination of five hepatitis B items as an example. In the past, ELISA method was commonly used, but now many hospitals have switched to chemiluminescence method, because chemiluminescence method has a shorter detection time than ELISA method, and the detection More comprehensive, even if the patient’s hepatitis B virus and hepatitis B antibody content is low, it can be detected, which greatly shortens the window period of hepatitis B detection, but the cost of chemiluminescence method will be much higher than that of ELISA method.
Actually, the cost of testing is relatively cheap compared to the current price. For example, blood sugar testing is generally only about 5 yuan, which is cheaper than a cup of milk tea; even a full set of biochemical tests is only four or five hundred yuan. , which is equivalent to the price of buying a coat in a specialty store. In this comparison, the inspection fee is really not expensive.
3. What happens if I cancel the inspection fee?
If the hospital cancels the examination fee, then some examination items may be cancelled, and the symptoms of many diseases are similar, the early symptoms are not obvious, and the patient may not understand It is difficult for doctors to objectively understand the patient’s true physical condition if their own situation or description is wrong, which will undoubtedly greatly increase the difficulty of diagnosing the disease, and may also increase the rate of misdiagnosis.
And the hospital mainly relies on the collection of examination fees, registration fees, surgery fees and drug fees. Registration fees are generally relatively cheap, and medicines for common diseases are not expensive, but it is necessary to maintain the normal operation of a hospital, such as water and electricity fees, equipment maintenance fees,There are also a lot of medical and nursing salaries. If the examination fee is cancelled, in order to make up for the reduced income, the hospital will reduce the number of doctors and increase the price of medical services. harder and more expensive.
4. Which examinations are more expensive in the hospital?
Many patients have a misunderstanding that the more expensive the examination, the better. In fact, different diseases have their own inspection methods, which is the best for you. Hu Yang, an attending physician of the Department of Respiratory Medicine, Shanghai Pulmonary Hospital Affiliated to Tongji University, said that the following types of examinations are indeed expensive.
1.PET-CT
PET-CT is more accurate than ordinary imaging in analyzing malignant tumors, which can help patients find earlier tumor lesions. The inspection cost of PET-CT is usually more than 7,000 yuan, which is related to its equipment cost and drug cost. The price of a PET-CT device alone has exceeded 30 million yuan, and it also requires millions of maintenance costs every year.
2. Coronary angiography
Coronary angiography is widely used in the diagnosis of coronary heart disease and other heart diseases. The main and branch lumens of the entire left and right coronary arteries help doctors understand whether the patient’s blood vessels have stenotic lesions, and clearly diagnose the location, scope, and severity of the lesions. The accuracy of the results and the safety of the inspection are high.
The general price of coronary angiography is about 5,000 yuan. If the coronary artery has an abnormal origin of the coronary ostium, a special angiography catheter needs to be used, and the examination cost will increase by about 1,000 yuan. And because coronary angiography is an invasive examination, patients need to be hospitalized for 3-5 days after the examination, which will also increase certain other costs.
3.CT and magnetic resonance
CT and magnetic resonance are both commonly used imaging examination items. In terms of price, magnetic resonance is higher than CT, while Enhanced CT is higher than plain CT. Both CT and MRI are charged according to the part, and the price of a single part is about 200-500 yuan. If you need to do multiple parts at the same time, or perform plain and enhanced CT through water, the cost is 2000-3000 yuan.
If the patient also needs vascular imaging, then the price of CT angiography (CTA) and magnetic resonance angiography (MRA) will be higher. The price of scanning is around 400-500 yuan, while the price of CT head arterial angiography is around 700-1000 yuan.
The upgrading of inspection instruments and methods can improve the diagnosis rate of diseases, which is the progress of modern medicine. Therefore, we need to treat the cost of examination rationally, so as to form a good doctor-patient relationship.
References:
[1]Wei Mo. Is the inspection fee in the hospital really expensive? Laboratory Medicine, 2019-12-24
[2] Implement free medical care for all? National Medical Insurance Administration: It is still necessary for individuals to bear certain medical and health expenditures. China Economic Net, 2021-10-27
[3] Which examinations in hospitals are too expensive to accept, and the more they cannot be shared, the more expensive they are. Doctors can’t stand it either. Respiratory doctor Hu Yang, 2020-01-03