This year's government work report involves the medical part. The most difficult part of everyone's work is still in the practical problems of medical care, such as medical care, medical insurance, medical linkage, public hospital reform, reform of medical insurance payment methods, and social medical treatment is still in the encouragement stage.
If we put the lens in the long run, we will find that Chinese society is at the crossroads of demographic structure and disease spectrum changes. The aging and new round of birth will become the sharpest contradiction in the next decade. Hospital services, basic medical care, old-age care, social medical services, commercial insurance, what role should they assume? How to determine the boundaries of public health? What should the social doctors encourage and discourage? How should basic medical care develop? However, all of this has not yet been incorporated into a clear and clear plan of action for the country.
Many people may say that China can only cross the river by feeling the stones. But the fact is that many of the problems mentioned above are clearly defined in many countries, such as Japan. China's medical reform department is in the transition period between the old and the new, and perhaps the most basic social foundation in China, and their approach will give us more inspiration.
Why is the social foundation of China's health care reform much like Japan? First of all, the payment method of the Japanese medical system is the closest to China. From the public medical insurance payment method, whether it is basic medical care or hospital medical service, it is mainly paid according to the project (FFS). Second, Japan does not implement a family doctor system, nor does it have a mandatory grading system. Third, the government's decision-making role in the medical system is relatively strong, such as drug pricing and medical service pricing. Fourth, Japan has already completed the governance of “medicating with medicineâ€. Since 1956, Japan has revised the Pharmacist Law and the Physician Law, and has clearly defined the pharmaceutical separation system. Until 1974, Japan continued to improve doctors’ compensation, and finally got rid of medical care and over-medical treatment. This process is going through. Fifth, after Japan entered an aging society, it established long-term care insurance and infrastructure, successfully completed the transformation and leap, and our country is facing the challenge of population aging.
Let's take a closer look at the situation in Japan. Japan's medical expenditure accounts for 10.3% of GDP, and most of the expenditure comes from the public health insurance system (that is, the mandatory universal health insurance we will introduce later, rather than the direct government financial input), accounting for 82.4%. Medical spending is stable, and this level is maintained in both 2012 and 2013. The Japanese medical service system is diversified, but they prohibit private for-profit hospitals from operating. Long-term care insurance and public health insurance are the most important components of the Japanese medical system. Among all medical expenses, premiums, tax exemptions, and self-funded expenses accounted for 48.8%, 38.4%, and 12.3%, respectively.
The government regulates the various components of public medical care in Japan. According to the law, the responsibility of the central and local governments is to strive to make medical services efficient, high-quality, and appropriate. Important laws include the Medical Care Act, the Health Insurance Act, the National Health Insurance Act, and so on.
The central government formulates various medical service fees, formulates local government subsidies, insurance agency subsidies, and subsidies for medical institutions. These regulations set by the government apply to all institutions, including private institutions.
Established a diverse and bottom-line medical service system
Japanese primary care is provided by individual clinics, and hospital medical services are mainly undertaken by private non-profit hospitals. However, Japan’s demand for social medical treatment has a bottom line, prohibiting social capital from holding private for-profit hospitals.
Primary clinics are mainly in the form of specialist clinics, and a small number of public hospitals provide primary medical services, Japanese medicine is separated, and most hospital outpatient clinics are stripped. In the primary health care system, one-third of the doctors are employed by the clinic, and the rest are doctors themselves. Clinics are usually opened by doctors or by doctors. In Japan, the doctor's group consists of several doctors who own a hospital or a clinic. The clinic can provide both general and specialist services. Japanese primary medical services are usually organized by one doctor + several nurses. In 2011, the average number of full-time staff in Japanese clinics was 7.2, including 1.2 doctors, 1.8 nurses, and 2.1 front desks.
From the perspective of hospital composition, in 2013, 15% of hospitals in Japan were organized by the central government or local governments, and the remaining hospitals were private non-profit hospitals. From the bed, 20% of the beds belong to public hospitals, and 80% of the beds belong to private non-profit hospitals. It is particularly important to note that private non-profit hospitals are considered to be part of public health care, and receive various government subsidies and subsidies, which are also covered by public health insurance funds. Japan does not allow private for-profit hospitals to open, but allows corporate hospitals to exist and provide medical services to employees. We can understand for-profit and non-profits in such a simple way: “for-profit†means that the balance of the hospital can be used for dividends. “Non-profit†means that the balance of the hospital is considered to be public funds. The funds cannot be handled privately and can only be used for all. The development of hospitals, more requirements are reflected in the Japanese medical law, and the Taiwan region of China has also borrowed from Japan.
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Lamp panel
The lamp panel is divided into ordinary infrared lamps (Dingyuan and Guanglei) and array lamps. The array camera is also divided into 1W, 2W and 3W. Therefore, when choosing infrared lamps, if it is an ordinary infrared lamp, try to choose Dingyuan and 3W array lamps. Since the appearance of infrared lamps is generally invisible, some cottage cameras are filled with Guanglei and 1W array cameras are filled with 3W array cameras. Therefore, try to choose a large brand when choosing cameras.
Maximum Aperture
The real value of the maximum aperture is to improve the light intake under low light conditions, so as to achieve the best exposure combination. In general, the ability to visualize the lens is not required for shooting landscapes. In addition, the lens caliber is not required for shooting landscapes except in particularly dark places. However, when the 70-200mm zoom lens is equipped with a 2-fold zoom lens to make the telephoto section become 400mm and AF is used for automatic focusing, it is better to choose a lens with the largest aperture of F2.8. Large aperture is conducive to accurate focusing in dark conditions. When shooting people with a large aperture lens, even in places where the light is weak, the handset can also use natural light to shoot. In addition, the lens with the largest aperture can bring fast shutter speed, so sports photography also needs a large aperture lens.
Another reason for requiring the lens aperture to be large is to be able to visualize the background freely and ensure the quality of visualization. When the aperture of the lens with the maximum aperture of F1.4 is reduced to F2, both the imaging quality and the blurring quality of the background are better than those of the lens with the maximum aperture of F2. Therefore, it is of great value to reduce the aperture of a large aperture lens by one stop. Any photographer should be good at using the lens.
focal length
The first thing to pay attention to when selecting a lens is the focal length of the lens. In fact, focal length is a matter of perspective. Different focal lengths and perspectives are different. In addition, users should be clear about what is the main purpose of buying lenses? Is it for scenery or people. As we all know, it is better to use a wide-angle lens when shooting landscapes, and a telescopic lens when shooting people. Therefore, you should first decide the focal length of the lens you want to buy according to the purpose of photography.
The best focal sections for shooting scenery are 24 mm wide angle focal section and 200 mm telescopic focal section (both are based on 35 mm specifications, the same below). When the wide-angle focus segment of the standard zoom lens evolves from 28mm to 24mm, the viewing angle becomes larger, and the range of scenery that can be stored is greatly expanded. Generally speaking, the maximum aperture of the lens is not required for shooting landscapes. If you are mainly shooting landscapes, a wide angle focal length of 24mm is basically enough when you select a zoom lens. As for the telephoto section, it must be at least 200mm. If the telephoto section is 300mm or 400mm, it is more ideal, and the degree of freedom will be greatly improved. The telephoto focus segment of traditional zoom lens is 300 mm, which is 450 mm for digital SLR. The focal length has been expanded by 1.5 times, which makes it more enjoyable to use. This is the value of digital SLR. The wide-angle focal section of the digital special ultra wide-angle lens produced is generally 12mm, equivalent to 18mm of 35mm, which is nearly 1.5 times larger than the 28mm focal section of 35mm, thus greatly widening the left and right range of the scenic scene.
The best focal length for shooting people is 85mm. In terms of 35mm standard, 85mm focal length is basically used as the standard for shooting characters. The portrait taken by the 85mm focal section is basically close to the picture effect taken by the medium frame camera. It is not only suitable for the distance, but also the face of the person looks very natural. The distance between the camera and the person being photographed can basically be kept at the normal speaking distance. The 85mm focal length can also effectively blur the background and prominent characters. In order to obtain good visualization effect, the lens with the largest aperture should be selected. The 85mm focal length is about 135mm on the digital SLR. Although the sense of distance of the shot is a little weak, it is basically OK, so the focal length of the person lens should be at least about 85mm.
A 100mm macro lens is enough for traditional SLR to shoot flowers. The 100mm macro lens can be used for equal magnification photography, which can make the flowers very large. However, when taking equal magnification photography or near equal magnification photography, due to the depth of the long focus scene, it is easy to shake, so anti shake measures should be considered when taking photos. From this point of view, 50mm macro lens is easier to use on digital SLR.
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