You find here? Feeling of love, always feel very sweet in the beginning, I felt much more a stay, one more person to help you share, you finally no longer alone, at least one person thinking of you, Lianzhao you, Whatever you love, as long as together, is good, but slowly, with the deeper understanding of each other, you begin to discover each other's shortcomings, so the problem occurred one after another, you start trouble, tired, or even want to escape, some say love is like picking up rocks, always want to pick up a suitable, but you know when and how it can be picked up? her for you, then you may also suitable for her? In fact, love is like terrazzo Like, maybe just pick up when you are not so satisfied, but remember that people are resilient, many things can be changed as long as you determination, courage, and their unknown everywhere to pick up a stone, not as good will they have a polished stone, you start to wear out you?
a lot of people thought it was because of feelings of light, so people would become lazy. wrong! actually conquered people get to be inert, so the feeling will pale .
at a dinner occasion, it was suggested to eat more shrimp on the body good, this time there is a middle-aged man suddenly said: Ten years ago, when my wife or my girlfriend, she said eat ten shrimp, I peel twenty to her! Now, if she wanted me to help her peel shrimp shell, kidding! I did not even help her interest in clothes off, and also peeling shrimp shell blanket!
hear me ? understand? No wonder more and more people just want to talk about a lifetime of love, has refused to marriage. because, marriage easy to become lazy. If people are too lazy to talk, listen too lazy, too lazy to create surprises, too lazy to tenderness, then between husband and wife or lover, how would not drift apart gradually silent it? So remember: a dynamic of love, is the need to moderate irrigation hospitality, love, it is not lazy Oh!
have a couple, similar to the meal after work, shopping, but the girls because the company delayed the meeting, and when she arrived, when Mao Zhaoyu has more than 30 minutes late, and his boyfriend is happy to say: every time you have it, now I did not feel anything, and I will no longer waiting for you! instant, the girl finally burst its banks collapsed, and she was thinking: Maybe they never the future of the.
the same in the same place, another couple is facing the same situation; girl arrived late for half an hour when his boyfriend, said: it! love, hate is often only one of our idea! love not only tolerance but also to understand the time and many things may just change that fills your heart! understand you?
When someone loves you, and you think he was good. That does not mean that you would choose him. We always said: , you can not answer him, because you do not know.
Yes, we always thought that we would love to find a man she loved. But later, when we suddenly look back, we will find how he had been naive. if never started, how do you know she will love it love that person?
fact, love the feeling, is to experience a lot of things together, found only after . Maybe everyone wants to be able to find their own favorite partner hundred percent, but you have not thought about: your side would already been a long time in silence to pay you, but you do not find it? So, still a close look to see the people around you! he might have been waiting for you myself!
When you love someone, love to just eight absolute good. All the expectations and hopes are only Qi Bafen; the remaining two or three minutes with to love yourself. If you continue to love even more, is likely to give each other a heavy pressure, so that each breath, completely lost the love of fun. So remember, do not drink drunk more than six points, eat not more than seven full, love a person no more than eight.
day my friend asked me: views on love are not the same, say the name is to enlighten, but the wrong hand, afraid to become misleading. it bad! : love a person, to understand, but also open solution; to apologize, but also thanks; to admit, but also error correction; to be considerate, but also understanding; is to accept, rather than endure; is tolerance, not condoned; is to support rather than domination; is sympathy, not questioned; is talk, not a complaint; is memorable, but not forgotten; is communicate with each other, rather than explain everything; is silent pray for each other, not many of the demands to each other; to romantic , but do not waste; can always holding hands, but it should not break up. respectively, and also in the back? If you come back we do? do not expect you and I spend the life that person, I only hope is to give you that most deep-seated feelings of gratitude for life who never fail.
Thursday, February 17, 2011
Wednesday, February 16, 2011
Three-Chuang Zhu
Three strikes Zhu Jia Zhuang ;. Two days ago, special secretary to find understanding
degree brigade found the harvest behind schedule, introduced a few brigade south to help the task force wheat harvest has started, the brigade secretary Wang Hanren agreed with the Commissioner to invite gay task force to the village before the village to help the harvest, the panel get this information, just .
Zhuang village before the brigade Party branch meeting, the comrades here have been plagued by the slow progress of the current harvest, the group has emerged in turmoil Cadres, study and plan to change the current status of the harvest, the Secretary Wang said: Red Brigade, the dawn Battalion of the harvest is over, we mainly rely on the original task force to help Murakami, so I specifically discuss with the Commissioner, please come to us, Comrade task force to help. the public security officer heard the whole Sheng gay task force to help please , immediately tried and said: These people have been in and turn our Murakami, which makes life no two people thought they could do these people come to Han things, they come, not to help a good busy, fix also To a disservice. Wanghan Ren said gravely: People will not steal your work points and, by the momentum of their surge to drum out all the fresh, several villages south do not is that they help start the end of wheat harvest, now, do not rush time, how to do once the weather changes to rain. women officers actively support the secretary's comments, said: I think that the views of the Han Ren head, and I advocate for them, they come not prevent us busy. catch caught in agriculture and sideline Eqing Members of the degrees are in favor of the two branches. Finally, the group secretary, said: this thing to such a set, you grasp at the original division of the progress of closing.
brigade secretary of the panel should be invited to the village before the village, the project staff assigned to participate in the various production teams work, mingle with the peasants, collected the opportunity to carry out investigation work space work. Murakami task force has been recognized almost all men and women comrades, especially the Xiao Tang, Xiao Li, Wang these people figure appeared in the Agrocybe, Murakami's people take the initiative to strike up a conversation with them, each about the old space, some villagers also claim kinship to the task force with the comrades made it; some big lady even made it to the panel's comrades: Li ah, you find objects in our bar Murakami, before the village to do our son village; task force to find what gay people to understand the situation, do not need to beat around the bush, can express their intentions straightforward, the villagers kept to them about the situation; in the labor gap, Xiao Tang flourish, local drama open throat singing, came together to attract men and women of the village and enjoy the field, a section over and over, the villagers tried clapping, shouting: Encore hh.
the end of the day labor, After dinner, men and women, young and old, a change in the habits of the past, go to bed after dinner, especially young men and women in droves, like go to the market, like go to Aqing home, to have a water barrier around Eqing home, because the task force join as a partner in the Aqing home comrades, who is gay and ran to the task force, or rather to bear the pak, there rhythmically shouted in unison: pak, sang one, okay? good! Quick! quick! quick! a cry, a clapping, shouting, said: Welcome, Xiao Tang comrades to one. Commissioner ran out and said: you miles to Xiaotang sing, to receive tickets. there is a small youth said: Good! tickets to receive tickets. brigade secretary Wang Hanren came to find the labor commissioner to discuss how to arrange rush in the harvest, is said, grasping a branch of agriculture came to find members of Eqing sweat brigade secretary, said: radio stations, according to forecasts, the next evening middle of the night with heavy rain, and now, there are two teams, two teams of five teams of over kung no harvest, how do you see? brigade secretary, said with resignation: name two teams, five teams will not break the night, quickly rush in the harvest. Eqing hurry to say: I say with them, they are reluctant, self-serving to the home run. Commissioner, said in no uncertain terms: Pharaoh, in any case, mobilizing them overnight rush in the harvest. Laohong comrades immediately to exchange with the task force views, then the face we said: boys, girls, we have set up a production team. young woman said: We package the fifth production team. Carter, lead by the Xiao Tang, waved his hand, singing: forward! forward! our team to the sun hh. the panel's comrades with Murakami farmers together with the song, the whole team off. Laohong turned to the old Yin said: Do not worry to the village meeting, the harvest situation I am with you on the phone. old Yin said: Please, your attention to safety. Here, the group secretary excitedly to find Eqing dinner. a group of people headed back home got sickle Agrocybe, apart from anything else, went ahead, a harvest, a mouth and shouted, said: Comrades, na, na dry fuel. young women are unwilling to loneliness, followed by the beat of young men shouted, said: girls na, to skillfully, harvesting crops rely on our na ....... Xiaotang interfaces, said: girls na, ambitious, and you skillfully, we hard work, we Huan than anyone else done more than anyone else ....... At the same time, two teams, five teams of the farmers saw the mighty work force toward their Agrocybe, also quickly drive back home took a sickle to the field rush in the harvest; Shangban Ye coming to an end, in starting a crying sound, twenty acres of rice harvest, bundling, stacking to the field, A Qing shouted in court: Good to the battalion office set. the labor force in a laughter in the office gathered to eat supper mm potato brigade, instant, lightning sky along with the crisp sound of the clap of thunder, the crowd in the room instinctively frightened body vibration, shock and some young women will be in the hands of potato fell to the ground shock Some cover your ears, instantaneous Leiguang Cross, like pouring rain like a waterfall, Lao Hong Yin will talk with the old harvest progress in the end, the group secretary, said happily: We worked hard. It is said in the crowd: Secretary, you get I Han reward miles. Aqing see secretary was asked to stay, specifically to help him rescue, said: sing a call pak. Sarkozy said the crowd well. Xiaotang live up to expectations, let go off the throat singing of a ceramic bar, this time, outside The rain has stopped, the group shouted secretary, said: We go home tomorrow, we need to do life. and some young men and women began to move, although the pace of home, but it still linger.
harvest in the village before the village was over, began planting wheat, the panel of gay people ate, lived through the same with labor, mingle with local farmers, discovering and developing a group of activists to fully mobilize the masses, activists great help, after three days of investigation, people voluntarily sickle out of home registration, the rural areas saying the catch phrase were summarized, one by one discharge of 213 sickle register, then people with sickle-by condemnation, was basically left out. Li, Xiao Tang in order to prevent omissions, came home to find Eqing Eqing check, A investigation looked at the roster celebration, he opened his notebook control, puzzled and said: the total is correct, but the village after the discovery of a strange phenomenon, and the rest Zhu Ruze, old Yeung offer two two people only a sickle, fair to them They have a sickle, the best, you are looking for special check, because the last registration information submitted to him are.
in the forest Jiaci Tang, the panel sitting in the grass covered with all the comrades to discuss the investigation of progress of work, the investigation results by the Li were said to you: total discharge of 213 sickle, through condemnation, got left Zhu Ruze, two of the old oceanic plate is only one, the scythes they going to the old foreign disk Or Zhu Ruze's still a mystery? It Aqing recalled, the two individuals have the sickle. Laohong turned Li said: I remember a time I left the task force, you have around the village before the village had conducted the investigation of Fusarium, when Hou investigation of the situation and the investigation of the information I do not know still there? Laohong then said: Now, the question before us, to reveal the mystery, involving four people: there are no loopholes in the investigation, mainly related to the Arab League Qing, Chen Sheng full two; sickle anyone who is not, an old foreign disk, then one is Zhu Ruze, my opinion we Next, focus on doing the work of these four individuals, the best investigation of the raw data will take time out for control.
next day, Xiao Li, Xiao Tang went to the village, in the Commissioner Office of the Commissioner found, Mike will troubleshoot problems encountered sickle return to the Commissioner, said: Now, have a problem, discharge of 213 sickle, others with sickle condemnation, we find Aqing check the total number of people with sickle is, but, according to Aqing memories, old oceanic plate with Zhu Ruze has sickle, and this is only the old oceanic plate with sickle The person is not Huxi Zhu Ruze, no registration of the scythe, the last investigation, according to A Qing said the raw data here in your custody? Commissioner heard the original check information on the registration sickle, then a bunch of material in the drawer, pulls out register and record of the original investigation and sickle list, and two people's handwriting, and most of the people writing neat handwriting comparison, only the village after the village before the village, 6 sickle register, is a relatively illegible handwriting of people handwriting, reading: sickle column , Xiao Tang was ignorant of the three suddenly. Commissioner smiled and said: they had no old oceanic plate, there is now a sickle; and Zhu Ruze the last registration of a sickle, this is not registered with the sickle, the matter was easy to handle, handwriting from the registration point of view, was registered to participate in two people, one is A Qing, Chen Sheng and then one is full, just ask Sheng and do not have to solve the problem? Li did not immediately agree that: All is not appropriate directly to Chen Sheng, He is now a party. Commissioner do not mind to say: A Qing was also the people, Sheng all the old members, ask him these things is no big deal, otherwise, could not find a third person can understand the situation, you see ? Xiaotang echo Mike's comments, said: Under normal circumstances should be looking for full-Sheng, who is not only a reliable party, and he was the public security officer, and he handled things, the problem is that he handled things, if there is any mistake, make him ugly, even embarrassed, I understand the comments go first to A Qing, Chen Sheng later decide whether to find the whole. Commissioner nodded and said: This method rolls more, well, then what you are looking for A Qing, we can again discuss.
Li, Xiao Tang was two, now can only find with the original data to verify Aqing sickle situation. Li, Xiao Tang was immediately rushed to the Aqing home, the family is eating hit Eqing dinner, Aqing saw Li, Xiao Tang, the rushed move almost dinner. Xiaotang said: You eat your dinner, we eat so you say. Aqing said: do not eat your miles, I could not eat of, say, so what happened? Li agreed that in future a bit, Eqing seriously then said: At the time, sickle investigation division, you join me for the former Li village investigation, and later, the bureau back to something you to the city, I request you to continue in accordance with the investigation; Sheng is moving mouths full command of me, mainly because I was busy preparing, including the village after which I went door to door to register, and then again he returns, is again by the Commissioner of his return. Li to Aqing reflect the specific division of labor, A Qing said: I am responsible for most of the former village after village and register, after the village has a small part of all personally collected by the Sheng sickle register, all Data were submitted to Commissioner of the old Yin there. Li brought there from the Commissioner of the raw data spread on the table and said: This information has two handwriting, you identify it. Aqing looked at, said: most of the is my handwriting, after the village was registered six full-Sheng handwriting. Li, Xiao Tang get Aqing affirmative answer to the Commissioner of the Li also straightforward access to the raw data, where the problems identified for the A Qing the ear, then, to seek views on this issue A Qing said: You see two individuals of the sickle, how it was? Eqing say unequivocally that: both of them should have the sickle, because they are two people I handled all sickle. Then, the old oceanic plate A Qing, Zhu Ruze two sickle recalled in detail the origin: we have a habit in rural areas, who settled in the countryside to participate in labor, there must be the University of graduating from high school to return home without obtaining settled farming, but also by the brigade secretary of the task entrusted to me, which I accompanied him to the Three Rivers street store to buy tools of the said: that he was not at home, how could register with the sickle? A Qing said: This is to ask all of the Chen Sheng, who is Zhu Ruze's uncle, is he registered, others hard to tell what they were out.
from aspects together, and proved that the original old oceanic plate, Zhu Ruze family has sickle, the last registration, Zhu Ruze is not home, responsible for the registration of the Chen Sheng all his maternal uncle, that is the maternal uncle nephew registered on behalf of the does not reflect the old Pacific plate sickle; the investigation and registration, Sheng whole did not attend, he will not replace the registration of his nephew, sickle, sickle became a registered Zhu Ruze the task force comrades eye, like the night, people use the flashlight, a strong beam of light shooting Zhu Ruze, he put a body and a question mark?
degree brigade found the harvest behind schedule, introduced a few brigade south to help the task force wheat harvest has started, the brigade secretary Wang Hanren agreed with the Commissioner to invite gay task force to the village before the village to help the harvest, the panel get this information, just .
Zhuang village before the brigade Party branch meeting, the comrades here have been plagued by the slow progress of the current harvest, the group has emerged in turmoil Cadres, study and plan to change the current status of the harvest, the Secretary Wang said: Red Brigade, the dawn Battalion of the harvest is over, we mainly rely on the original task force to help Murakami, so I specifically discuss with the Commissioner, please come to us, Comrade task force to help. the public security officer heard the whole Sheng gay task force to help please , immediately tried and said: These people have been in and turn our Murakami, which makes life no two people thought they could do these people come to Han things, they come, not to help a good busy, fix also To a disservice. Wanghan Ren said gravely: People will not steal your work points and, by the momentum of their surge to drum out all the fresh, several villages south do not is that they help start the end of wheat harvest, now, do not rush time, how to do once the weather changes to rain. women officers actively support the secretary's comments, said: I think that the views of the Han Ren head, and I advocate for them, they come not prevent us busy. catch caught in agriculture and sideline Eqing Members of the degrees are in favor of the two branches. Finally, the group secretary, said: this thing to such a set, you grasp at the original division of the progress of closing.
brigade secretary of the panel should be invited to the village before the village, the project staff assigned to participate in the various production teams work, mingle with the peasants, collected the opportunity to carry out investigation work space work. Murakami task force has been recognized almost all men and women comrades, especially the Xiao Tang, Xiao Li, Wang these people figure appeared in the Agrocybe, Murakami's people take the initiative to strike up a conversation with them, each about the old space, some villagers also claim kinship to the task force with the comrades made it; some big lady even made it to the panel's comrades: Li ah, you find objects in our bar Murakami, before the village to do our son village; task force to find what gay people to understand the situation, do not need to beat around the bush, can express their intentions straightforward, the villagers kept to them about the situation; in the labor gap, Xiao Tang flourish, local drama open throat singing, came together to attract men and women of the village and enjoy the field, a section over and over, the villagers tried clapping, shouting: Encore hh.
the end of the day labor, After dinner, men and women, young and old, a change in the habits of the past, go to bed after dinner, especially young men and women in droves, like go to the market, like go to Aqing home, to have a water barrier around Eqing home, because the task force join as a partner in the Aqing home comrades, who is gay and ran to the task force, or rather to bear the pak, there rhythmically shouted in unison: pak, sang one, okay? good! Quick! quick! quick! a cry, a clapping, shouting, said: Welcome, Xiao Tang comrades to one. Commissioner ran out and said: you miles to Xiaotang sing, to receive tickets. there is a small youth said: Good! tickets to receive tickets. brigade secretary Wang Hanren came to find the labor commissioner to discuss how to arrange rush in the harvest, is said, grasping a branch of agriculture came to find members of Eqing sweat brigade secretary, said: radio stations, according to forecasts, the next evening middle of the night with heavy rain, and now, there are two teams, two teams of five teams of over kung no harvest, how do you see? brigade secretary, said with resignation: name two teams, five teams will not break the night, quickly rush in the harvest. Eqing hurry to say: I say with them, they are reluctant, self-serving to the home run. Commissioner, said in no uncertain terms: Pharaoh, in any case, mobilizing them overnight rush in the harvest. Laohong comrades immediately to exchange with the task force views, then the face we said: boys, girls, we have set up a production team. young woman said: We package the fifth production team. Carter, lead by the Xiao Tang, waved his hand, singing: forward! forward! our team to the sun hh. the panel's comrades with Murakami farmers together with the song, the whole team off. Laohong turned to the old Yin said: Do not worry to the village meeting, the harvest situation I am with you on the phone. old Yin said: Please, your attention to safety. Here, the group secretary excitedly to find Eqing dinner. a group of people headed back home got sickle Agrocybe, apart from anything else, went ahead, a harvest, a mouth and shouted, said: Comrades, na, na dry fuel. young women are unwilling to loneliness, followed by the beat of young men shouted, said: girls na, to skillfully, harvesting crops rely on our na ....... Xiaotang interfaces, said: girls na, ambitious, and you skillfully, we hard work, we Huan than anyone else done more than anyone else ....... At the same time, two teams, five teams of the farmers saw the mighty work force toward their Agrocybe, also quickly drive back home took a sickle to the field rush in the harvest; Shangban Ye coming to an end, in starting a crying sound, twenty acres of rice harvest, bundling, stacking to the field, A Qing shouted in court: Good to the battalion office set. the labor force in a laughter in the office gathered to eat supper mm potato brigade, instant, lightning sky along with the crisp sound of the clap of thunder, the crowd in the room instinctively frightened body vibration, shock and some young women will be in the hands of potato fell to the ground shock Some cover your ears, instantaneous Leiguang Cross, like pouring rain like a waterfall, Lao Hong Yin will talk with the old harvest progress in the end, the group secretary, said happily: We worked hard. It is said in the crowd: Secretary, you get I Han reward miles. Aqing see secretary was asked to stay, specifically to help him rescue, said: sing a call pak. Sarkozy said the crowd well. Xiaotang live up to expectations, let go off the throat singing of a ceramic bar, this time, outside The rain has stopped, the group shouted secretary, said: We go home tomorrow, we need to do life. and some young men and women began to move, although the pace of home, but it still linger.
harvest in the village before the village was over, began planting wheat, the panel of gay people ate, lived through the same with labor, mingle with local farmers, discovering and developing a group of activists to fully mobilize the masses, activists great help, after three days of investigation, people voluntarily sickle out of home registration, the rural areas saying the catch phrase were summarized, one by one discharge of 213 sickle register, then people with sickle-by condemnation, was basically left out. Li, Xiao Tang in order to prevent omissions, came home to find Eqing Eqing check, A investigation looked at the roster celebration, he opened his notebook control, puzzled and said: the total is correct, but the village after the discovery of a strange phenomenon, and the rest Zhu Ruze, old Yeung offer two two people only a sickle, fair to them They have a sickle, the best, you are looking for special check, because the last registration information submitted to him are.
in the forest Jiaci Tang, the panel sitting in the grass covered with all the comrades to discuss the investigation of progress of work, the investigation results by the Li were said to you: total discharge of 213 sickle, through condemnation, got left Zhu Ruze, two of the old oceanic plate is only one, the scythes they going to the old foreign disk Or Zhu Ruze's still a mystery? It Aqing recalled, the two individuals have the sickle. Laohong turned Li said: I remember a time I left the task force, you have around the village before the village had conducted the investigation of Fusarium, when Hou investigation of the situation and the investigation of the information I do not know still there? Laohong then said: Now, the question before us, to reveal the mystery, involving four people: there are no loopholes in the investigation, mainly related to the Arab League Qing, Chen Sheng full two; sickle anyone who is not, an old foreign disk, then one is Zhu Ruze, my opinion we Next, focus on doing the work of these four individuals, the best investigation of the raw data will take time out for control.
next day, Xiao Li, Xiao Tang went to the village, in the Commissioner Office of the Commissioner found, Mike will troubleshoot problems encountered sickle return to the Commissioner, said: Now, have a problem, discharge of 213 sickle, others with sickle condemnation, we find Aqing check the total number of people with sickle is, but, according to Aqing memories, old oceanic plate with Zhu Ruze has sickle, and this is only the old oceanic plate with sickle The person is not Huxi Zhu Ruze, no registration of the scythe, the last investigation, according to A Qing said the raw data here in your custody? Commissioner heard the original check information on the registration sickle, then a bunch of material in the drawer, pulls out register and record of the original investigation and sickle list, and two people's handwriting, and most of the people writing neat handwriting comparison, only the village after the village before the village, 6 sickle register, is a relatively illegible handwriting of people handwriting, reading: sickle column , Xiao Tang was ignorant of the three suddenly. Commissioner smiled and said: they had no old oceanic plate, there is now a sickle; and Zhu Ruze the last registration of a sickle, this is not registered with the sickle, the matter was easy to handle, handwriting from the registration point of view, was registered to participate in two people, one is A Qing, Chen Sheng and then one is full, just ask Sheng and do not have to solve the problem? Li did not immediately agree that: All is not appropriate directly to Chen Sheng, He is now a party. Commissioner do not mind to say: A Qing was also the people, Sheng all the old members, ask him these things is no big deal, otherwise, could not find a third person can understand the situation, you see ? Xiaotang echo Mike's comments, said: Under normal circumstances should be looking for full-Sheng, who is not only a reliable party, and he was the public security officer, and he handled things, the problem is that he handled things, if there is any mistake, make him ugly, even embarrassed, I understand the comments go first to A Qing, Chen Sheng later decide whether to find the whole. Commissioner nodded and said: This method rolls more, well, then what you are looking for A Qing, we can again discuss.
Li, Xiao Tang was two, now can only find with the original data to verify Aqing sickle situation. Li, Xiao Tang was immediately rushed to the Aqing home, the family is eating hit Eqing dinner, Aqing saw Li, Xiao Tang, the rushed move almost dinner. Xiaotang said: You eat your dinner, we eat so you say. Aqing said: do not eat your miles, I could not eat of, say, so what happened? Li agreed that in future a bit, Eqing seriously then said: At the time, sickle investigation division, you join me for the former Li village investigation, and later, the bureau back to something you to the city, I request you to continue in accordance with the investigation; Sheng is moving mouths full command of me, mainly because I was busy preparing, including the village after which I went door to door to register, and then again he returns, is again by the Commissioner of his return. Li to Aqing reflect the specific division of labor, A Qing said: I am responsible for most of the former village after village and register, after the village has a small part of all personally collected by the Sheng sickle register, all Data were submitted to Commissioner of the old Yin there. Li brought there from the Commissioner of the raw data spread on the table and said: This information has two handwriting, you identify it. Aqing looked at, said: most of the is my handwriting, after the village was registered six full-Sheng handwriting. Li, Xiao Tang get Aqing affirmative answer to the Commissioner of the Li also straightforward access to the raw data, where the problems identified for the A Qing the ear, then, to seek views on this issue A Qing said: You see two individuals of the sickle, how it was? Eqing say unequivocally that: both of them should have the sickle, because they are two people I handled all sickle. Then, the old oceanic plate A Qing, Zhu Ruze two sickle recalled in detail the origin: we have a habit in rural areas, who settled in the countryside to participate in labor, there must be the University of graduating from high school to return home without obtaining settled farming, but also by the brigade secretary of the task entrusted to me, which I accompanied him to the Three Rivers street store to buy tools of the said: that he was not at home, how could register with the sickle? A Qing said: This is to ask all of the Chen Sheng, who is Zhu Ruze's uncle, is he registered, others hard to tell what they were out.
from aspects together, and proved that the original old oceanic plate, Zhu Ruze family has sickle, the last registration, Zhu Ruze is not home, responsible for the registration of the Chen Sheng all his maternal uncle, that is the maternal uncle nephew registered on behalf of the does not reflect the old Pacific plate sickle; the investigation and registration, Sheng whole did not attend, he will not replace the registration of his nephew, sickle, sickle became a registered Zhu Ruze the task force comrades eye, like the night, people use the flashlight, a strong beam of light shooting Zhu Ruze, he put a body and a question mark?
Tuesday, February 15, 2011
Suqian controversial analysis of health system reform
Suqian analysis of health system reform debate
mm and the path of market reform options
Wei Fengchun
First, the reform of the controversial Suqian What?
Suqian City by the community health system reform concern, which can be summarized as the view of two odds: First, the medical and health system reform Suqian increased burden on the residents, not the failure of reform in other areas, especially in underdeveloped areas to promote. Second, the practice of representatives of the Chinese Suqian Yiwei direction of reform, not an exception, but a general rule, for the economically less developed areas Yiwei system provides a valuable experience.
the dispute expressed in a specific motivation for reform, methods with the results of the different views. motive for reform focus of the dispute as controversy summarized as Based on the study can be summarized in Suqian reform experiences and lessons. This Suqian itself, and the country, especially in economically underdeveloped regions Yiwei system are of great significance.
Tsinghua University Health System Reform Meanwhile, the three dispute a clear answer. In this paper, to answer three questions based on the evaluation of Suqian reforms.
second, whether the reform is the Government's motivation of the different views of reform is the biggest controversy the focus of reform Suqian. Suqian Yiwei pre-reform system is is four one, that is, management from operation, health, medicine, medical anti-unity. the hospital all the government investment, direct provision of medical services. reform, the government no longer directly hold hospitals, medical services are mainly produced by the market. This is not the Government in the Before reform, health care or the demand side, supply-side there was a big problem.
1, supply-side problems
this mainly as a shortage of medical and health resources. source of personal risk from the disease point of view , a serious shortage of medical resources, medical supply and demand contradiction, expensive and difficult to see a doctor .2000 exist, Suqian 515 million people, only the medical and health assets of 588 million yuan. only 1.07 beds per thousand, per thousand 168 health staff person. per capita health assets and thousands of people with health technicians in Jiangsu Province, the last one, below the national average. low level of local medical care, residents are out for medical treatment. Urban health insurance coverage, the level of protection low, almost no health insurance of farmers rely mainly on their own expense for medical treatment is a heavy burden.
source of public risk from the disease point of view, it is difficult to survive township hospitals and tertiary health prevention security system in name only. in the original system, the township health hospital and community health service centers, on the one hand to provide preventive health services, on the other hand to provide medical services, the former is free service, which is paid services. At the time, system, crowding out the free service paid services, health prevention security system in name only. Meanwhile, the viability of rural township hospitals is extremely low self-survival is difficult to ensure the year 1999, 124 township hospitals Suqian total assets of 170.58 million yuan, total liabilities 83.167 million yuan, asset-liability ratio 48.8%, bed utilization rate is only 20%, non-medical personnel accounted for 40%. There is not two-thirds of the normal payment of salaries of township hospitals, faced a new crisis.
2, to be This side of the issue
mainly for residents of a serious shortage of capacity to pay. Suqian is the history of disaster areas, war zones and agricultural areas, a city in 1996 after the economic pillar is the primary industry, secondary industry and tertiary industry is very backward In 1996 after the inflation-adjusted real per capita net income of farmers was only 1,848 yuan, the real per capita income of urban residents is only 2733 yuan .2000, urban residents consumption expenditure in the health care spending accounted for 10.90% in rural areas residents, compared with 11.85%. because of financial difficulties ratio of 34.15% without treatment, in patients discharged own request, due to financial difficulties required rate of discharge up to 81.82%.
objectives of the reform is to solve medical and health resources inadequate and the problem of insufficient capacity to pay residents.
(b) reformers on the different perceptions of the medical and health reform
Suqian They are considered a do not agree.
Suqian reform, from the theory of medical and health were re-interpretation. The local government believes that health care and public health have different properties, which were provided by the market and the government can achieve maximum efficiency . to maternal and child health, communicable disease control, first aid as the main content of the health services are public goods should be provided by the Government, and the need for the central government or local government to choose between. medical services are mainly private goods, the main by the market mechanism through hospitals, clinics, clinics, clinic, etc. available. for medical services outside of strong, such as SARS, AIDS, etc. can be provided by the government. for the poor medical services can be funded by the government.
ideal example of the pre-reform after reform
pure public goods public health
central government
the level of government
the levels of government
offside
SARS
local public goods local government
the level of government
the appropriate level of government maternal and child health
medical
market private goods market, the appropriate level of government
renal transplantation
local public goods local government
the level of government
lack
Government + market
health care
1, the financial pressure and public spending determines the order of the Government to ensure that public health expenditure in the financial position
the background, the Government in the provision of health services, to provide medical services. If the government financial pressure significantly, the Government can only guarantee that he must be expenditure priorities. This is the public health, compulsory education and basic administrative expenses.
Suqian Statistical Yearbook (2000) data show that the former government in health care reform is a very fragile financial . Although from 1996 to 1999 fiscal revenue from the 767.68 million yuan rose to 1.0162 billion yuan, but the total financial expenditure has increased to 1.42779 billion yuan from the 807.37 million yuan. budget deficit growing, from the deficit-GDP proportion of view, the deficit ratio increased from 0.32% to 2.26%. in accordance with international standards, this indicator means that the pressure of being in great financial.
1999, the Suqian financial expenditure of the project, accounting for Education Expenses 30% of all expenditures, administrative costs accounted for 15%, accounting for 8% of the basic construction costs. health expenses account for only 5%. the government's budget deficit growing, education and administrative expenses of the statutory nature of the decision its expenditure in the priority of capital expenditures to increase in emerging market economies of the basic requirements. In this context, the Government's financial resources is difficult to guarantee the health of adequate investment. government limited funds into medical services suppliers, and refused access to social capital. The Government can not afford much-needed assistance to the demand side of medical services and public health service inputs, and thus bear too much responsibility. responsibility and ability to asymmetric, making the government with the reform dynamic health care.
public risk from the disease control sources is fundamental to improve citizen health initiatives. The Government clearly their main functions of providing public services, the implementation of a separate management from operation, medical anti-separation reform. The Government will prevent security functions of township hospitals to separate from. township hospitals conducted by the government, mainly responsible for disease prevention, health education, health monitoring and other public health functions, do not engage in general medical activities. township hospitals conducted by the market engaged in basic medical services. For the preventive function of township hospitals and the financial support of the implementation of the system, township hospitals and village staff members against insurance subsidies by the fiscal year were less than 6,000 yuan per person (president of 8,000 yuan) and 1,200 yuan payment. in accordance with the standard 6 yuan per capita of rural public health services to establish special funds for rural public health services.
government ownership of public hospitals after the replacement of special account funds used for other purposes. permutation with the first funds paid workers in pension, medical and unemployment insurance, and the rest as a health development fund for investment in health and development. the government began constructing a system Mining for the center. cooperative medical care system.
2, not to property rights reform can improve efficiency
insufficient to resolve the core of medical and health resources is to improve efficiency. the original low efficiency of public hospitals is your doctor and the doctor is difficult to source. reform, Suqian public hospitals by the government monopoly, the lack of incentives and constraints, full redundancy. The results, not only provides inadequate medical care, and poor service quality and service attitude. The Government is the owner, but also managers, can not be effectively implemented on the hospital possible supervision. received a red envelope, drug rebates and other chronic illnesses despite severe blow, but still difficult to eradicate.
under the old system makes the Government's determination to carry out the drawbacks of mechanism innovation, the Government faces two options, or stocks that incremental reform reform? to now, the biggest reform of the outside world Suqian question is why the reform of hospital property from the start? If you do not reform public hospitals, the medical market is only open to allow other forms of ownership into the medical field is more reliable? This is necessary to answer problem.
health under the existing system of mechanisms and development of market economy can not meet the objective requirements. Prior to this, the hospital Suqian also been the reform of property rights, but none were successful .1997 Shuyang The president of contract responsibility system reform, the effect is very poor. the one hand, there is no active management; the other hand, few hospitals have the backbone to do more, surgery, medicine, nurse income less the same egalitarian serious, extremely unfair distribution.
The reason why health care reform Suqian reform of property rights from the start, reformers have given the following reasons:
First, the shortcomings of public hospitals is caused by the ownership, only the reform of ownership, ; medical treatment is difficult, a platform for fair competition.
Third, market-oriented reform in the Suqian background, property rights reform is the rapid development of the economy is relatively backward areas of the party. the idea has gone deep into the minds of local government officials. Shuyang reform successful example of interpretation of this philosophy.
Fourth, the policy of the central support of Jiangsu Province. Shiliu Tai, the Central Government that health reform policy to become straight Suqian policy basis for property rights. In addition, the Jiangsu provincial government support for the reforms of Suqian its attempt to provide an opportunity for reform of property rights.
public hospitals if the government just sold to a private, certainly is cast it, because it is only a government monopoly into a private monopoly. monopolization is the result of high prices of medical services less. Only the introduction of competition will improve efficiency, increase output. and thus the stock of government reform during the time while incremental reforms, the introduction of different owners to compete. the result of competition is beginning to improve efficiency, a substantial increase in medical and health resources.
3, the government does not produce health care services does not mean that the Government does not provide medical Service
reform, mixed ownership, the government no longer directly hold hospitals, means that the government no longer directly the production of medical services, this does not mean that the government no longer provides health care services. the way the provision of medical services, mainly the following Species:
First, subsidies to rural cooperative medical care .2003 October, under the jurisdiction of Suqian Shuyang in the new rural cooperative medical experiments conducted in 2004, expanded to all counties in the city, when the city from the new type rural cooperative medical care there are 314.29 million farmers, according to 30 yuan per person (individual farmers 10 yuan, 10 yuan County supporting the provincial fill 10 million) financing, insurance rate of 79.8% .2006, the urban and rural as 343.57 million, according to 50 yuan per capita (individual farmers 10 yuan, 10 yuan supporting the county, city, Jiangsu Province, on the residential standard of 25 yuan per person grants to other counties in the standard 30 yuan per person supplement) Financing. Meanwhile, the government introduced a management, the end of July, the city's new rural cooperative medical care funds raised a total of 106.423 million yuan, of which 34.357 million yuan paid by individuals, counties supporting 23,126,000 yuan, 48,940,000 yuan provincial meeting. the city's total compensation amount of 56,396,400 yuan, of which total compensation for outpatient 8,126,400 yuan, 48.27 million yuan hospital total compensation; total compensation 1.1082 million people, including compensation for 59,400 patient visits, outpatient visits compensation 1,048,800.
two persons for the establishment of urban low ill hospitalized medical aid co-ordination and co-ordinate fund. Government plan before the end of 2006, will bankrupt the city shut down all enterprises included in the basic retiree medical insurance. some of the basic medical insurance premium payable by the competent department of units affordable, all levels of financial reveal all the details. for the enjoyment of the minimum living allowance for urban residents who, on the non- construction of individual accounts, one set way to co-ordinate the management of the Fund, the establishment of co-ordination and ill hospitalized medical aid system to co-ordinate regional financial subsidy 240 yuan per person per year, individuals paid 120 yuan per year.
the quality of these mechanisms is the way government subsidies changes in government subsidies to the original supplier, is now the subsidies to the demand side. the adoption of new agricultural cooperation, the city health insurance and poverty Zhe relief, etc., were free to choose the hospital. Because the hospital Buzai point, in order to attract patients and gain government subsidies, the hospital only at low prices, friendly service, high-tech efforts. In this system, the enthusiasm of doctors and nurses substantial increase in the output of medical and health services are also large-scale growth.
4, important regulatory functions of government ownership after
mixed, private capital is certainly to be profit-driven. private hospitals out of policy concerns and forced financial pressure, short-sighted phenomenon occurs in the operation, which targets the people there the great conflict. transpose public hospitals, the health departments and hospitals no longer have a direct interest, began to increase the independence of regulators. through market competition and government regulation of the conflict with the public hospitals began to decline medical treatment is difficult and your doctor initially solved the problem.
(c) Summary: Financial mechanism under the pressure of innovation
Therefore, the government health system reform Suqian in the context of great financial pressure, seek medical market economy the process of health system. essence of reform is the professionalization of government and market division, which provides medical services to market-based, public health to government, a government purchase of medical services for the poor funding.
third, health care reform by reform, whether it is sold out?
Suqian revitalize the stock of hospital restructuring and expansion, including incremental levels. revitalize the stock refers to the original restructuring public hospitals and health centers. expand the increment refers to the release medical market, encourage the development of private hospitals. until July 2006, the city Suqian 135 township hospitals in more than 134 were property replacement, type of reform was called sold out.
way to understand the reform not sold Reform, the need to convert the program from the property, transfer and use of funds set after the reform of ownership structure.
(a) replacement of property rights reform program
Shuyang hospital procedures, as Suqian City, representatives of the hospital reform program. It can be summarized in six steps:
one of the hospitals in the fixed assets, current assets, special clean production assets accounting; Second, qualified by the rating agencies to assess the situation of assets, evaluation report issued by then recognized by the state-owned sector; third, 7-10 days in advance notice to the community restructuring, and reform by the leaders in charge of the staff do go to the staff meetings held in various hospitals, unify their thinking; Fourth, the transfer of property held public auction the General Assembly, the official auction; five hospitals after the reform of land use rights to the transferee by the Land Bureau of assets according to relevant procedures; six, regulate the use of property rights transfer of funds. property rights transfer of funds to implement special accounts stored, used for other purposes, mainly Yongyu pay employee pension insurance, the introduction of unemployment insurance funds and the establishment of health development fund for rural health, particularly the development of anti-Paul.
transfer process from the perspective of property rights, reform the legal framework is based on the way transpose the property. not all sell public hospitals to private, public hospitals began to break the monopoly.
(b) use of funds
property replacement process of restructuring in the public hospital does not appear the phenomenon of loss of state assets . a lot of restructuring the hospital when the hospital director reflects the high bid, the auction premium of individual hospitals is high. such as asset evaluation of the hospital sold 200 million 400 million, a premium of as much as 2 times. Suqian Party Secretary Zhang is 2006 June 27 interview with Shanghai Dragon TV interview that the restructuring of the funds recovered, greatly exceeded the reserve price at the time the Government.
how to use the funds after the replacement, is widespread concern. Suqian City Health Bureau, according to statistics restructuring the city's capital of 422,863,700 yuan exchange, is capital in place of 330,910,100 yuan, the use of these funds is as follows:
17.8 million yuan for Disease Control Building, the blood center 7.9 million yuan, , City Centre, 80.59 million yuan infectious diseases, maternal and child health center outpatient 1800 yuan. Suqian three counties and two districts City township hospitals, disease prevention and control system, maternal and child health system funds 50 million yuan. To pay the full insurance workers 41.19 million yuan. The total expenditure of 26,317 yuan. Suqian surplus funds into the health care development fund account.
(c) the reform of ownership structure after the hospital reform Suqian
medical services is a mixed-ownership The. which the Government has Siyang county owned hospital. shareholding hospitals, including various forms: state-owned shares, state-controlled, full ownership, personal holding, and the medical system and other shares. Some township hospitals and clinics, mostly taken by individuals wholly-owned.
(d) Summary: property rights reform of property rights reform is just the beginning
the greatest benefit is the ability to improve efficiency, the same resources, the market more efficient output. output efficiency is reflected in two aspects: First, the provision of medical services, and second, the ability of patients to purchase services. medical services to the final output is not entirely determined by the system, it depends on the payment pattern of reform. whether it is state-owned hospitals or private hospitals, If you pay for the lack of an effective incentive or a blending of services, medical services, the output will be high quality and low price.
This means that if the corresponding set of reforms, especially the standard of medical services and lack of supervision, the effectiveness will be greatly reduced so that property rights reform. Suqian reason why the reforms did not achieve the desired objectives, the main reason is that facilities are not in place.
Fourth, the medical services provided by the market can solve, difficult balance. through increased efficiency to solve the problem of shortage of medical services, increase service availability, reduce the
(a) medical treatment is difficult problem
1,
growth in demand for medical services, according to number of visits by a 2.36 times increased to 2.49 times, increased 5.51%. two weeks visiting rate fell 2.84%, no treatment within two weeks prevalence rate has dropped 44.45%, within two weeks of illness should be hospitalized without hospitalization rate has dropped 15.73% , two weeks increased 0.26% prevalence rate of hospitalization, hospital delivery rate increased by 7.47%, while the rate of home births decreased by 7.77%. This shows that the medical needs of the residents improved significantly Suqian.
judge reform ; the issue is resolved, must be based on the medical needs of the residents on the basis of improved significantly.
2, and sexual health services can be enhanced, and above the county hospital patients waiting a long time, but the basic rural hospitals do not need to wait, you can receive timely diagnosis and treatment of common diseases.
2005, the Suqian City households less than 1 km from the nearest percentage WHO 76.5%, 1 -2 km to 17.24%, 5.30% for 2-3 km, 5 km above was only 0.12%, relatively rational layout of the medical WHO. township hospitals and village clinics and community hospitals widely distributed, it is Investigation from the supply perspective, the residents can truly enjoy the convenience of the services also need to be the result of their choice.
2005 and 2000 compared to rates of primary care visits decreased by 10.66%, rural district hospitals attendance rate has dropped by 0.27%, above the county hospital rate increased by 12.5%. This shows that although people close to the WHO from the nearest, to reach a relatively short time, but due to reasons such as medical technology, the patient chose to relatively high level of hospital. Suqian county rapid development of a secondary hospital, talent and technology and equipment capable of gathering to provide more medical services. township hospitals because the flow of talent, competitiveness is difficult with large hospitals compared. In addition, the convenience of transport also makes people have the ability to a higher level of technology hospital.
3, ability to significantly enhance the supply of medical services is enhanced medical services and basic medical services
availability of medical services mainly attributed to the increase in supply of .2005, Suqian hospitals from 148 in 2000 grew to 188, an increase of 27%. beds increased by 57.40%, 51.68% growth in the number of beds per thousand, per thousand Health Professionals who grow 16.45%, medical institutions, asset growth of 139.64%.
increase in medical equipment to improve the ability to supply medical services. restructured before the city's only 5 CT, Shuyang People's Hospital, Siyang County People's Hospital , Sihong County People's Hospital, Suyu County Chinese Medicine Hospital, City People's Hospital, one each .2006 7 months ago, the city's total of CT machine 32, in which municipal 7 sets, 3 sets of urban places, Suyu District 3 sets , Sihong 4, 5 Siyang, Shuyang 10.
4, the establishment of incentive and restraint mechanisms liberated Yiwei staff productivity
mechanism innovation, making the stimulation and Yiwei more reasonable restraint mechanism, the productivity of medical services has greatly liberated. five years, the total number of health institutions increased by 11.11%, 20.85% increase in health professionals, including physicians and over the number of titles rose 115.42%, managers decrease by 27.54%.
after the reform, the income of doctors has improved a lot. If a hospital president Shuyang monthly income of 800 yuan five years ago, the current monthly income of 3,000 yuan. Shuyang a rural hospital treatment by a physician up to 1,200 yuan 2,000. incomes, inspired Yiwei staff motivation, which is prerequisite for the sustainable development of the hospital. in the hospital competition, talent competition to further promote brand competition triggered the development of productivity.
5, non-qualified clinic
survey data is still there, residents in the doctor's choice of location, proximity to the first choice, the percentage is 50.33%. quality in second place, 17.22%. low prices only in third place, 11.26 %. the attitude of only 2.87%, ranked fifth. and thus can be said that although the doctor has eased the difficult problem, but to take time to achieve the desired state.
residents in some of the choice extent, non-statutory medical organizations say there's an important reason. Task Force found that the clinic is known as black or repeated unlicensed practitioners. the patient feels the services of these clinics are convenient, prices are low, but the service quality is not guaranteed. ailment patients feel no need to go to regular hospitals will choose this type of clinic. They reflect, as its identity is not clear, it is sometimes difficult to distinguish between formal and informal clinics clinics. Some very low-income people because the price of reasons for choosing these clinics. We work with some of the exchange of unlicensed physicians, most of them because of low qualifications, who has suffered punishment, inadequate capital and other reasons, do not meet the criteria for access to government clinics.
(b) Suqian list provided by the Municipal Health Bureau show that the substantial increase in hospital revenue after the reform than in 2000 .2005 prices nominal income growth rate 964%, 473% growth rate of outpatient visits, number of visits per thousand population growth rate 454%. hospital visits also increased. hospital incomes, whether the increased burden of patients?
this is changes in prices of medical services, not only vertical and horizontal comparison, patients also need to look at changes in capacity to pay.
1, the reform of medical services before and after the change in the price of Longitudinal
1.1 Suqian City Health Bureau, according to data provided by the health care reform, the price five years following changes have taken place.
first five years, municipal fees and charges for each hospital outpatient visits increased 7.11%, 6.31% growth in county hospitals, township-level hospitals decreased by 6.26% .
second, five years, the level of charges per bed day down 1.40% municipal and county hospitals, township-level hospitals fell 3.91%.
third, five years, the average medical cost of hospital and municipal hospital rose 21.78 %, 0.66% increase in county hospitals, township-level hospitals decreased by 5.25%.
data collected from the research group can draw the following conclusions:
First, lower-level hospitals, the basic registration fee to cancel, a large The registration fee to keep the hospital at a lower level.
Second, the general decline in the cost of surgery, the higher the cost of the higher-level hospitals. with simple appendicitis, for example, county hospitals, the cost of the pre-reform general yuan in 2000, after the reform costs at 1,500 yuan. township roughly the cost of hospital reform in 1200 before the yuan, reform, remain at 700 yuan. the cost of cesarean section before the reform in general in 4000 yuan , the reformed county hospital costs from 2,500 to 3,000 yuan, 1,500 yuan in rural hospitals. eutocia surgery, the pre-reform cost around 2,000 yuan, county hospital costs after the reform in 1200 yuan, 500 township hospitals yuan.
Third, routine examination costs down. CT in the pre-reform cost of single-site single is about 300 yuan, 120 yuan or so after the reform. new inspection costs of the project began to grow. Some pre-reform Suqian large hospital equipment does not exist, so this can not be compared with the pre-reform.
Fourth, the conventional drug prices within the government's limit. Hospital, the higher the level, the higher drug prices. new drugs prices down than before. lower prices of non-prescription drugs, prescription drug prices are relatively high, unit prices also declined.
1.2
horizontal comparison of the same disease in different hospitals in the local and foreign cost analysis is the horizontal comparison .
county hospitals, in addition to cerebral infarction and cerebral hemorrhage and thyroid tumors, a number of common diseases such as appendicitis, cesarean section, stones, cancer and other treatment costs are generally lower than the field at the county level hospitals. This shows that health care reform increased competition in the hospital, the general decline of the hospital medical expenses. However, due to being in its infancy, for some heavy treatment of the disease, not to form a fully competitive local hospital, in a few cases, the hospital costs of monopoly are relatively high.
municipal hospitals, local hospitals are generally lower than the cost of field hospitals, the treatment of lumbar disc herniation of the local cost of 2578 yuan, the field is 5343 yuan; esophageal local as 6394 yuan, the field was 7418.29 yuan.
the local provincial hospital costs are generally higher than outside the provincial hospital, the cost of the treatment of esophageal cancer than the local provincial hospital provincial hospitals outside the high 52%, 83% higher lung cancer, gastrointestinal bleeding in high 79%. cancer, ectopic pregnancy and other local the hospital than outside the hospital.
2, medical services, the reasons for price changes
2.1
residents ability to pay changes with the increase of disposable financial resources, the potential consumer demand into real demand. Reform Ten years, after inflation-adjusted real income per capita Suqian overall upward trend. the real per capita net income of farmers by the 1848 yuan to 3782 yuan increase. In addition to 7% in 2003 fell outside the rose in other years, especially 2004 and 2005, respectively, an increase of 9.31% and 13.66%. the real per capita income of urban residents rose from 2,733 yuan to 7,101 yuan, after 2004 growth rate of over 11% year on year. For farmers, agricultural policies in recent years, the effectiveness of the central re-start show, the burden has been reduced. the local market-oriented reform, especially the adjustment of industrial structure, attracting southern Jiangsu, Zhejiang and other places in the industry shifted to the Suqian, the increase in local employment led to increased revenue.
the same time, health care Insurance .2005 participation rate improved significantly compared with 2000, the ratio of residents to have health insurance increased significantly. which, to participate in health insurance rate increase of 6.90% to 87.90%, up 81%. and members of rural cooperative medical care of the population the proportion rose from 5.97% to 84.30%, an increase of 78%.
these have shown the capacity to pay for medical services improved. from 2000 to 2005, no treatment because of financial difficulties down the rate of 21.80%, in their own requirements discharged patients, due to financial difficulties required rate of discharge decreased 16.12%.
2.2 competition reduces the price of conventional health care, technology upgrading to increase the supply of services in the Suqian
...
mm and the path of market reform options
Wei Fengchun
First, the reform of the controversial Suqian What?
Suqian City by the community health system reform concern, which can be summarized as the view of two odds: First, the medical and health system reform Suqian increased burden on the residents, not the failure of reform in other areas, especially in underdeveloped areas to promote. Second, the practice of representatives of the Chinese Suqian Yiwei direction of reform, not an exception, but a general rule, for the economically less developed areas Yiwei system provides a valuable experience.
the dispute expressed in a specific motivation for reform, methods with the results of the different views. motive for reform focus of the dispute as controversy summarized as Based on the study can be summarized in Suqian reform experiences and lessons. This Suqian itself, and the country, especially in economically underdeveloped regions Yiwei system are of great significance.
Tsinghua University Health System Reform Meanwhile, the three dispute a clear answer. In this paper, to answer three questions based on the evaluation of Suqian reforms.
second, whether the reform is the Government's motivation of the different views of reform is the biggest controversy the focus of reform Suqian. Suqian Yiwei pre-reform system is is four one, that is, management from operation, health, medicine, medical anti-unity. the hospital all the government investment, direct provision of medical services. reform, the government no longer directly hold hospitals, medical services are mainly produced by the market. This is not the Government in the Before reform, health care or the demand side, supply-side there was a big problem.
1, supply-side problems
this mainly as a shortage of medical and health resources. source of personal risk from the disease point of view , a serious shortage of medical resources, medical supply and demand contradiction, expensive and difficult to see a doctor .2000 exist, Suqian 515 million people, only the medical and health assets of 588 million yuan. only 1.07 beds per thousand, per thousand 168 health staff person. per capita health assets and thousands of people with health technicians in Jiangsu Province, the last one, below the national average. low level of local medical care, residents are out for medical treatment. Urban health insurance coverage, the level of protection low, almost no health insurance of farmers rely mainly on their own expense for medical treatment is a heavy burden.
source of public risk from the disease point of view, it is difficult to survive township hospitals and tertiary health prevention security system in name only. in the original system, the township health hospital and community health service centers, on the one hand to provide preventive health services, on the other hand to provide medical services, the former is free service, which is paid services. At the time, system, crowding out the free service paid services, health prevention security system in name only. Meanwhile, the viability of rural township hospitals is extremely low self-survival is difficult to ensure the year 1999, 124 township hospitals Suqian total assets of 170.58 million yuan, total liabilities 83.167 million yuan, asset-liability ratio 48.8%, bed utilization rate is only 20%, non-medical personnel accounted for 40%. There is not two-thirds of the normal payment of salaries of township hospitals, faced a new crisis.
2, to be This side of the issue
mainly for residents of a serious shortage of capacity to pay. Suqian is the history of disaster areas, war zones and agricultural areas, a city in 1996 after the economic pillar is the primary industry, secondary industry and tertiary industry is very backward In 1996 after the inflation-adjusted real per capita net income of farmers was only 1,848 yuan, the real per capita income of urban residents is only 2733 yuan .2000, urban residents consumption expenditure in the health care spending accounted for 10.90% in rural areas residents, compared with 11.85%. because of financial difficulties ratio of 34.15% without treatment, in patients discharged own request, due to financial difficulties required rate of discharge up to 81.82%.
objectives of the reform is to solve medical and health resources inadequate and the problem of insufficient capacity to pay residents.
(b) reformers on the different perceptions of the medical and health reform
Suqian They are considered a do not agree.
Suqian reform, from the theory of medical and health were re-interpretation. The local government believes that health care and public health have different properties, which were provided by the market and the government can achieve maximum efficiency . to maternal and child health, communicable disease control, first aid as the main content of the health services are public goods should be provided by the Government, and the need for the central government or local government to choose between. medical services are mainly private goods, the main by the market mechanism through hospitals, clinics, clinics, clinic, etc. available. for medical services outside of strong, such as SARS, AIDS, etc. can be provided by the government. for the poor medical services can be funded by the government.
ideal example of the pre-reform after reform
pure public goods public health
central government
the level of government
the levels of government
offside
SARS
local public goods local government
the level of government
the appropriate level of government maternal and child health
medical
market private goods market, the appropriate level of government
renal transplantation
local public goods local government
the level of government
lack
Government + market
health care
1, the financial pressure and public spending determines the order of the Government to ensure that public health expenditure in the financial position
the background, the Government in the provision of health services, to provide medical services. If the government financial pressure significantly, the Government can only guarantee that he must be expenditure priorities. This is the public health, compulsory education and basic administrative expenses.
Suqian Statistical Yearbook (2000) data show that the former government in health care reform is a very fragile financial . Although from 1996 to 1999 fiscal revenue from the 767.68 million yuan rose to 1.0162 billion yuan, but the total financial expenditure has increased to 1.42779 billion yuan from the 807.37 million yuan. budget deficit growing, from the deficit-GDP proportion of view, the deficit ratio increased from 0.32% to 2.26%. in accordance with international standards, this indicator means that the pressure of being in great financial.
1999, the Suqian financial expenditure of the project, accounting for Education Expenses 30% of all expenditures, administrative costs accounted for 15%, accounting for 8% of the basic construction costs. health expenses account for only 5%. the government's budget deficit growing, education and administrative expenses of the statutory nature of the decision its expenditure in the priority of capital expenditures to increase in emerging market economies of the basic requirements. In this context, the Government's financial resources is difficult to guarantee the health of adequate investment. government limited funds into medical services suppliers, and refused access to social capital. The Government can not afford much-needed assistance to the demand side of medical services and public health service inputs, and thus bear too much responsibility. responsibility and ability to asymmetric, making the government with the reform dynamic health care.
public risk from the disease control sources is fundamental to improve citizen health initiatives. The Government clearly their main functions of providing public services, the implementation of a separate management from operation, medical anti-separation reform. The Government will prevent security functions of township hospitals to separate from. township hospitals conducted by the government, mainly responsible for disease prevention, health education, health monitoring and other public health functions, do not engage in general medical activities. township hospitals conducted by the market engaged in basic medical services. For the preventive function of township hospitals and the financial support of the implementation of the system, township hospitals and village staff members against insurance subsidies by the fiscal year were less than 6,000 yuan per person (president of 8,000 yuan) and 1,200 yuan payment. in accordance with the standard 6 yuan per capita of rural public health services to establish special funds for rural public health services.
government ownership of public hospitals after the replacement of special account funds used for other purposes. permutation with the first funds paid workers in pension, medical and unemployment insurance, and the rest as a health development fund for investment in health and development. the government began constructing a system Mining for the center. cooperative medical care system.
2, not to property rights reform can improve efficiency
insufficient to resolve the core of medical and health resources is to improve efficiency. the original low efficiency of public hospitals is your doctor and the doctor is difficult to source. reform, Suqian public hospitals by the government monopoly, the lack of incentives and constraints, full redundancy. The results, not only provides inadequate medical care, and poor service quality and service attitude. The Government is the owner, but also managers, can not be effectively implemented on the hospital possible supervision. received a red envelope, drug rebates and other chronic illnesses despite severe blow, but still difficult to eradicate.
under the old system makes the Government's determination to carry out the drawbacks of mechanism innovation, the Government faces two options, or stocks that incremental reform reform? to now, the biggest reform of the outside world Suqian question is why the reform of hospital property from the start? If you do not reform public hospitals, the medical market is only open to allow other forms of ownership into the medical field is more reliable? This is necessary to answer problem.
health under the existing system of mechanisms and development of market economy can not meet the objective requirements. Prior to this, the hospital Suqian also been the reform of property rights, but none were successful .1997 Shuyang The president of contract responsibility system reform, the effect is very poor. the one hand, there is no active management; the other hand, few hospitals have the backbone to do more, surgery, medicine, nurse income less the same egalitarian serious, extremely unfair distribution.
The reason why health care reform Suqian reform of property rights from the start, reformers have given the following reasons:
First, the shortcomings of public hospitals is caused by the ownership, only the reform of ownership, ; medical treatment is difficult, a platform for fair competition.
Third, market-oriented reform in the Suqian background, property rights reform is the rapid development of the economy is relatively backward areas of the party. the idea has gone deep into the minds of local government officials. Shuyang reform successful example of interpretation of this philosophy.
Fourth, the policy of the central support of Jiangsu Province. Shiliu Tai, the Central Government that health reform policy to become straight Suqian policy basis for property rights. In addition, the Jiangsu provincial government support for the reforms of Suqian its attempt to provide an opportunity for reform of property rights.
public hospitals if the government just sold to a private, certainly is cast it, because it is only a government monopoly into a private monopoly. monopolization is the result of high prices of medical services less. Only the introduction of competition will improve efficiency, increase output. and thus the stock of government reform during the time while incremental reforms, the introduction of different owners to compete. the result of competition is beginning to improve efficiency, a substantial increase in medical and health resources.
3, the government does not produce health care services does not mean that the Government does not provide medical Service
reform, mixed ownership, the government no longer directly hold hospitals, means that the government no longer directly the production of medical services, this does not mean that the government no longer provides health care services. the way the provision of medical services, mainly the following Species:
First, subsidies to rural cooperative medical care .2003 October, under the jurisdiction of Suqian Shuyang in the new rural cooperative medical experiments conducted in 2004, expanded to all counties in the city, when the city from the new type rural cooperative medical care there are 314.29 million farmers, according to 30 yuan per person (individual farmers 10 yuan, 10 yuan County supporting the provincial fill 10 million) financing, insurance rate of 79.8% .2006, the urban and rural as 343.57 million, according to 50 yuan per capita (individual farmers 10 yuan, 10 yuan supporting the county, city, Jiangsu Province, on the residential standard of 25 yuan per person grants to other counties in the standard 30 yuan per person supplement) Financing. Meanwhile, the government introduced a management, the end of July, the city's new rural cooperative medical care funds raised a total of 106.423 million yuan, of which 34.357 million yuan paid by individuals, counties supporting 23,126,000 yuan, 48,940,000 yuan provincial meeting. the city's total compensation amount of 56,396,400 yuan, of which total compensation for outpatient 8,126,400 yuan, 48.27 million yuan hospital total compensation; total compensation 1.1082 million people, including compensation for 59,400 patient visits, outpatient visits compensation 1,048,800.
two persons for the establishment of urban low ill hospitalized medical aid co-ordination and co-ordinate fund. Government plan before the end of 2006, will bankrupt the city shut down all enterprises included in the basic retiree medical insurance. some of the basic medical insurance premium payable by the competent department of units affordable, all levels of financial reveal all the details. for the enjoyment of the minimum living allowance for urban residents who, on the non- construction of individual accounts, one set way to co-ordinate the management of the Fund, the establishment of co-ordination and ill hospitalized medical aid system to co-ordinate regional financial subsidy 240 yuan per person per year, individuals paid 120 yuan per year.
the quality of these mechanisms is the way government subsidies changes in government subsidies to the original supplier, is now the subsidies to the demand side. the adoption of new agricultural cooperation, the city health insurance and poverty Zhe relief, etc., were free to choose the hospital. Because the hospital Buzai point, in order to attract patients and gain government subsidies, the hospital only at low prices, friendly service, high-tech efforts. In this system, the enthusiasm of doctors and nurses substantial increase in the output of medical and health services are also large-scale growth.
4, important regulatory functions of government ownership after
mixed, private capital is certainly to be profit-driven. private hospitals out of policy concerns and forced financial pressure, short-sighted phenomenon occurs in the operation, which targets the people there the great conflict. transpose public hospitals, the health departments and hospitals no longer have a direct interest, began to increase the independence of regulators. through market competition and government regulation of the conflict with the public hospitals began to decline medical treatment is difficult and your doctor initially solved the problem.
(c) Summary: Financial mechanism under the pressure of innovation
Therefore, the government health system reform Suqian in the context of great financial pressure, seek medical market economy the process of health system. essence of reform is the professionalization of government and market division, which provides medical services to market-based, public health to government, a government purchase of medical services for the poor funding.
third, health care reform by reform, whether it is sold out?
Suqian revitalize the stock of hospital restructuring and expansion, including incremental levels. revitalize the stock refers to the original restructuring public hospitals and health centers. expand the increment refers to the release medical market, encourage the development of private hospitals. until July 2006, the city Suqian 135 township hospitals in more than 134 were property replacement, type of reform was called sold out.
way to understand the reform not sold Reform, the need to convert the program from the property, transfer and use of funds set after the reform of ownership structure.
(a) replacement of property rights reform program
Shuyang hospital procedures, as Suqian City, representatives of the hospital reform program. It can be summarized in six steps:
one of the hospitals in the fixed assets, current assets, special clean production assets accounting; Second, qualified by the rating agencies to assess the situation of assets, evaluation report issued by then recognized by the state-owned sector; third, 7-10 days in advance notice to the community restructuring, and reform by the leaders in charge of the staff do go to the staff meetings held in various hospitals, unify their thinking; Fourth, the transfer of property held public auction the General Assembly, the official auction; five hospitals after the reform of land use rights to the transferee by the Land Bureau of assets according to relevant procedures; six, regulate the use of property rights transfer of funds. property rights transfer of funds to implement special accounts stored, used for other purposes, mainly Yongyu pay employee pension insurance, the introduction of unemployment insurance funds and the establishment of health development fund for rural health, particularly the development of anti-Paul.
transfer process from the perspective of property rights, reform the legal framework is based on the way transpose the property. not all sell public hospitals to private, public hospitals began to break the monopoly.
(b) use of funds
property replacement process of restructuring in the public hospital does not appear the phenomenon of loss of state assets . a lot of restructuring the hospital when the hospital director reflects the high bid, the auction premium of individual hospitals is high. such as asset evaluation of the hospital sold 200 million 400 million, a premium of as much as 2 times. Suqian Party Secretary Zhang is 2006 June 27 interview with Shanghai Dragon TV interview that the restructuring of the funds recovered, greatly exceeded the reserve price at the time the Government.
how to use the funds after the replacement, is widespread concern. Suqian City Health Bureau, according to statistics restructuring the city's capital of 422,863,700 yuan exchange, is capital in place of 330,910,100 yuan, the use of these funds is as follows:
17.8 million yuan for Disease Control Building, the blood center 7.9 million yuan, , City Centre, 80.59 million yuan infectious diseases, maternal and child health center outpatient 1800 yuan. Suqian three counties and two districts City township hospitals, disease prevention and control system, maternal and child health system funds 50 million yuan. To pay the full insurance workers 41.19 million yuan. The total expenditure of 26,317 yuan. Suqian surplus funds into the health care development fund account.
(c) the reform of ownership structure after the hospital reform Suqian
medical services is a mixed-ownership The. which the Government has Siyang county owned hospital. shareholding hospitals, including various forms: state-owned shares, state-controlled, full ownership, personal holding, and the medical system and other shares. Some township hospitals and clinics, mostly taken by individuals wholly-owned.
(d) Summary: property rights reform of property rights reform is just the beginning
the greatest benefit is the ability to improve efficiency, the same resources, the market more efficient output. output efficiency is reflected in two aspects: First, the provision of medical services, and second, the ability of patients to purchase services. medical services to the final output is not entirely determined by the system, it depends on the payment pattern of reform. whether it is state-owned hospitals or private hospitals, If you pay for the lack of an effective incentive or a blending of services, medical services, the output will be high quality and low price.
This means that if the corresponding set of reforms, especially the standard of medical services and lack of supervision, the effectiveness will be greatly reduced so that property rights reform. Suqian reason why the reforms did not achieve the desired objectives, the main reason is that facilities are not in place.
Fourth, the medical services provided by the market can solve, difficult balance. through increased efficiency to solve the problem of shortage of medical services, increase service availability, reduce the
(a) medical treatment is difficult problem
1,
growth in demand for medical services, according to number of visits by a 2.36 times increased to 2.49 times, increased 5.51%. two weeks visiting rate fell 2.84%, no treatment within two weeks prevalence rate has dropped 44.45%, within two weeks of illness should be hospitalized without hospitalization rate has dropped 15.73% , two weeks increased 0.26% prevalence rate of hospitalization, hospital delivery rate increased by 7.47%, while the rate of home births decreased by 7.77%. This shows that the medical needs of the residents improved significantly Suqian.
judge reform ; the issue is resolved, must be based on the medical needs of the residents on the basis of improved significantly.
2, and sexual health services can be enhanced, and above the county hospital patients waiting a long time, but the basic rural hospitals do not need to wait, you can receive timely diagnosis and treatment of common diseases.
2005, the Suqian City households less than 1 km from the nearest percentage WHO 76.5%, 1 -2 km to 17.24%, 5.30% for 2-3 km, 5 km above was only 0.12%, relatively rational layout of the medical WHO. township hospitals and village clinics and community hospitals widely distributed, it is Investigation from the supply perspective, the residents can truly enjoy the convenience of the services also need to be the result of their choice.
2005 and 2000 compared to rates of primary care visits decreased by 10.66%, rural district hospitals attendance rate has dropped by 0.27%, above the county hospital rate increased by 12.5%. This shows that although people close to the WHO from the nearest, to reach a relatively short time, but due to reasons such as medical technology, the patient chose to relatively high level of hospital. Suqian county rapid development of a secondary hospital, talent and technology and equipment capable of gathering to provide more medical services. township hospitals because the flow of talent, competitiveness is difficult with large hospitals compared. In addition, the convenience of transport also makes people have the ability to a higher level of technology hospital.
3, ability to significantly enhance the supply of medical services is enhanced medical services and basic medical services
availability of medical services mainly attributed to the increase in supply of .2005, Suqian hospitals from 148 in 2000 grew to 188, an increase of 27%. beds increased by 57.40%, 51.68% growth in the number of beds per thousand, per thousand Health Professionals who grow 16.45%, medical institutions, asset growth of 139.64%.
increase in medical equipment to improve the ability to supply medical services. restructured before the city's only 5 CT, Shuyang People's Hospital, Siyang County People's Hospital , Sihong County People's Hospital, Suyu County Chinese Medicine Hospital, City People's Hospital, one each .2006 7 months ago, the city's total of CT machine 32, in which municipal 7 sets, 3 sets of urban places, Suyu District 3 sets , Sihong 4, 5 Siyang, Shuyang 10.
4, the establishment of incentive and restraint mechanisms liberated Yiwei staff productivity
mechanism innovation, making the stimulation and Yiwei more reasonable restraint mechanism, the productivity of medical services has greatly liberated. five years, the total number of health institutions increased by 11.11%, 20.85% increase in health professionals, including physicians and over the number of titles rose 115.42%, managers decrease by 27.54%.
after the reform, the income of doctors has improved a lot. If a hospital president Shuyang monthly income of 800 yuan five years ago, the current monthly income of 3,000 yuan. Shuyang a rural hospital treatment by a physician up to 1,200 yuan 2,000. incomes, inspired Yiwei staff motivation, which is prerequisite for the sustainable development of the hospital. in the hospital competition, talent competition to further promote brand competition triggered the development of productivity.
5, non-qualified clinic
survey data is still there, residents in the doctor's choice of location, proximity to the first choice, the percentage is 50.33%. quality in second place, 17.22%. low prices only in third place, 11.26 %. the attitude of only 2.87%, ranked fifth. and thus can be said that although the doctor has eased the difficult problem, but to take time to achieve the desired state.
residents in some of the choice extent, non-statutory medical organizations say there's an important reason. Task Force found that the clinic is known as black or repeated unlicensed practitioners. the patient feels the services of these clinics are convenient, prices are low, but the service quality is not guaranteed. ailment patients feel no need to go to regular hospitals will choose this type of clinic. They reflect, as its identity is not clear, it is sometimes difficult to distinguish between formal and informal clinics clinics. Some very low-income people because the price of reasons for choosing these clinics. We work with some of the exchange of unlicensed physicians, most of them because of low qualifications, who has suffered punishment, inadequate capital and other reasons, do not meet the criteria for access to government clinics.
(b) Suqian list provided by the Municipal Health Bureau show that the substantial increase in hospital revenue after the reform than in 2000 .2005 prices nominal income growth rate 964%, 473% growth rate of outpatient visits, number of visits per thousand population growth rate 454%. hospital visits also increased. hospital incomes, whether the increased burden of patients?
this is changes in prices of medical services, not only vertical and horizontal comparison, patients also need to look at changes in capacity to pay.
1, the reform of medical services before and after the change in the price of Longitudinal
1.1 Suqian City Health Bureau, according to data provided by the health care reform, the price five years following changes have taken place.
first five years, municipal fees and charges for each hospital outpatient visits increased 7.11%, 6.31% growth in county hospitals, township-level hospitals decreased by 6.26% .
second, five years, the level of charges per bed day down 1.40% municipal and county hospitals, township-level hospitals fell 3.91%.
third, five years, the average medical cost of hospital and municipal hospital rose 21.78 %, 0.66% increase in county hospitals, township-level hospitals decreased by 5.25%.
data collected from the research group can draw the following conclusions:
First, lower-level hospitals, the basic registration fee to cancel, a large The registration fee to keep the hospital at a lower level.
Second, the general decline in the cost of surgery, the higher the cost of the higher-level hospitals. with simple appendicitis, for example, county hospitals, the cost of the pre-reform general yuan in 2000, after the reform costs at 1,500 yuan. township roughly the cost of hospital reform in 1200 before the yuan, reform, remain at 700 yuan. the cost of cesarean section before the reform in general in 4000 yuan , the reformed county hospital costs from 2,500 to 3,000 yuan, 1,500 yuan in rural hospitals. eutocia surgery, the pre-reform cost around 2,000 yuan, county hospital costs after the reform in 1200 yuan, 500 township hospitals yuan.
Third, routine examination costs down. CT in the pre-reform cost of single-site single is about 300 yuan, 120 yuan or so after the reform. new inspection costs of the project began to grow. Some pre-reform Suqian large hospital equipment does not exist, so this can not be compared with the pre-reform.
Fourth, the conventional drug prices within the government's limit. Hospital, the higher the level, the higher drug prices. new drugs prices down than before. lower prices of non-prescription drugs, prescription drug prices are relatively high, unit prices also declined.
1.2
horizontal comparison of the same disease in different hospitals in the local and foreign cost analysis is the horizontal comparison .
county hospitals, in addition to cerebral infarction and cerebral hemorrhage and thyroid tumors, a number of common diseases such as appendicitis, cesarean section, stones, cancer and other treatment costs are generally lower than the field at the county level hospitals. This shows that health care reform increased competition in the hospital, the general decline of the hospital medical expenses. However, due to being in its infancy, for some heavy treatment of the disease, not to form a fully competitive local hospital, in a few cases, the hospital costs of monopoly are relatively high.
municipal hospitals, local hospitals are generally lower than the cost of field hospitals, the treatment of lumbar disc herniation of the local cost of 2578 yuan, the field is 5343 yuan; esophageal local as 6394 yuan, the field was 7418.29 yuan.
the local provincial hospital costs are generally higher than outside the provincial hospital, the cost of the treatment of esophageal cancer than the local provincial hospital provincial hospitals outside the high 52%, 83% higher lung cancer, gastrointestinal bleeding in high 79%. cancer, ectopic pregnancy and other local the hospital than outside the hospital.
2, medical services, the reasons for price changes
2.1
residents ability to pay changes with the increase of disposable financial resources, the potential consumer demand into real demand. Reform Ten years, after inflation-adjusted real income per capita Suqian overall upward trend. the real per capita net income of farmers by the 1848 yuan to 3782 yuan increase. In addition to 7% in 2003 fell outside the rose in other years, especially 2004 and 2005, respectively, an increase of 9.31% and 13.66%. the real per capita income of urban residents rose from 2,733 yuan to 7,101 yuan, after 2004 growth rate of over 11% year on year. For farmers, agricultural policies in recent years, the effectiveness of the central re-start show, the burden has been reduced. the local market-oriented reform, especially the adjustment of industrial structure, attracting southern Jiangsu, Zhejiang and other places in the industry shifted to the Suqian, the increase in local employment led to increased revenue.
the same time, health care Insurance .2005 participation rate improved significantly compared with 2000, the ratio of residents to have health insurance increased significantly. which, to participate in health insurance rate increase of 6.90% to 87.90%, up 81%. and members of rural cooperative medical care of the population the proportion rose from 5.97% to 84.30%, an increase of 78%.
these have shown the capacity to pay for medical services improved. from 2000 to 2005, no treatment because of financial difficulties down the rate of 21.80%, in their own requirements discharged patients, due to financial difficulties required rate of discharge decreased 16.12%.
2.2 competition reduces the price of conventional health care, technology upgrading to increase the supply of services in the Suqian
...
Monday, February 14, 2011
Friends to go with his life
Along the way, maybe hit it a lot, but too little real forever. Is not treasure do not know, but did not do and to cherish, only to cherish the friendship can only be a long time.
Always look back, those who have friends, such as the pigeon flew across the sky, I heard the whistle, an arc, ray of thought.
some do not cherish, after they will be forgotten.
Some are not worth the value, but also remember to remember not mind.
missed some treasure, accompanied by only regret.
declare himself a poor man can not have true friends; a poorly paid, do not have a true friend; a sincere person is not enough, not worthy of a real friends.
and I am a kind of person? the kind of friend that?
previously, I have not thought about it, at least in my previous life, with or lost friends, I do not want to this issue.
nostalgia, friendship should be cherished, I have been so treated myself. I do and cherish everything around, though not deliberately to do what, in my heart, I will memorization.
everyone has the defects of his life, here I am talking about is the character and psychology major defects. This determines that, when we selective friends. But whatever choice to get along, or give up, to treat, but also very valuable.
so others can take the initiative and contacts, that within our hearts, to accept the presence of friendship.
very reluctant to analyze their own or others, a person's mind and soul together , each person has the criteria for human friends, as I like to have a suitable corner alone, hidden in the depths of love as the soul. Of course, this is not a good way, I have tried to change this attitude of life attitude, but often more beautiful, more vulnerable to attack. repeated injuries, all from the closest friend, a true friend is always because of the reality but to separate. So, learn Dankan all, edge to edge scattered, all the wind blowing it. However, this does not mean do not want friendship, real friends who do not want to have, such as books on hand, as can be in joy or calm, sad when the heart to read, without knowing save grudge. hurt of course inevitable, but it is only a flash, for a long life is truly just an instant. So, do not let it stop longing for the good, because of injury, we will know better value.
here do not want to ignore the network of friendship, this is no longer an unfamiliar topic. network is a fantasy but real environment, real and imaginary friends are the individual, everything is like a fantasy. But Leaving aside how the process , the outcome is what I always believe that friendship is real. maybe you'll stay away from, maybe I'll retire, has been, and should be is there, and we do not deny the power, enough to be able to cherish the time to cherish , to have the time to have at least lost, will always go to remember.
friend, an eternal topic.
Always look back, those who have friends, such as the pigeon flew across the sky, I heard the whistle, an arc, ray of thought.
some do not cherish, after they will be forgotten.
Some are not worth the value, but also remember to remember not mind.
missed some treasure, accompanied by only regret.
declare himself a poor man can not have true friends; a poorly paid, do not have a true friend; a sincere person is not enough, not worthy of a real friends.
and I am a kind of person? the kind of friend that?
previously, I have not thought about it, at least in my previous life, with or lost friends, I do not want to this issue.
nostalgia, friendship should be cherished, I have been so treated myself. I do and cherish everything around, though not deliberately to do what, in my heart, I will memorization.
everyone has the defects of his life, here I am talking about is the character and psychology major defects. This determines that, when we selective friends. But whatever choice to get along, or give up, to treat, but also very valuable.
so others can take the initiative and contacts, that within our hearts, to accept the presence of friendship.
very reluctant to analyze their own or others, a person's mind and soul together , each person has the criteria for human friends, as I like to have a suitable corner alone, hidden in the depths of love as the soul. Of course, this is not a good way, I have tried to change this attitude of life attitude, but often more beautiful, more vulnerable to attack. repeated injuries, all from the closest friend, a true friend is always because of the reality but to separate. So, learn Dankan all, edge to edge scattered, all the wind blowing it. However, this does not mean do not want friendship, real friends who do not want to have, such as books on hand, as can be in joy or calm, sad when the heart to read, without knowing save grudge. hurt of course inevitable, but it is only a flash, for a long life is truly just an instant. So, do not let it stop longing for the good, because of injury, we will know better value.
here do not want to ignore the network of friendship, this is no longer an unfamiliar topic. network is a fantasy but real environment, real and imaginary friends are the individual, everything is like a fantasy. But Leaving aside how the process , the outcome is what I always believe that friendship is real. maybe you'll stay away from, maybe I'll retire, has been, and should be is there, and we do not deny the power, enough to be able to cherish the time to cherish , to have the time to have at least lost, will always go to remember.
friend, an eternal topic.
Sunday, February 13, 2011
Korean Air cold
The third round of the AFC, the Chinese team really felt the cold of the hit.
two games as if the four players to play against the chess game, then the Yankees and the south and almost the strength of a very, just missed the national security that led to the last paragraph of the disk crash, the score is actually not true Comparison of the performance of both strength; and AFC's Henan Jianye first time, then, and their opponents Suwon Blue Wings on the existence of the gap between the Dan.
start with the national security of the war, in the early lead, the Guo'an The overall strategy is correct, although the scene of ugly, but the basic containment of the opponent's offensive attack the other side is not much threat to the side of the goal, but the physical decline in the second half team, we became the vulnerability of personnel adjustments in personnel short period of turmoil after adjustment by opponents, leading to the final collapse. be fair, Hong Won-seok adjust the wing of the substitutions coach thought no errors, and his adjustment was also targeted, such as Du Wenhui playing activate the winger, and Lu Jiang's play is replaced burnout for Wang Changqing, but it was replaced in the Wang Changqing, after a few seconds, Lu Jiang, after not playing a good defensive position and his teammates exchange, the opponent scored quickly, and this second time is just confused opponents use some bad luck. then the morale of opponents are motivated, highly offensive, the other targeted substitutions up young winger Song Haozhe adjustment also takes full advantage of this loophole Guo'an, called Taiwan coach Shen Long sweet skill. Seongnam's equalizer a ball and pull the East Silajdzic overtake a ball, it rivals the effects of this adjustment reflects the sidewalks.
say Henan game. Henan Jianye, after all, is the first time in AFC's stadium, and learning is their primary task, not to mention significantly higher than the face of a length or strength of the Suwon Blue Wings. the whole game, in addition to momentum, the Henan Jianye not an index over opponents, regardless of control or the whole idea is to watch the first three games Henan Jianye the performance of this AFC, Hutouhunao is that they give the impression that the first impression, fearless nature should be commended for his bravery, but the AFC tournament, after all, is not Spirit alone can win. Henan Jianye need to do is pick up filled with blood, the convergence of mind, a solid lineup, more honed, gain experience, so-called ; is the best policy.
today's sad, the overall strength of the gap, not a victory to reverse the two, and slowly, do not toss on the line.
the way, do not toss.
two games as if the four players to play against the chess game, then the Yankees and the south and almost the strength of a very, just missed the national security that led to the last paragraph of the disk crash, the score is actually not true Comparison of the performance of both strength; and AFC's Henan Jianye first time, then, and their opponents Suwon Blue Wings on the existence of the gap between the Dan.
start with the national security of the war, in the early lead, the Guo'an The overall strategy is correct, although the scene of ugly, but the basic containment of the opponent's offensive attack the other side is not much threat to the side of the goal, but the physical decline in the second half team, we became the vulnerability of personnel adjustments in personnel short period of turmoil after adjustment by opponents, leading to the final collapse. be fair, Hong Won-seok adjust the wing of the substitutions coach thought no errors, and his adjustment was also targeted, such as Du Wenhui playing activate the winger, and Lu Jiang's play is replaced burnout for Wang Changqing, but it was replaced in the Wang Changqing, after a few seconds, Lu Jiang, after not playing a good defensive position and his teammates exchange, the opponent scored quickly, and this second time is just confused opponents use some bad luck. then the morale of opponents are motivated, highly offensive, the other targeted substitutions up young winger Song Haozhe adjustment also takes full advantage of this loophole Guo'an, called Taiwan coach Shen Long sweet skill. Seongnam's equalizer a ball and pull the East Silajdzic overtake a ball, it rivals the effects of this adjustment reflects the sidewalks.
say Henan game. Henan Jianye, after all, is the first time in AFC's stadium, and learning is their primary task, not to mention significantly higher than the face of a length or strength of the Suwon Blue Wings. the whole game, in addition to momentum, the Henan Jianye not an index over opponents, regardless of control or the whole idea is to watch the first three games Henan Jianye the performance of this AFC, Hutouhunao is that they give the impression that the first impression, fearless nature should be commended for his bravery, but the AFC tournament, after all, is not Spirit alone can win. Henan Jianye need to do is pick up filled with blood, the convergence of mind, a solid lineup, more honed, gain experience, so-called ; is the best policy.
today's sad, the overall strength of the gap, not a victory to reverse the two, and slowly, do not toss on the line.
the way, do not toss.
Friday, February 11, 2011
New energy bubble has emerged, and guard against continued expansion
New energy bubble has emerged, to guard against continued expansion
text / NI payments section
9 4, the Opening of Tianjin Binhai New Area the morning of 5 March .9, the National Development and Reform Commission Chen Bin Industrial Coordination Division threw out the The author of view that the current trend of new energy bubble has emerged, the relevant departments must be highly vigilant, avoid repeating the mistakes of the Internet and the real estate bubble. departments must learn before the excess capacity of the industry's warning, had just to make China the next round of economic growth does not fall behind and become the true beneficiaries of the new energy industry.
Chen Bin, Director of views and the recent hot topic of new energy bubbles exist side by side, policy makers have already started the introduction of real new energy bubble containment policy to prevent the further expansion of the bubble 26 .8, the State Council executive meeting of the study and plan the inhibition of iron and steel, cement, polysilicon, wind power and other emerging industries excess capacity, redundant construction and other issues. This means that the Government is intends to promptly stopped production of new energy industry development trend of disorder.
Yes, new bubble in the energy industry has already generated. If left unchecked, the ultimate and inevitable outcome of the Internet bubble and the beginning of the century caused by the round of financial crisis culprits of the tragic fate of the real estate bubble. According to the author's observation, a new domestic energy boom has come and go, proper regulation and control policy of the new energy industry to re-shuffle of new domestic energy companies, for the healthy development of major new energy benefit.
the first half of the amount of days the Chinese economy suffered a blow to credit, new energy concepts into local government and enterprises is a major subject of large-scale investment. As the Secretary said Chen Bin, , enterprises have to take action on the new energy car project, the new thermal energy vehicles have emerged, many companies simply do not have the R & D capability in fact, do not grasp the core technology, but the outsourcing of key parts for assembly, one to meet policy and market demand, but made by the above auto car project to seek qualification, which is not in line with our policy direction, new energy is not conducive to the healthy development of automobile industry. cases, usually accompanied by some serious industry overcapacity, such as four or five years ago, overheating investment in heavy industry during the hot, steel mills, cement plants everywhere, leading to severe overcapacity. and now the background of financial crisis under the sharp decline in economic growth, many traditional industries in China experienced unprecedented difficulties. Therefore, the more the influx of liquidity is bound to remain , in addition to academics and printing of all hot engine of economic growth for the next round of new energy, a large number of enterprises and local government intervention which will within reason. But this makes sense, but contains deep signs of a bubble.
representatives of the new energy polycrystalline silicon as an example. polysilicon, the highest price has more than 400 U.S. dollars a kilogram, while in 2004, when only 50 U.S. dollars a kilogram, even though such gains are difficult commodity bubble hold a candle. As of the end of June, Sichuan, Henan, Jiangsu, Yunnan, more than 20 provinces, nearly 50 companies are building, expansion and build polysilicon production lines, with a total building size of more than 17 million tons, total investment of more than 100 billion yuan.
This abnormal growth rate than in 2003 and 2004 during the blind expansion of the steel industry is more serious. This type of development springing up the path to the final will usher in a strong central government control, as . is to give new energy is being trapped bubbles of many entrepreneurs and government officials sounded the alarm. If we disregard their own reality, blind development, and ultimately will bear the consequences of a burst bubble.
Yes, the current world economic and industrial patterns have reached a critical time node, mature new energy technologies may become the engine of economic growth in the next round, profoundly changing the lives of each of us. Thus, under the guidance of the appropriate policies, develop new energy technologies and industries, and form investment boom should have been a good thing. But all things are subject to a degree, and the current development of China's economic structure is still extensive, blind projects, repeated investment in the construction of chaotic behavior for a long time did not change. In the new energy development process, the authorities had to learn before the excess capacity of the industry a lesson, it would only be able to make the next round of economic growth in China do not fall behind and become the true beneficiaries of the new energy industry.
text / NI payments section
9 4, the Opening of Tianjin Binhai New Area the morning of 5 March .9, the National Development and Reform Commission Chen Bin Industrial Coordination Division threw out the The author of view that the current trend of new energy bubble has emerged, the relevant departments must be highly vigilant, avoid repeating the mistakes of the Internet and the real estate bubble. departments must learn before the excess capacity of the industry's warning, had just to make China the next round of economic growth does not fall behind and become the true beneficiaries of the new energy industry.
Chen Bin, Director of views and the recent hot topic of new energy bubbles exist side by side, policy makers have already started the introduction of real new energy bubble containment policy to prevent the further expansion of the bubble 26 .8, the State Council executive meeting of the study and plan the inhibition of iron and steel, cement, polysilicon, wind power and other emerging industries excess capacity, redundant construction and other issues. This means that the Government is intends to promptly stopped production of new energy industry development trend of disorder.
Yes, new bubble in the energy industry has already generated. If left unchecked, the ultimate and inevitable outcome of the Internet bubble and the beginning of the century caused by the round of financial crisis culprits of the tragic fate of the real estate bubble. According to the author's observation, a new domestic energy boom has come and go, proper regulation and control policy of the new energy industry to re-shuffle of new domestic energy companies, for the healthy development of major new energy benefit.
the first half of the amount of days the Chinese economy suffered a blow to credit, new energy concepts into local government and enterprises is a major subject of large-scale investment. As the Secretary said Chen Bin, , enterprises have to take action on the new energy car project, the new thermal energy vehicles have emerged, many companies simply do not have the R & D capability in fact, do not grasp the core technology, but the outsourcing of key parts for assembly, one to meet policy and market demand, but made by the above auto car project to seek qualification, which is not in line with our policy direction, new energy is not conducive to the healthy development of automobile industry. cases, usually accompanied by some serious industry overcapacity, such as four or five years ago, overheating investment in heavy industry during the hot, steel mills, cement plants everywhere, leading to severe overcapacity. and now the background of financial crisis under the sharp decline in economic growth, many traditional industries in China experienced unprecedented difficulties. Therefore, the more the influx of liquidity is bound to remain , in addition to academics and printing of all hot engine of economic growth for the next round of new energy, a large number of enterprises and local government intervention which will within reason. But this makes sense, but contains deep signs of a bubble.
representatives of the new energy polycrystalline silicon as an example. polysilicon, the highest price has more than 400 U.S. dollars a kilogram, while in 2004, when only 50 U.S. dollars a kilogram, even though such gains are difficult commodity bubble hold a candle. As of the end of June, Sichuan, Henan, Jiangsu, Yunnan, more than 20 provinces, nearly 50 companies are building, expansion and build polysilicon production lines, with a total building size of more than 17 million tons, total investment of more than 100 billion yuan.
This abnormal growth rate than in 2003 and 2004 during the blind expansion of the steel industry is more serious. This type of development springing up the path to the final will usher in a strong central government control, as . is to give new energy is being trapped bubbles of many entrepreneurs and government officials sounded the alarm. If we disregard their own reality, blind development, and ultimately will bear the consequences of a burst bubble.
Yes, the current world economic and industrial patterns have reached a critical time node, mature new energy technologies may become the engine of economic growth in the next round, profoundly changing the lives of each of us. Thus, under the guidance of the appropriate policies, develop new energy technologies and industries, and form investment boom should have been a good thing. But all things are subject to a degree, and the current development of China's economic structure is still extensive, blind projects, repeated investment in the construction of chaotic behavior for a long time did not change. In the new energy development process, the authorities had to learn before the excess capacity of the industry a lesson, it would only be able to make the next round of economic growth in China do not fall behind and become the true beneficiaries of the new energy industry.
Thursday, February 10, 2011
Most Western men handsome, elegant and
Most Western men handsome, elegant, because they were trained to a good education, the city has several McDonald's Kentucky Fried Chicken restaurant, I often go to dinner with friends in the restaurant to see Western men are obviously well bred, the first the door to let others into the Chinese men do, the door to the counter yixian to Ji Houhou of Ben, who often hit the inside out, a look that is E Sigui reborn into the foreigners are queuing, the Chinese men surrounded them around counter clamored to eat, eight children did not eat rice like generation, not too embarrassing, eating throw wrapping paper can be regarded after eating those foreigners in the paper tray folded for easy clean up, do not eat End of all their trash to get drained, there is simply not a level one. I was nothing, and do not want into what happened. No one needs me, no one worried about me, I do not want to worry anyone. I so alone, sleepwalk to live in this world, can not see there would be any improvement. every day into the lazy melancholy.
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