◎ Lu Junwei
The total amount of health insurance for 2016 has been negotiated today. The total amount of primary-level medical insurance has reached the upper limit of 5.5% growth rate, and the annual budget has reached 196.58 billion yuan. (Provided by the Medical Association)
On September 23, the consultation on the total amount of health insurance for the 116th year was reached. The growth rate of hospitals, primary Western medicine, dentistry and traditional Chinese medicine departments all reached 5.5%, and the total amount exceeded 1 trillion yuan. Negotiations have been concluded for two consecutive years, reflecting the consensus between the medical community and payers on increasing medical investment. Next, can these investments improve treatment and retention on the front line?
This negotiation adds nearly 5.8 billion yuan to improve nursing benefits, which belongs to next year's budget, and the effectiveness remains to be seen. The total growth also covers population aging and medical costs, and cannot be directly regarded as surplus for the hospital to use freely. The scale of investment and the method of use are two issues that need to be examined simultaneously.
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From the increase in health insurance benefits to the increase in medical salaries, there are also internal distribution within the hospital. The payment system affects income, and management controls salary structure, recruitment quotas and shift arrangements. When discussing manpower retention, in addition to being concerned about how much government investment there is, we must also ask how employers use the resources they obtain.
Also called a salary increase, is the increase a fixed salary or a conditional bonus? The Ministry of Health and Welfare has stated that the published average monthly nursing salary includes regular and non-recurring salary. Therefore, it is impossible to know the changes in the treatment of individual personnel by looking at the average alone. If the increase in income comes from more night shifts and overtime, this does not necessarily mean that working conditions have improved.
The Ministry of Health and Welfare has stated that the public average monthly nursing salary includes regular and non-recurring salary. Therefore, it is impossible to know the changes in the treatment of individual personnel by looking at the average alone. (File photo)
The effectiveness test of retention can be more specific: How much of the new funding is used for personnel? How much is the fixed salary adjustment? After the increase in staff, will the nursing load per shift decrease? Comparing salaries, actual working hours, vacancies and turnover rates can help us understand how much front-line work has changed after the increase in funding. When improving the benefits of one job category, it is also worth observing whether the salary and workload of other job categories are affected.
To clarify the distribution within the hospital, it is also necessary to distinguish the service content and financial constraints of different hospitals to avoid attributing all absenteeism to the same reason. However, operating difficulties and assigned responsibilities can coexist. While explaining the cost pressure, specific arrangements for retaining talents also need to be explained.
When consensus is reached through negotiation, one stage of budget allocation is completed. For the front line, the more direct questions are still: can the salary reflect the effort, can the vacation be arranged, and can the company see a stable future if they stay? These questions require answers from employers who have control over wages and work arrangements.
For front-line medical care, the most important questions are: can the salary reflect the hard work, can the vacation be arranged, and can the employee see a stable future if he stays? Schematic diagram. (File photo)
(The author is an associate professor of dermatology)
