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Health System
U.S. may have one of the best health system in the World due to the following reasons:
1. Massive basic medical research, if you review the current most prestigious medical research journals, you will find that most of the medicine related research is carried out in U.S. Most licensed physician practice evidence based medicine which is based on most current medical research, not based on個人經驗， 祖傳密方，或 不實廣告.
2. The hospitals, physicians, pharmacy and public/private insurances are financially separated.
a. The hospitals provide Emergency service, the wards, nurses』 service, lab and imaging studies, the hospital have no right to decide which patient should be admitted, and how long the patient should stay in hospital.
b. The physicians are responsible for the patient』s medical care, and decide which patient should be admitted and how long the patient should stay in the hospital. Because the physician』s service is paid by patient』s insurance or patient themselves, physician usually does not need to worry about hospital position because of admitting non insurance or no money patients. The physicians are more interested in their patients』 medical condition and doctors』 own medical license, because if the doctor refuse to admit or premature discharge the non insurance patient in order to save money for the hospital and if this cause the patient injury and patient and family may sue the doctor and the doctor (malpractice insurance) has to pay a great amount of money or even loss their medical license, no matter that patient has the ability to pay doctors/hospitals or not. This will provide relative fair environment for all patients, and the decision for hospital admission and medical care mainly depends on the patient's severity of illness not the patient's ability to pay.
c. Although pharmacy and pharmaceutical company have tried hard to influence the physicians' decision to prescribe their company drugs, but it is illegal and doctors may loss their medical license in most of state if doctor receive sales commission (回扣).
d. Public and private insurance company is responsible for the patient's medical care costs. Hospital bill patient's insurance company for patient's hospital usage during hospital admission, the physician bill insurance company for the service the doctor provide during patient's hospitalization or office visit. In order to cut down the cost, the insurance company usually invest their money for public health, public education, and encourage preventive medicine, also provide the guideline to help physician practice more efficient and better. They also limit the certain tests and usage of certain medication (such as need authorization for CT/MRI scan, not cover high cost medication etc.)
3. The huge trial lawyer team is there and eager to pick up the doctor's mistake mercilessly.
In summary, U.S health system may be not perfect but the over all are excellent, fair and logic. it is expensive due to defensive medicine and increased non medical care expense (manage fee).
I believe that well trained doctor are needed in any society, but well balance, fair health system are much more important for common people. China may eventually find their own way for their health system, but obviously, the current system does not work, not fair, not efficient. There is no way for sick Chinese patients and their families fight with this big monster (financially close related huge entity: hospital, doctor and pharmaceutical company) and traditional Chinese medicine (TCM) make this system even more complicated.
I have a dream that one day half of U.S. trial lawyers will move to China and practice there. I am sure that will be a wonderful thing for both countries.
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