Original Bajiuling Wu Xiaobo Channel

It may be difficult for pharmaceutical companies to embark on the road of OEM, but it is not a long-term solution after all.

Text/Ba Jiuling (WeChat WeChat official account: Wu Xiaobo Channel)

01

These things you bought online are probably branded products.

Have you bought scar cream, hair tonic, warm palace stickers, diet pills and other health care products online? If these products come from well-known pharmaceutical companies such as Renhe, Tongrentang and Xiuzheng, will you have more trust, even if its price is higher than similar products, will you pay for them?

But in fact, the products you bought are probably not from the pharmaceutical companies’ own factories, but are OEM products.

For example, Tmall’s "Medicine Capital Renhe Flagship Store" has a monthly sales of 10,000+and more than 7,000 comments. According to the product details page, this product is from Renhe Pharmaceutical, but it does not appear in the product list of Renhe Pharmaceutical official website.

According to the approval number of this product "G20180064", minibus found the registration information of this product in official website of the Food and Drug Administration, which showed that the manufacturer was "Guangzhou Aifuyi Biotechnology Co., Ltd.", and the last remark information also stated that its actual manufacturer was: Guangzhou Tengyu Cosmetics Co., Ltd.

Enterprise investigation shows that Guangzhou Aifuyi and Guangzhou Tengyu have no equity relationship with Renhe Pharmaceutical. This is a typical OEM product.

On the platform of investor interaction, many investors have raised a similar topic to Renhe Pharmaceutical, such as "What is the relationship between anti-alopecia lotion and Renhe Pharmaceutical", and they are concerned about the actual relationship between such branded products and Renhe Pharmaceutical.

02

The OEM model has spread to the medical field.

Today, the OEM model has been very popular in all walks of life. The most typical is the Antarctic people. Open a shopping platform, there will be many shops related to Antarctic people, and the products are countless, from shoes and clothing to bedding, from electric irons to gas stoves.

Antarctic people were originally a company that started from making underwear. Since 2008, Antarctic people have closed all the production lines of their own factories, and since then they have changed from "selling products" to "brand authorization", earning a lot of money. In 2019, Antarctic people earned 1.3 billion yuan through brand authorization. In 2020, the gross profit margin of Antarctic OEM service will reach 93.26%.

In recent years, the OEM model has spread to the medical and health care industries. Renhe, Tongrentang, Xiuzheng, Sunflower and many other well-known pharmaceutical companies increase their income through brand authorization.

Taking Renhe Pharmaceutical as an example, according to its 2020 annual report, the company achieved a total operating income of 4.106 billion yuan. The company’s products are divided into self-owned products and OEM products. From the perspective of income, self-owned products and OEM products basically account for half.

The OEM model supports half of the revenue of an old pharmaceutical company, which is enough to prove the dependence of well-known pharmaceutical companies on the OEM model.

Compared with R&D, OEM is obviously an easier shortcut. Accustomed to taking shortcuts, they are even more reluctant to take the difficult but correct path.

According to the third quarterly report of 2021 disclosed by Renhe Pharmaceutical, in the first three quarters, the company’s R&D expenses were 42.76 million yuan, and its revenue was about 3.659 billion yuan. The proportion of R&D expenses in revenue was only 1.1%. According to the annual report of Renhe Pharmaceutical for nearly 4 years, its annual sales expenses are 14-26 times as much as R&D expenses. Renhe’s characteristics of "emphasizing marketing and neglecting research and development" are often criticized by the outside world.

However, this is not the problem of Renhe. According to the survey report of the consulting industry in China, the R&D expenditure of large international pharmaceutical companies generally accounts for 15%-20% of the total sales, while the R&D investment of domestic pharmaceutical companies accounts for only 2%-3% of the sales revenue on average.

03

Want to win by branding? I’m afraid not.

Although the road to OEM is easy, it is not once and for all.

Just like Antarctic people, they thought they could "win" by brand authorization, but these two years have not been easy.

Since July last year, the share price of Antarctic e-commerce has dropped from the highest point of 24.41 yuan to around 7 yuan today, and its market value has evaporated by nearly 40 billion yuan. According to its 2021 semi-annual report, in the first half of 2021, the net profit of Antarctic e-commerce attributable to shareholders of listed companies was 246 million yuan, down 42.85% year-on-year.

The OEM model is like a double-edged sword, which not only contributes a lot of profit to the enterprise, but also brings various negative problems to the brand, such as product quality, word of mouth and even false propaganda.

There are many complaints about branded products of pharmaceutical companies on the websites of Black Cat Complaint and 315 Consumer Protection Complaint. Most of the complaints revolve around "invalid products", "fake goods", "no refund" and "false propaganda".

Minibus searched Pinduoduo for a wound care ointment. According to the industry details page, this product comes from a national brand-Amendment. Its function is "scar removal without leaving any trace", and it has been put on record by the Drug Administration, with good safety effect.

The actual manufacturer of this ointment is "Jiangxi Bingshuangjiefu Industrial Co., Ltd.", which has no equity relationship with Xiuzheng Pharmaceutical and belongs to OEM products.

According to the record number "Ganzhang Machinery Equipment No.20190083" provided by it, the minibus made an inquiry on the website of National Medical Products Administration, and the record information showed: "This product is ointment. The contained components have no pharmacological effects. The ingredients contained cannot be absorbed by the human body. Non-sterile. "

The "intended use" item is blank.

The minibus inquired about other brands of scar-removing ointment of the same type, and the column of "expected use" said "suitable for inhibiting and relieving hyperplastic scars caused by burns, trauma, surgery and other reasons".

In other words, this ointment probably has no scar removal effect. If so, then this product has the problem of false propaganda.

04

How can you post it? Who is responsible for the problem?

Who should be responsible for the quality problems of OEM products? The minibus consulted Chang Dongyue, the director of Shanghai Law and Craftsman Law Firm, and he thought that once the branded goods had quality problems, the brand supplier was the direct responsible person, and the processor was also liable under normal circumstances. Moreover, this is based on the quality problems of legally produced products, and it is necessary to bear civil liability.

However, more and more enterprises don’t talk about "martial arts", and many enterprises alienate OEM into pure lending brands, which is very problematic without any quality supervision on quality. In this case, if the illegal production leads to extremely bad social consequences, the brand and producer of OEM products not only need to bear civil liability, but also need to bear administrative responsibility and even criminal responsibility.

Chang Dongyue also said that the safety of food and drugs is related to people’s right to health and even life. Quality problems may cause irreversible damage to the body, and no matter how strict the quality supervision of food and drugs is. Regrettably, although China’s Food Safety Law, Drug Administration Law and Product Quality Law all stipulate product quality responsibility, the sanctions for violating food and drug safety are still too light, so that the food and drug field in China is still not safe enough. In this regard, the United States and Japan’s practice of using heavy codes to control food and drug safety is quite good and worth learning.

Relying on legal sanctions is the last step. As an enterprise, it should be its duty to abide by the rules. How can have no martial ethics, a post it?

According to Shi Lichen, the founder and strategic marketing expert of Beijing Dingchen Management Consulting Co., Ltd., OEM is not illegal, and the key is how to continue to control quality while authorizing. Whether you are OEM or OEM, consumers only know that they are buying your brand. Pharmaceutical companies should pay special attention to quality, otherwise, as the authorized products become more and more miscellaneous, the quality can not be controlled, and finally the reputation of the main business will be affected, which will not be worth the candle.

05

Difficulties and new ways for pharmaceutical companies

The advantages and disadvantages of OEM mode are very clear, and it can easily make money, but it is difficult to control the quality and the brand is easily damaged. The reason is very simple. The question is, those old pharmaceutical companies that have spent a hundred years settling down should have cherished their feathers. Why are they addicted to OEM?

Shi Lichen explained the reasons behind it: in recent years, the competition in the pharmaceutical industry has been fierce, and the operating pressure of pharmaceutical companies has increased. The old pharmaceutical companies have to find a way out. First, solve the fundamental problems and increase investment in research and development; Second, based on its own cost advantage, to achieve economies of scale. But these two roads are not easy to walk.

"In contrast, the OEM business has almost no cost and high net profit, so those pharmaceutical companies with brand awareness and strong premium ability naturally embarked on this road."

From this point of view, it is difficult for the old pharmaceutical companies to embark on the road of OEM, but this is not a long-term solution after all. Is it possible to open up a new road?

There is indeed a new road that has emerged-the field of cross-border beauty cosmetics and daily chemicals for pharmaceutical companies.

With the strong growth of functional skin care products, pharmaceutical companies such as Renhe, Pien Tze Huang, Tongrentang, Ma Yinglong, Yunnan Baiyao, Panlong Yunhai, Dong ‘e Ejiao and Xiuzheng Pharmaceutical have all set foot in the cosmetic and daily chemical industry.

Pien Tze Huang disclosed the 2020 financial report, and the company achieved operating income of 6.511 billion yuan, a year-on-year increase of 13.78%; The net profit was 1.672 billion yuan, a year-on-year increase of 21.62%. Behind the growth, the cosmetics sector contributed a bit. Its holding subsidiary Fujian Pien Tze Huang Cosmetics Co., Ltd. achieved revenue of 611 million yuan, up 42.01% year-on-year, and net profit of 114 million yuan, up 41.23% year-on-year.

In July this year, Renhe Pharmaceutical announced that it planned to acquire 80% equity of seven cosmetics companies for 719 million yuan. One of them, Shenzhen Miura Natural Cosmetics, has been independently producing Renhe brand cosmetics, and some of the products distributed by the other six target companies come from this company.

In this regard, Shi Lichen analyzed that there is a huge Japanese industry called cosmeceuticals, which is not available in China, but we can make some functional cosmetics. Well-known pharmaceutical companies have natural advantages in making cosmetics across borders. For example, if brands can support the premium of products, they can get higher profit points. In addition, pharmaceutical companies themselves already have strong management teams, marketing teams and capital levels, which are not available to ordinary enterprises.

"The difference is nothing more than that some pharmaceutical companies, such as Renhe, have cultivated Renhe brand cosmetics related products through OEM before, and some products already have a certain market share, brand awareness and user base. At this time, it is logical to conduct mergers and acquisitions. Some pharmaceutical companies have had less involvement in this area before, so they may have to do it from scratch. "

In this way, pharmaceutical companies cross-border to make beauty cosmetics and daily chemical products. Originally, they just wanted to be a sideline through brand authorization. In the future, they may become one of their main businesses and gain new profit growth points by creating explosive IP products.

Author | Li Mengqing | Duty Editor | Zhang Wenlong

Editor | He Mengfei | Editor | Zheng Yuanmei | Tuyuan | vision china

Original title: "Old pharmaceutical companies learn from online celebrity brand. Have you ever bought such branded products? 》

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　　CCTV News:During the Ming and Qing Dynasties, the maritime industry flourished, and colored gems and jade from various countries entered China with merchant ships. In the jewelry category exhibition being exhibited in Changsha Museum, about 300 pieces of collected treasures show the beauty of the blending of Chinese and Western cultures.

　　With the continuous development of navigation and trade, China is rich in precious stones and stored in by going up one flight of stairs. Jewelry inlay technology developed rapidly in the Ming and Qing Dynasties. This Ming Dynasty’s "gold inlaid with precious silk and five phoenix crowns" is very rich in decorative elements, including the flower shape of peony, dragons, phoenixes, butterflies and other forms of decoration, using a variety of complex techniques such as tired silk and hammering.

　　The continuous export of China’s artworks has also made westerners know and understand China culture. These two French cosmetic boxes, dating from about 1920, are rich in China elements in design.

　　Bronze decoration embodies the cultural characteristics of Shang and Zhou Dynasties.

　　At the special exhibition of Shang and Zhou cultural relics on display in Tianjin Museum, more than 150 pieces (sets) of Oracle bones, bronzes and other cultural relics provide important clues for studying the origin of Chinese civilization.

　　The typical animal face pattern in Shang bronzes is the reorganization and deformation of many animals based on people’s imagination. All kinds of animal-faced tripod in the exhibition reflect the reverence and worship of nature by the ancestors of Shang and Zhou Dynasties.

　　Cicada pattern is also a common animal pattern decoration on bronzes, which means it is high in food and dew, clean and valuable. This cicada-patterned tripod in the late Shang Dynasty has a complicated craft, which embodies the exquisite skills of ancient craftsmen.

　　Zhaoji civilization sees the origin of Chinese characters from cultural relics

　　Through this special exhibition, we can learn about the history and culture of that period from the Oracle bones and bronzes with inscriptions.

　　The word "China" combined together first appeared on the bronze ware "He Zun" more than 3,000 years ago. In fact, the earliest Chinese characters "Zhong" and "Guo" can also be found in Oracle Bone Inscriptions in Shang Dynasty.

　　Oracle Bone Inscriptions can not only reflect the political and military situation at that time, but also reflect the ecological environment at that time. From the Oracle inscriptions carved on this piece of Oracle bones, we can see that the Central Plains at that time had traces of elephant survival and reproduction.

　　In Shang dynasty, people not only carved words on Oracle bones, but also wrote on wooden slips and silks with brush. Although it is no longer possible to see the Shang dynasty classics written with a brush, the inscriptions on bronzes basically retain the form of brush writing. In the inscription of Xin Ding, the father of the Shang Dynasty, we can intuitively see the trace of the writing of the word "father" with a brush.

On April 16th, BYD personalized brand equation Leopard Technology Tide SUV Titanium 3 was officially launched, with a total of five versions, with a surprise price of 133,800 yuan, and a financial discount policy of up to 5,500 yuan and five super-value car purchase rights.

"One abnormal titanium gives birth to everything", Equation Leopard Titanium 3 creates the trend aesthetics with science and technology. With its unique "one machine, three cabins" trend configuration, "E+2C" intelligent three-piece suite and "iCT" safety three-piece suite, it has the super-value value of surpassing technology, space and configuration, and at the same time, it further realizes the "scientific and technological trend products, which are shared by the whole people". Titanium 3 will work with all users to open a new chapter in urban travel and create a new era of high-tech products.

Titanium 3 configuration is full, technology is full, value is full, sincerity is full

Inspired by "Star Wars Aesthetics", Titanium 3 has created a new category of "science and technology fad" and led a brand-new "science and technology fad" with its unique technology of "one machine and three cabins". "One Machine" refers to the intelligent vehicle-mounted unmanned aerial vehicle system of Lingyuan jointly developed by BYD and DJI, which can easily achieve a good shot with one button.

"No.3 cabin" refers to the electric front cabin, ecological cockpit and convenient rear cabin. The electric front cabin is equipped with the only electric opening and closing function at the same level and a large volume of 151L; Eco-cockpit includes multifunctional smart island, ergonomic chair, custom buttons, 15.6-inch central control screen, dual-temperature air conditioner, cold and warm refrigerator, Divale audio, 6kW high-power external discharge, one-button down of the rear seat, and official customized air mattress, which can easily lie flat and change into a big bed room every second; 28L’s convenient rear schoolbag is stylish in appearance and dry in content, which can meet the daily personalized storage needs of more yuan and more flexibility.

The "iCT" safety three-piece set makes the safety technology configuration full, including iTAC intelligent torque control system, extremely fast vehicle response and one-button drift mode; CTB vehicle safety structure, which is resistant to extrusion, folding and collision, makes every trip feel at ease; TSC high-speed tire burst stability control system, assisted by 140km/h high-speed tire burst control, allows users not to panic when they are in danger. Let every time you drive actively and passively, it is safe, and the safety guard will accompany you all the time.

The "E+2C" intelligent three-piece set makes the intelligent technology configuration full, including the intelligent EVO+ platform, which has a product performance of 1 super and 3 strong, and its unique iATS intelligent all-terrain recognition system can automatically identify road conditions such as grass/sand/mud/snow, and automatically switch driving modes, so that users’ travel scenes can be opened infinitely; High efficiency, shortening the charging time of users at low temperature by 40% and the charging time of 30-80%SOC at room temperature by 18min；; Strong handling, titanium 3 is equipped with a million-class suspension, and the front two-ball joint McPherson rear five-bar linkage brings users the ultimate driving feeling; Strong performance, 20000 rpm motor, 100 km acceleration of 4.9 s; Eye of God C high-order intelligent driving assistance system can easily realize high-speed navigation assistance, intelligent parking and active obstacle avoidance; Active preview+Yunqi -C intelligent damping body control system can realize intelligent preview of road conditions and intelligent damping control, and bring users a driving experience with light sensitive cornering, smooth handling, stable body posture and strong road adaptability. Let the platform drive intelligently, and intelligent technology is always online.

Titanium 3 surprise listing, rights and interests in place, 0 yuan can also buy.

Titanium 3 successfully set off a "tide wind" and brought three surprises. First of all, it has brought a very competitive price of 133,800 Pro version of 501KM rear-drive intelligent driving, 139,800 Max version of 501KM rear-drive intelligent driving, 153,800 Max version of 501KM four-wheel drive intelligent driving, 163,800 Ultra version of 501KM four-wheel drive intelligent driving, and 193,800 UAV version of 501KM four-wheel drive intelligent driving, which will be delivered as soon as it goes on the market, with excellent price and the whole people can close their eyes.

Secondly, Titanium 3 also brought a financial discount policy of up to 5,500 yuan, and provided multiple financial schemes of "0 down payment, 0 interest and 0 monthly payment" for selection. "0 down payment", up to 5 years long loan; "0 interest", starting from 50% down payment, 24 installments with 0 interest; "Payment in 0 months", with 50% down payment and 50% final payment, and payment in 0 months at least for one year.

Finally, it sent out four great car purchase rights! Replacement subsidy of up to 6000 yuan; 7kW charging piles are delivered free of charge, and the first owner enjoys the rights and interests of charging pile basic installation service within two years from the date of self-delivery; Smart internet services, including lifelong OTA upgrade, online navigation, free car traffic for 2 years and 5G every month, etc. After-sales service, the whole vehicle repair of non-operating vehicles for 6 years or 150 thousand kilometers, the lifetime warranty of the "three power" system, etc.

Titanium 3 has launched two major reform plans, which are often used for renovation.

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High-tech products are shared by the whole people. Equation Leopard Titanium 3 is officially listed.

CCTV News:A few days ago, Ni Hong, Minister of Housing and Urban-Rural Development, said that a series of policies and measures introduced this year, such as denying housing loans, reducing down payment ratio and interest rate, continuing to implement personal income tax policies to support residents to buy houses, and reducing intermediary fees for second-hand housing sales, have played a positive role in stabilizing the real estate market.

For the real estate market next year, the Ministry of Housing and Urban-Rural Development said that it will continue to optimize real estate policies, support cities to adjust real estate policies according to local conditions, and at the same time further increase support for the first and improved housing policies to benefit the people. In addition, we will continue to do a good job in ensuring the delivery of buildings, people’s livelihood and stability.

Shanghai: the new real estate policy promotes the active first-hand housing market.

Last week, Shanghai introduced a new real estate policy, adjusting ordinary housing standards and optimizing differentiated housing credit policies. A week after the introduction of the new policy, the reporter visited the market and found that the actual exhibition and transaction volume of some new housing projects have increased to some extent compared with before the introduction of the policy.

This new house in Songjiang District was officially opened shortly before the introduction of the New Deal in Shanghai. From the afternoon of this week’s working day to the evening, the reporter saw that buyers would visit from time to time. According to this new policy, Shanghai has implemented a differentiated policy in the Lingang New Area of the Free Trade Zone and six administrative regions of Jiading, Qingpu, Songjiang, Fengxian, Baoshan and Jinshan, and the down payment for the second home has been reduced to a minimum of 40%.

According to industry insiders, since Shanghai began to implement the policy of "recognizing houses but not loans" in September, the market has generally stabilized and picked up. After this policy optimization, it is expected to effectively enhance the activity of the real estate market and improve the level of second-hand houses and new houses.

Beijing: In the first week of the New Deal in the property market, some demand for home purchases began to be released.

Beijing also introduced a new policy of real estate adjustment and optimization a week ago. These two days, the reporter visited and found that although the second-hand housing market is still relatively strong at present, there have been some changes in the new housing market affected by policies.

On December 14th, Beijing issued a new property market policy, which lowered the minimum down payment ratio of the first set of housing personal housing loans to 30%, and the minimum down payment ratio of the second set of housing personal housing loans to 50% in the six districts of the city and 40% in the six districts of the non-city. At the same time, the mortgage interest rate, loan life and general housing standards have been optimized and adjusted. After the release of the New Deal, many people who are interested in buying houses have chosen to come out to see the house.

The reporter saw in this sales office in Fangshan District, Beijing that although it was the morning of a working day, there were still some people who came to see the house. After a round of inquiries, the reporter found that most of them are customers who want to improve their sexual needs and just-needed groups who want to buy the first suite.

According to the sales staff of the sales office, the new policy has lowered the threshold for buying houses, broadened everyone’s choice space, and at the same time reduced the repayment burden of loans, which has stimulated the activity of buyers. Now, the number of consultations, exhibitions and sales of stores has improved to a certain extent.

However, the reporter observed that not all new housing projects are like this, and there are not a few properties with less passenger flow. Insiders told reporters that it will take more time for the market to improve because the New Deal was promulgated only one week ago.

This article comes from WeChat WeChat official account:Gu San Gu Si (ID: GH _ A68D56C34119), Author: Gu Yuan, the first picture from: vision china.

There are not so many things in this world, but there are always some people who create various theories to create various problems. Medical impossible trinity is such a stupid theory.

There is a Mundell impossible trinity in financial theory. It is said that the financial system can only choose two of the three: free capital flow, exchange rate stability and monetary policy independence, and it is impossible to have all three, otherwise it will lead to financial collapse. In this financial theory, there is actually a premise, and that is legal tender.

Someone made up another theory with this theory, which is called impossible trinity’s theory of medical system. Cheap, efficient and good service. You can’t have both, otherwise it will lead to collapse.

At first glance, does this theory make sense? It seems to make sense.

Let me discuss the common views of this theory first. For example, the United States has chosen high efficiency and good service, which leads to extremely high medical costs. It’s so expensive that ordinary families can go bankrupt by getting a rabies vaccine and calling an ambulance. The United States is efficient and has good service, but it is expensive.

Many people praise American medical care and find it particularly humanized. Doctors and nurses are patient and smiling because they choose high efficiency and good service. Since efficiency and good service are satisfied in impossible trinity, the cost can never be cheap.

American nuclear magnetic resonance imaging costs $1,100, appendicitis surgery costs about $15,000, and hospitalization costs $5,000 a day. A federal survey in 2012 found that the average cost per ambulance ride was $224.(about 1485 yuan)To $2204(about 14610 RMB)Between

For another example, Commonwealth countries and Europe choose cheap and good service, and as a result, it is difficult to see a doctor and queue up to death. Make an appointment with a dentist for one month, an ophthalmologist for seven months, and a B-ultrasound for three months. As long as it’s not a dying disease that needs emergency treatment, you have to queue up slowly. In the case of limited medical resources, low price and good service are required, and the result is extremely low efficiency.

Similarly, the medical systems in impossible trinity, the Commonwealth and Europe chose cheap and good service. The reason is simple. Good service requires doctors to listen patiently to every patient and give them time to talk. It takes at least half an hour to see a patient like this. Every doctor can see 16 patients in an eight-hour working day.

The limited number of doctors leads to the limited number of patients you can see every day, so you need to queue up in advance to make an appointment. As long as it’s not a dying disease, it’s not unusual to wait for three to five months before it’s your turn. The Canadian documentary "You are Dead" is about the problem of long queues in the medical systems of Commonwealth countries.

Choice determines efficiency, which is the case in all Commonwealth and European countries. The inefficiency of medical system is everywhere. In order to prevent patients from waiting too long, there is even a law that 90% of patients should be treated by a specialist within 13 weeks, and the rest must be treated within 26 weeks. The waiting time for surgery should not exceed 18 months.

China, with its large population and tight per capita expenses, chose cheap and efficient.The price is high-intensity work of doctors, high turnover of beds and high turnover of outpatient clinics, so that everyone can see a doctor.

Because of the large population and limited medical resources, and I hope everyone can see a doctor, we can only choose cheap and efficient. Choosing cheap and efficient means that it is normal to see a person for three minutes and ask two sentences to diagnose the disease.

If you register in the public top three, you shouldn’t queue up. Doctors need to serve smiles and have patience to listen. Is it possible? How many patients are there in a big hospital a day? Really want to engage in patient service, every patient has to talk about his illness for half an hour, and the efficiency is simply not allowed.

It is also the best hospital in China and America. The Mayo Clinic has 15 times as many medical staff as Concord, but only half the number of patients. 15 times the number of medical staff and 1/2 of the number of patients, which means that the efficiency of Concord is 30 times that of Mayo Clinic.

The outpatient fee of Mayo Clinic started at $500, but after the outpatient fee increased in Beijing, it was 50 Qian Qi.

Do you think Concord is tired enough? In fact, compared with Beijing Children’s Hospital, Concord is already relaxed. The average daily attendance of Beijing Children’s Hospital in winter is 12,000, with a peak of 16,000. In other words, 360,000 people will be treated every month in winter.

But now the first-and second-level hospitals and community clinics can basically be on call. Except for some top hospitals, most tertiary hospitals can also go to the hospital on the same day, see a doctor on the same day, and get the results within the same day or a few days. If this is all difficult to see a doctor, it is hard to imagine that Canada, where the average waiting time for emergency treatment is six to eight hours, and Britain and the United States, where appointments are made for several months.

It is difficult to see a doctor in people’s mouth now. In fact, it is difficult to find the top three famous experts in the region.It is actually not difficult to find the top three directors in the region to see a doctor, because many hospitals are not limited to the number, and they will finish reading it on the same day. Patients are crowded into the top three, which also causes a structural shortage of hospital bed resources. Judging from the number of inpatients undertaken by hospitals at all levels, the trend is very obvious. Low-level hospitals are getting empty, but high-level hospitals are getting crowded.

The beds in the top three are overcrowded. Let’s take a look at the first-and second-level hospitals and community hospitals below. Except for the old people who prescribe drugs for chronic hypertension for a long time, they are basically empty. Why? Because patients simply don’t believe that they can cure the disease.

Ok, is there a problem with the above discussion? Is it the actual situation?The reality discussed above is true, but the theory is wrong.What’s wrong with that?

The first big mistake: the definition of inefficiency, free and high quality in the Commonwealth system is wrong

If you don’t talk about other countries, say Britain. In Britain, the annual per capita absolute medical cost is 3327 pounds.($4,356). However, in recent years, the average life expectancy in Britain has remained basically unchanged, while in other countries, it has improved significantly. For example, in Singapore, the average life expectancy is 82.7 years, and medical expenditure only accounts for 4.3% of GDP.

Health care in the UK has increased from 21 in 2014.(A total of 56 countries participated in the ranking)It fell to 35 places in 2015, down 14 places, and currently lags behind Chile, Algeria and the Czech Republic. This change means that it has fallen to the bottom half of the Bloomberg list, and it is now behind Mexico, which is equivalent to Slovakia and Peru. The NHS is notorious for frequent accidents, insufficient supply and low efficiency.

It can be seen that the medical system of the Commonwealth system is expensive, poor in quality and inefficient. Medical impossible trinity theory,Mistreating welfare medical care as free medical care and giving him a cheap label is actually just medical care implemented by taxation.The cost is very high,Per capita expenditure is close to half that of the United States.

Secondly, medical impossible trinity theory.Completely ignoring people’s needs, and actually treating queuing for medical treatment as a good service.It takes months to see a doctor. Is this called service? Is there only one dimension of good attitude as the standard of medical service quality?

I won’t see a doctor. I’m not a doctor. If you are sick, you can spend 10 thousand yuan to find me. I will accompany you with a smile all day. Is it called service? Helping patients to solve their pain is the first dimension of medical service quality, and even seeing a doctor in time can’t be done. How can this be called good service?

The second big mistake: the definition of the most special American medical care in the world is wrong.

Impossible trinity Theory defines the United States as expensive, good in service and efficient.

Consumers are pursuing cost performance when they consume any commodity.

If you spend 30 yuan to press a foot in a street foot bath shop, you won’t pursue a luxurious hall and beautiful welcome. As long as you press it comfortably, you will say that the service is really good because of its high cost performance. On the contrary, you spend 500 yuan to press a foot in a high-end club. If a stingy man brings you tea and water, you will turn around and leave, because you will calculate your input-output ratio, and you spend more money in the hope of enjoying better service.

That ambulance will cost 1200 dollars for a trip. Is this called service? Just like if you order a fast food, you get 1000 yuan RMB. Who will say that this is good service? I can’t afford to get sick. You told me that this service is efficient and good? What kind of dog theory is this?

Let’s look at what is efficient.Whether efficiency only refers to speed depends on the result.Barefoot doctors in China used to see a doctor very quickly. Most patients came to prescribe some anti-inflammatory drugs and painkillers and sent them away. There was no inspection equipment, so the speed was certainly fast.

Efficiency depends on what the result is. What is an important criterion for the quality of medical services? It is the index of life expectancy and the calculation of input cost. Americans spend an average of tens of thousands of dollars a year on medical care, but the average life expectancy of Americans is the lowest in developed countries, and it often drops in some years. What kind of efficiency and good service is this?　

The third mistake: take medical service for granted as a pot of rice.

According to impossible trinity’s definition, a good doctor’s service attitude means a good service. Hurry up and see that a doctor is called efficient and a low fee means cheap. He also made a big mistake. He ignored people’s different needs.

Does the catering market exist in impossible trinity? If you have a big dining hall that everyone must go to, there will be impossible trinity:

Ma Yun came to dinner and ate the dishes of migrant workers, which is called poor service.

It is not expensive for middle-class people to eat, but they have to queue up, which is called inefficiency.

When the poor go to eat, they find that the price is more expensive than the roadside stalls. This is called the price is not cheap.

But didn’t the multi-level catering market completely solve this problem? Isn’t it cheap, efficient and good service for everyone to eat in a place that suits them?You mix all the people at all levels of consumption. Isn’t this an artificial contradiction?As a result, no one is satisfied. Is this the inevitable impossible trinity of the medical market?

More market-oriented medical care is that the needs of the poor will also be met, and it will be efficient and cheap.

India, which we despise, will show the world a model of medical marketization in 20 or 30 years. Private hospitals in India have innovated ophthalmic cataract surgery. One doctor performed cataract surgery for five or six patients at the same time. The doctor only did the key parts, while the rest were all operated by nurses. Low cost, low charge, high efficiency and good effect.

There is a private hospital in India that needs only $1,200 for heart surgery, which is a few tenths of the price of such surgery in the United States, but the level of surgery has surpassed that of ordinary hospitals in the United States. Just because other fields in India have not developed and people’s consumption power is insufficient, the results of medical marketization in India are not eye-catching.

The fourth mistake: misjudgment of China medical care.

If we just compare the United States, Commonwealth countries and China, my point is,Compared with medical care in these countries, medical care in China is efficient, good in service and cheap.

The per capita medical expenditure in China is about 10,000 yuan, but the average life expectancy in China is close to that in the United States. That is to say, it is close to that in the United States at one sixth of the medical expenses of Americans. Isn’t this efficient? When Chinese is ill, he can see a doctor at any time. Even if he goes to see an expert, he doesn’t have to wait for months. As long as you go to the queue, even if you buy a number from a scalper, you can always see him.

If you have to wait a month to meet experts in Beijing, how can 700 thousand people go to Beijing every day? In other words, you can quickly see experts who are equal to the severity of the disease, which is good service. Because the first dimension of medical service is not a good attitude, but that the other party can solve your problems.

Then it’s cheaper, the total expenditure is less, and of course it’s cheaper. The total expenditure of Chinese is lower than that of the United States or the United Kingdom. Once again, this is a comparison, and the bar is fine.

Then why? There’s actually only one reason,The degree of marketization of medical care in China is higher than that in Europe and America.

Nani, what are you talking about? It’s acceptable to say that all medical services in Britain are public, while hospitals and insurance companies in the United States are mainly private, while hospitals in China are mainly public. What makes you conclude that medical services in China are more market-oriented?

The world is often so strange, and the name is easy to deceive people. American hospitals are playing a private name, as if they were the product of marketization. Is this true? No, you have to look at the essence through the phenomenon. What is medical marketization? To put it more popularly, it isHospitals and doctors aim at making money, and the process of making money is less interfered.The less intervention, the higher the degree of marketization.

Do you think hospitals and doctors in China aim at making money? Of course it is. Because hospitals in China are not like public hospitals in Britain, which are fully funded, but hospitals in China have very little financial allocation.The main income of the hospital comes from the fees paid by patients.

Zhu Hongbiao, inspector of the Department of Physical Reform of the National Health and Wellness Commission, said that the direct subsidies from all levels of finance to public hospitals nationwide increased from 84.9 billion yuan in 2010 to 270.5 billion yuan in 2018. There are 50,000 public hospitals and health centers, with an average allocation of more than 5 million a year. Even the money for buying equipment is not enough, let alone paying salaries.

Therefore, hospitals in Britain do not aim at making money. They are the same as civil servants, and they are fully funded units. They do not need to cater to the needs of consumers, so they have a fixed source of income.

What is the difference between a fully funded hospital and a hospital that relies on patients to pay for medical treatment? The difference is,If you want to earn money, you must cater to consumers.Otherwise, consumers will not come to see you.

Although public hospitals are subject to various controls,But doctors in China have the motivation to improve their medical skills and to form a good reputation in the local society.Because skills and reputation can be exchanged for money, which can make more consumers come here.

Why can so many doctors operate for more than ten hours from day to night? What are they for? Because medical skills need practice, contact with various cases and repeated operations. Such doctors will become scarce resources, and thus get higher income.

If doctors are managed according to the civil service system, why should doctors improve their medical level? Why are you working so hard? Can’t you see fewer patients? Can’t you do a few less operations? Don’t I get the same salary? Under real public ownership, doctors have no incentive to improve efficiency.

Therefore, for a long time, doctors in public hospitals in China have been working hard, because efforts will have results, and efforts can increase income. At present, the level of treatment and operation of doctors in China is not inferior to that of developed countries, and even leads the world in many fields. The treatment level is high and the fees are not high, which is called good service.

It’s just that Dr. China’s income is limited, so he can’t raise the operation fee, so he can replace it with a red envelope, but he can’t raise the outpatient fee, so he can replace it with drug commission and inspection commission. Of course, these methods are not good, but they still constitute an incentive for doctors, and finally they have not blocked the way for doctors to make money.

Therefore, China hospitals have the motivation to continuously expand their scale, increase equipment and wards, and doctors have the motivation to continuously improve their level. Because they can make money, although they are restricted, they still have access.

At present, the scale of well-known top-three hospitals in various places is often very large, and some of them have operating income as high as several billion yuan. Is this entirely funded by the government? No. It is brought by the rush of consumers. There are always endless queues at the entrance of the top three hospitals, and the bustling crowds come to the door on their own initiative, and they vote with banknotes.

Many people say that private hospitals in China are terrible, and there is nothing wrong. Except ophthalmology and dentistry, other private medical services are really not so good, and they are full of fraud and low quality. Why is this? Because the marketization of public hospitals is not low. If it was a fully funded unit, the doctor would have finished running.

This makes it more difficult for private hospitals and public hospitals to compete. Many doctors don’t want to leave the public to go private for the simple reason.There are many public patients, and consumers have voted with their feet to prove that public hospitals in China can partially satisfy consumers.

Going back to American medical care, American medical care is completely private. Why is it so expensive? American medical care is subject to a lot of government control. Although it is nominally private, it must be handled according to various government regulations, which is called insufficient marketization. Give a few examples and you will understand.

Private hospitals in the United States need to apply to the government to increase beds. Is this called marketization?

Doctors in the United States need to apply to the government for interstate practice. Is this called marketization?

The number of doctors in the United States is controlled by doctors’ unions, and the supply quantity is artificially controlled. Is this called marketization?

The profit rate of medical insurance companies in the United States is set by the government. Is this called marketization?

How many restrictions are there like this? There are hundreds of them, and it takes tens of thousands of words to make them clear, so I won’t expand them here.

Then I’ll tell you again, even if all the medical enterprises in China are private enterprises now, it can’t be called marketization. Because in today’s China, the government-run medical insurance is dominant, and the government becomes the consumer of medical care, and he sets the rules. Even if you are a private medical service, your customers are also the government.

Under the current medical insurance control means, private medical care will also become an inefficient service organization, because it no longer serves consumers, but caters to and obeys the rules of government-run medical insurance.

It doesn’t matter whether the medical institution is public or private. What matters is whether it is market-oriented enough. As long as there are more market-oriented factors, so that consumers can choose with their feet and medical service providers can only make money by satisfying consumers, then medical care can be cheap, good and efficient.

The so-called medical impossible trinity theory is a stupid theory, and it is an argument for the specialization of medical services. In fact, medical care and eating are the same thing, both of which are service industries. How should medical care be done?Would you be satisfied with running a public canteen now?

This article comes from WeChat WeChat official account:Gu San Gu Si (ID: GH _ A68D56C34119), author: Gu Yuan

　　Li dongzeng

　　editorial comment/note

　　Recently, a case of bubonic plague was confirmed in Wulate Zhongqi, Bayannaoer City, Inner Mongolia Autonomous Region. Subsequently, Inner Mongolia Autonomous Region announced that three plague foci had been discovered, and close contacts had been observed in isolation at home. This is the second case of plague in Inner Mongolia since last November. Because there have been many plagues in human history, many people turn pale at the sight of them. In fact, today, through effective preventive isolation measures and treatment, plague has long been less terrible. In this issue, we will introduce the spread characteristics and prevention methods of this disease in detail.

　　one

　　The infectivity of different plague is high or low.

　　There are three common types of plague, namely bubonic plague, pneumonic plague and septicemic plague. Plague is usually transmitted from animals to people through rat fleas biting the skin. After a rat flea carrying Yersinia pestis bites a person, Yersinia pestis invades the body from the skin and first reaches the nearest lymph node, causing inflammation of the lymph node, which leads to high fever and swollen lymph nodes. The swollen lymph nodes can be felt from pigeon eggs to the size of eggs, which is bubonic plague.

　　If patients with bubonic plague are not treated in time, swollen lymph nodes may fester and rupture. These pus are also contagious and may be infected if they are touched. Yersinia pestis may also spread to the blood and lungs, becoming septicemic plague and pneumonic plague.

　　Pneumonic plague developed from bubonic plague is called secondary pneumonic plague, and patients with pneumonic plague will have severe pneumonia. There is Yersinia pestis in the respiratory secretions of patients with pneumonic plague, which is highly contagious. Others will be infected after inhalation. People who inhale Yersinia pestis from the respiratory tract can directly suffer from pneumonic plague, which is called primary pneumonic plague. Whether it is primary pneumonic plague or secondary pneumonic plague, the manifestations are similar, and they all have the ability of respiratory transmission. Plague spread from person to person is mainly pneumonic plague.

　　Bubonic plague is the most common, but the risk is lower than pneumonic plague, and it is generally not contagious. However, patients with pneumonic plague are highly contagious, and the mortality rate is relatively high if they are not treated in time.

　　When Yersinia pestis spreads into the blood from lymph nodes or lungs, it may become septicemic plague. Septic plague is rare, but it is the most dangerous and has a high mortality rate. If the patient is not rescued in time, he may die within 1 to 3 days after onset. Septic plague appears ecchymosis because of bleeding under the skin, and the skin is purple-black. Therefore, it was called "Black Death" after the outbreak of plague in medieval Europe.

　　2

　　There is little chance of infection without entering the epidemic focus.

　　The main sources of infection of plague are rats and other rodents, and in China, it is mainly Rattus and Marmota. Other animals such as rabbits, foxes, wolves, camels and some domestic animals such as cats, dogs and sheep can also become sources of infection. The spread of plague among animals is mainly due to being bitten by rats and fleas.

　　Plague itself is spread among animals. There are 12 types of plague natural foci in China, distributed in 19 provinces, and animals in these natural foci may carry Yersinia pestis. Under normal circumstances, plague will not infect humans, but some people are at risk of being infected because of their professional needs or because of travel and exploration. Therefore, the staff in pastoral areas are often high-risk people infected with plague. People who enter pastoral areas are most likely to be bitten by rat fleas in the lower limbs, so the most common symptom of bubonic plague is swelling and pain of inguinal lymph nodes. There are also some people who enter the plague natural focus because of hunting or traveling, and they are also at risk of infection after contacting animals. If you strip animals suffering from plague, you may be infected by rat flea bites, or you may be infected by skin wounds touching the blood and body fluids of sick animals. Plague infected by stripping animals is more common in axillary and cervical lymph nodes of upper limbs.

　　If ordinary people do not enter the natural focus of plague, there is little chance of being infected with plague, and rats in urban areas usually do not carry Yersinia pestis. If you plan to travel to the plague natural focus, you must know the local plague situation in advance, try to keep a distance from wild animals, and don’t get in touch with the woodchuck when you see it. When entering the grassland, try to wear long trousers and gloves, avoid being bitten by rats and fleas, don’t sit and roll on the grassland, don’t picnic and camp on the grassland, and try to reduce the risk of infection.

　　three

　　Symptoms and treatment after plague infection

　　People infected with plague have different symptoms according to different types. The common characteristics of plague patients are rapid onset, repeated high fever, chills, shortness of breath, rapid heartbeat and severe headache. The symptoms of bubonic plague are mainly swelling and pain of lymph nodes, mainly groin, armpit and neck, which are generally unilateral swelling and pain. Patients dare not move easily when the pain is severe. The bubonic plague may be misdiagnosed as other causes of lymph node swelling and pain, such as acute lymphadenitis, lymphadenopathy caused by filariasis, tuberculosis of lymph nodes, etc., but other diseases with lymphadenopathy usually start slowly and develop less rapidly than bubonic plague.

　　Pneumonic plague is characterized by severe chest pain, cough, expectoration, hemoptysis, dyspnea and wheezing. Pneumonic plague is easily misdiagnosed as common bacterial pneumonia or viral pneumonia, so it needs to be distinguished from other pulmonary infection diseases, including lobar pneumonia, pneumonia secondary to influenza, novel coronavirus and so on.

　　Septic plague can be characterized by high fever, no increase in body temperature, unconsciousness, confusion and even coma, extensive bleeding, ecchymosis, cyanosis and necrosis of the skin, and some patients’ bodies are purple and black after death. Septic plague is easily misdiagnosed as coma and shock caused by other reasons, such as hemorrhagic fever with renal syndrome, septicemia caused by epidemic cerebrospinal meningitis, epidemic Japanese encephalitis spread by mosquito bites, shock caused by staphylococcus aureus or streptococcus infection, etc.

　　After people are infected with plague, the disease can be effectively controlled through timely drug treatment. At present, the treatment of plague is mainly antibacterial treatment, supplemented by symptomatic support treatment. Antibacterial treatment refers to the use of antibiotics to sterilize. Streptomycin is the most effective antibiotic against Yersinia pestis, especially in the treatment of pneumonic plague, mainly by intramuscular injection, which can be injected continuously for 10 days. Gentamicin can also be used in the case of human infection with plague. Tetracycline has bacteriostatic effect, which is effective for mild patients. It can be taken orally or used together with other antibiotics. Sulfonamides are widely used in the treatment and prevention of plague. Sulfonamides are the earliest synthetic antibacterial drugs, which have good curative effect on plague, and they are easy to use, stable in nature and low in price. Symptomatic support therapy refers to helping patients recover as soon as possible by means of antipyretic analgesia, anti-shock, respiratory support and nutritional support.

　　four

　　What should I do if I find a mouse at home?

　　Domestic hamsters and rabbits usually don’t have access to wild animals, and animals don’t naturally carry infectious diseases. Without the source of infection, they won’t be infected, so there is no need to worry about domestic hamsters and rabbits catching plague. However, rats, rabbits and other animals do have a lot of bacteria in their mouths. After being bitten, it is necessary to disinfect the wound in time to avoid bacterial infection. If the wound shows signs of infection such as redness, swelling, pain and skin color change, you need to seek medical attention in time.

　　Families find that rats need to be scientifically killed. The first is to clean up the dead corners and garbage in time to reduce the living space of rats. Secondly, try to block all the passages that mice may enter and leave the room, such as air-conditioning pipe holes and sewer holes, so that mice have nowhere to hide and can’t enter the room. Around houses, corridors and other areas, compliant rat traps, rat boards and rat poison can be placed in places where rats are infested, and eye-catching signs should be made at the same time to prevent others, especially children, from accidentally contacting rat poison.

　　Don’t put snacks in the house at will. The food and all kinds of food in the house should be stored out of the reach of mice. If conditions permit, community managers should invite professional rodent control companies to carry out rodent control in a unified way to improve efficiency. If you find dead rats at home, don’t touch them with your bare hands to avoid being bitten by rats and fleas. You can wear long trousers, masks and gloves, collect the dead rats in sealed plastic bags, and contact the community property management department to dispose of the dead animals.

　　Plague prevention includes bubonic plague prevention and pneumonic plague prevention. The bubonic plague is mainly caused by the bites of rats and fleas on animals, so the prevention of bubonic plague by ordinary people is mainly to avoid contact with animals in the natural focus of plague, and to prevent rats and fleas. If you must enter the epidemic area, you can wear long trousers, boots and gloves, and try not to expose your skin to avoid being bitten by rats and fleas.

　　During the tour, everyone should try not to touch wild animals, including wild animal carcasses. Don’t buy wild animals. If you find dead animals on the roadside, you should report them to the local health and disease control departments in time.

　　If you are just traveling, you can do these preventive measures well, and you don’t need to use drugs in advance to prevent it. If you are bitten by rat fleas in areas with plague, or have close contact with patients with pneumonic plague without protection, you can use tetracycline, doxycycline, sulfanilamide and other drugs to prevent it. (Author: Deputy Chief Physician, Department 2, Infection Center, Beijing You ‘an Hospital)

　　Safe disposal of medical waste is an important measure to cut off the route of virus transmission and prevent secondary pollution. Since the outbreak of the COVID-19 epidemic, the wastes produced by designated medical institutions in Hubei Province have been classified, collected and treated harmlessly in strict accordance with the standards, and the whole process of disposal has been regularly supervised and enforced, keeping the last pass of epidemic prevention.

　　"Combination boxing" improves disposal ability

　　In order to ensure the timely, orderly, efficient and harmless disposal of medical wastes, according to the requirements of the Ministry of Ecology and Environment, Hubei has achieved "one special class, one capacity, one scheme and one temporary storage" to strengthen the emergency reception and disposal capacity of medical wastes.

　　While the existing disposal companies are operating at full capacity, Hubei Province has upgraded and upgraded a number of factories and facilities, which can be used as emergency disposal units at any time. Huanggang Hongyuan Pharmaceutical Co., Ltd. and Huaxin Environmental Protection Company have completed the trial operation of emergency disposal, and the incineration facilities of Shiyan Dongfeng Environmental Protection Company have been maintained and overhauled, with emergency capability.

　　In the process of medical waste transportation, it is managed by special personnel, collected in time, recorded, classified and stored, and transported by special vehicle, and special transportation tools for preventing leakage and spillage are used. Provide personal protective materials and conduct daily temperature monitoring for relevant front-line operators to ensure safety.

　　In addition, the eco-environmental system of Hubei Province regularly supervises and enforces the whole disposal process to ensure the full coverage and treatment of medical wastes. Shiyan City has carried out several rounds of special law enforcement inspections on medical wastes; Huanggang City checks the sewage treatment facilities and medical waste storage rooms of township hospitals and other medical institutions every day to block the secondary transmission.

　　According to the emergency disposal requirements of the Ministry of Ecology and Environment, all cities and states in Hubei Province have built emergency storage warehouses for medical wastes, with an emergency storage capacity of 1,552.6 tons. Seventeen temporary storage warehouses for medical wastes have been built in Wuhan, with a total storage capacity of 1,118.6 tons. The province has put into operation 35 medical waste (emergency) disposal units, with a total of 1391 front-line staff. At the same time, we actively strive to bring the support policy for medical waste disposal enterprises into the scope of the provincial government’s support for small and medium-sized enterprises to tide over the difficulties, and coordinate Xiangyang Zhongyou Youyi Company to invest 35 medical waste transport vehicles and huaxin cement Company to invest 4 vehicles to support Wuhan’s medical waste transfer work free of charge.

The staff transferred the medical waste from the tongji hospital Sino-French New Town affiliated to Huazhong University of Science and Technology. Chu Huan photo (Zhongjing vision)

　　Strictly observe the last link of epidemic prevention

　　Collection, handling and loading … … Unlike the hospital linens collected in the past, Luo Jun collected linens infected by COVID-19 virus in dozens of hospitals in Wuhan these days. Luo Jun is the head of the logistics department of Hubei Renfu Medical Service Co., Ltd., a subsidiary of Renfu Pharmaceutical Group, which mainly provides services such as washing, disinfection and distribution of medical fabrics.

　　After the linen was transported back to the company, according to the standard operation flow, Luo Jun drove the truck to the designated isolation area, unloaded it with his colleagues and sorted it, and then the colleagues pulled the sorted linen into the isolation area for sorting, washing and disinfection, and finally disinfected the vehicle.

　　In Wuhan Jiangxia First People’s Hospital, medical waste was put into the yellow trash can marked with "Medical Waste", and then transported out of the hospital’s garbage outlet and sent to the medical waste emergency treatment system. "All medical waste barrels are disinfected before leaving the hospital, and then disinfected after being shipped out." According to Zhao Yanni, the person in charge of the medical waste emergency treatment point, the medical waste collected from the ward at ordinary times will be sent to the hospital’s temporary storage, which has a disposal center and will be transported to the disposal point by a professional team. However, Wuhan’s current transportation capacity and terminal disposal capacity are tight. In this case, the medical waste collected in the ward is treated harmlessly on the spot through the medical waste emergency treatment system.

　　Disinfected medical waste barrels are placed in the temporary storage area of medical waste, and emergency treatment is carried out in batches. The medical waste emergency treatment system includes six links: feeding, sterilization, discharging, transportation and unloading. It takes about 80 minutes to load and unload. The staff pushes one barrel of medical waste to the feeding station at a time. After automatic control, lifting and tipping, the waste is poured into the sterilization trolley and enters the high-temperature sterilization chamber.

　　Sterilization is the core link of the whole system. The reporter saw in the First People’s Hospital of Jiangxia, Wuhan that the medical waste emergency treatment system entered the hospital in a whole vehicle and was disposed of at a fixed point. Wei Bin, general manager of Qidi Environmental Solid Waste and Renewable Resources Center, the provider of the system, introduced that the temperature in the sterilization chamber is above 135℃, the working pressure is 0.23 MPa, and the high-temperature steam sterilization is required to last for more than 45 minutes. After the waste is treated up to standard, it is discharged, transferred to the transportation station, placed in a sealed plastic bag, and translated to the unloading station. The treated medical waste, like domestic waste, is removed by the sanitation system and sent to the nearest waste incineration site.

　　During the epidemic period, the amount of medical waste produced in Wuhan is several times higher than before, and a number of new technologies and products for disinfection have become the main force of medical waste treatment. The "medical waste virus killing device" jointly developed by Hubei Guanghui Energy Saving Technology Co., Ltd. and Institute of Electronics, China Academy of Engineering Physics uses microwaves to irradiate the medical waste in the container, so that the medical waste can automatically heat up, which can effectively kill bacteria and viruses. The "Environmental Protection Medical Waste Incinerator" developed by Hubei Weitian Environmental Protection Technology Co., Ltd. covers an area of less than 10 square meters. It can complete desulfurization and denitrification of flue gas while burning medical waste, and can handle 2 tons to 4 tons of medical waste every day.

The staff of Huanggang Environmental Protection Bureau inspected the medical waste disposal records. Chu Huan photo (Zhongjing vision)

　　Basically realize Nissan Nissin.

　　In other cities and prefectures in Hubei, the capacity of medical waste disposal has been continuously enhanced, and the daily production has basically been achieved.

　　"At present, the daily disposal of medical waste is about 20 tons." Xu Yang, director of Xiangyang Hazardous Solid Waste Management Center, introduced that Hubei Zhongyou Youyi Environmental Protection Technology Co., Ltd. was urgently approved by the city to start the emergency disposal of medical waste. This company is a hazardous waste disposal enterprise adopting rotary kiln incineration disposal technology, with a daily disposal capacity of 30 tons to 40 tons. Together with two other disposal enterprises, it can fully meet the needs of harmless disposal of wastes generated by designated diagnosis and treatment hospitals and centralized medical observation points in the city at present, and all medical wastes can be collected, transported and disposed daily.

　　On February 14th, huaxin cement (Yichang) Co., Ltd. successfully put the second cement kiln collaborative medical waste disposal system into trial operation. So far, the emergency collaborative disposal capacity of medical waste in huaxin cement has reached 10 tons/day. Together with the original medical waste disposal capacity of Sander Company and Qiduoyun Company of 21 tons/day, Yichang has formed a disposal capacity of 31 tons/day, and all medical wastes can be collected separately, transported safely and disposed harmlessly.

　　On February 26th, Yichang started the action of cleaning and rectifying rural domestic garbage. At present, the competent departments of counties and cities in Yichang have set up special working groups, focusing on four key points: cleaning and cleaning, garbage removal, disinfection of facilities and equipment, and collection and disposal of discarded masks. According to the working mechanism of "household classification, group cleaning, village collection, town transfer and county treatment", the village environmental sanitation and cleaning operations are carried out, and the rural "combat unit" for epidemic prevention and control is strictly adhered to.

　　Wang Sihai, deputy general manager of Huanggang Longzhong Environmental Protection Co., Ltd. said that the average daily medical waste collected, transported and disposed in the city is about 15 tons, which is twice the normal disposal amount (7 tons/day) and more than three times the usual volume. "The company strictly operates the process and tries its best to maximize the disposal capacity."

　　"Although the medical waste received every day is more than usual, the company is running well, ensuring the daily production of medical waste." As the only qualified hazardous waste disposal enterprise in Xianning City, Chen Zhou, manager of the production department of Hubei Huichu Hazardous Waste Disposal Co., Ltd., told the reporter that they will definitely hold the "last link" of the epidemic prevention work of medical waste disposal. (Economic Daily-China Economic Net reporter Liu Jie correspondent Xiong Xi’ an)

　　China is the hometown of tea. Chinese has discovered and used tea for thousands of years, and many people like drinking tea very much. However, there is news on the Internet recently that drinking tea is bad for the heart and may even lead to heart disease. Is it true?/You don’t say.

　　In fact, drinking tea is not bad for the heart, and it may even be beneficial — — This should start with the special ingredients in tea. Tea is usually rich in flavonoid antioxidants, such as tea polyphenols and catechins, which give tea an attractive fragrance. In addition, tea also contains a lot of caffeine. In the process of making tea, some of these substances will dissolve into the tea. Therefore, tea is actually a drink containing a variety of plant antioxidants and caffeine.

　　Tea is rich in antioxidant substances such as tea polyphenols, which can scavenge human free radicals and have certain benefits to health. Judging from a large number of current studies, drinking tea is good for the heart and cardiovascular system — — It may significantly reduce the risk of heart disease and stroke by reducing low-density lipoprotein cholesterol ("bad cholesterol").

　　A study in Journal of American Heart Association took six years to analyze the relationship between the change of high density lipoprotein cholesterol (HDL-C) level in the blood of more than 80,000 Chinese and drinking tea. The results show that the HDL-C level of people who insist on drinking tea for a long time decreases more slowly, and the risk of cardiovascular diseases decreases by 8%, which is beneficial to cardiovascular health.

　　China’s "Food and Health-Scientific Evidence and Consensus" summarizes and analyzes the research on tea and health, and thinks that drinking tea can reduce the risk of diabetes, stroke and cardiovascular diseases. Therefore, it can be considered that drinking tea is not only harmless to the heart, but also beneficial.

　　However, because tea contains caffeine, some people drink too much tea, which will lead to discomfort such as palpitations, so some people worry that drinking tea is not good for the heart. In fact, this is a normal phenomenon, which is called "tea drunk" by the people. As long as you drink it in moderation, there will be no problem.

　　At present, the international research on caffeine is relatively sufficient, and authoritative health institutions believe that moderate drinking of coffee and caffeine will not cause damage to the heart. For example, the American Heart Association, the European Heart Association, the Australian National Institute of Health and Medical Research and other institutions believe that healthy adults drinking coffee in moderation (1 to 2 cups a day, about 200 milligrams of caffeine) will not increase the risk of heart disease and cardiovascular disease.

　　Compared with coffee, there is much less caffeine in tea. The caffeine content in a cup of tea is usually only 40 to 80 mg, which is less than half that of an equivalent cup of coffee. Therefore, it is no problem to drink 3 to 4 cups of light tea, such as white tea and green tea every day; For some strong tea, such as black tea, the caffeine content will be more, but drinking 2 cups will not be a problem. Of course, if your heart and head are really uncomfortable after drinking tea, try not to drink or drink less.

　　According to the data of China Cardiovascular Disease Report 2017, the number of cardiovascular patients in China has reached 290 million, and cardiovascular deaths account for 40% of the deaths of residents, which is higher than tumors and other diseases, ranking first; Moreover, the morbidity and mortality are still on the rise. From the current research, maybe drinking some tea every day can also reduce the risk of cardiovascular disease, which is beneficial to the body.

　　It is worth noting that many people may drink tea in the wrong way. How can drinking tea be beneficial to health?

　　First, don’t drink too much tea or drink too much tea. Drinking a lot of tea, in addition to too much and too strong caffeine intake, tannic acid in tea may also affect the absorption of iron, which is not good for health — — It is recommended not to drink more than 4 cups of tea every day. Second, drinking tea every day is best arranged in the afternoon, not too late, so as not to affect sleep. What needs special reminder is that you should try to stay away from sugary tea drinks. At present, there is no evidence that sugary tea drinks also have cardiovascular protection. Therefore, tea drinks should not be used instead of drinking tea, let alone deliberately drinking tea drinks to protect cardiovascular health.

　　(The author is Ruan Guangfeng, Director of Science and Technology Department of Food Nutrition and Information Exchange Center)

　　In order to ensure that critically ill patients can receive timely priority treatment, the reporter learned from the Beijing Municipal Hospital Administration that from May 1, 2019, 20 Beijing-owned hospitals providing emergency services will uniformly implement emergency pre-examination and triage ("emergency classification").

　　According to the former Ministry of Health’s Guide to the Construction and Management of Emergency Department (Trial) (Wei Yi Zheng Fa [2009] No.50) and the national health industry standard "Standardized Process of Hospital Emergency Department" (WS/T390-2012), it is clearly put forward that "emergency departments should formulate and strictly implement triage procedures and triage principles": patients should be divided into "endangered, critical, emergency and non-emergency" 1.

　　Level 1 patients are in critical condition and may be life-threatening at any time, and immediately enter the resuscitation room or rescue room for rescue. Such as cardiac arrest, shock, definite myocardial infarction, status epilepticus, body temperature > 41℃, systolic blood pressure < 70mmHg, blood sugar < 3.33mmol/L, etc.

　　Grade 2 patients are critically ill or rapidly deteriorating and life-threatening, and enter the rescue room for treatment within 10 minutes. Such as severe dyspnea, lethargy, acute stroke, ECG suggesting acute myocardial infarction, active or severe blood loss, etc.

　　Grade 3 patients are in an urgent condition and have potential life threats, and priority is given to diagnosis and treatment before grade 4 non-emergency patients. Such as acute asthma, foreign body inhalation, dysphagia, persistent vomiting, chest and abdominal pain, mild and moderate trauma, mild and moderate bleeding, etc.

　　Grade 4 patients are non-emergency, and the degree of illness is average. According to the guidelines, the waiting time is longer. Such as mild pain without dangerous features, minor abrasions without suture, follow-up visit of patients in stable recovery period, and only issuing medical certificates.

　　How to achieve scientific classification and give consideration to fairness and safety? According to reports, first of all, the emergency departments of all hospitals have arranged experienced personnel to engage in emergency pre-examination and triage, and organized all medical staff related to emergency to conduct special training for all staff; Secondly, the most important basis for grading is the collection of patients’ vital signs by professional instruments, including heart rate, blood pressure, blood oxygen saturation, etc., and the medical staff will combine the patient’s medical history, symptoms and signs to make the final scientific grading and subordinate to the specialty; Third, professionals monitor the condition of patients in the waiting area. For Grade 3 and Grade 4 patients, when waiting in the waiting area, there will be specialized medical personnel to patrol regularly to dynamically evaluate the condition and potential risks of the patients waiting for treatment, and they can be graded again according to the latest evaluation to ensure the safety of patients. If the patient has sudden discomfort, please inform the medical staff in time so as to take corresponding medical care measures in time.

　　20 municipal hospitals providing emergency services:

　　1. Beijing Friendship Hospital affiliated to Capital Medical University

　　2. Beijing Tongren Hospital affiliated to Capital Medical University

　　3. Beijing Chaoyang Hospital affiliated to Capital Medical University

　　4. beijing jishuitan hospital

　　5. Beijing Tiantan Hospital affiliated to Capital Medical University

　　6. Beijing anzhen hospital affiliated to Capital Medical University.

　　7. Beijing Millennium Monument Hospital affiliated to Capital Medical University

　　8. xuanwu hospital of Capital Medical University

　　9. Tsinghua Chang Gung Memorial Hospital.

　　10. Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University

　　11. Beijing Children’s Hospital affiliated to Capital Medical University

　　12. Children’s Hospital Affiliated to Capital Institute of Pediatrics

　　13. Beijing Maternity Hospital affiliated to Capital Medical University

　　14. Beijing Chest Hospital affiliated to Capital Medical University

　　15. Beijing Stomatological Hospital affiliated to Capital Medical University

　　16. Beijing You ‘an Hospital affiliated to Capital Medical University

　　17. beijing ditan hospital affiliated to Capital Medical University.

　　18. Beijing Anding Hospital affiliated to Capital Medical University

　　19. Beijing huilongguan hospital

　　20. Beijing Geriatric Hospital

　　General Secretary of the Supreme Leader pointed out at the seminar on "Learning the spirit of the important speech of the General Secretary of the Supreme Leader and Meeting the 20th Party Congress" for leading cadres at the provincial and ministerial levels that in order to consolidate the long-term ruling position and always win the heartfelt support of the people, we must always be sober and firm in "catching the exam".

　　Looking back, in September, 2019, on the eve of celebrating the 70th anniversary of the founding of New China, the General Secretary proposed to answer the questions of the new era with sobriety and firmness in "catching the exam" when inspecting the memorial site of Xiangshan Revolution in Beijing. In 2021, at the Fifth Plenary Session of the 19th Central Commission for Discipline Inspection and the Party History Learning and Education Mobilization Conference, the General Secretary mentioned "keep &lsquo; Catch the exam &rsquo; Sober. "

　　"The times are the writers, we are the respondents, and the people are the reviewers." The examination papers are always new, the true colors are still the same, and "catching the exam" is always on the road.

　　Catch the exam all the way: the Communist Party of China (CPC) has lived up to history and people’s choice.

　　A political party, from small to large, from weak to strong, is also simple at the beginning, and it will be great at the end.

　　In July 1921, the Communist Party of China (CPC) was born in Shanghai Shikumen and Nanhu Red Boat. From Jinggangshan to northern Shaanxi, from northern Shaanxi to Xibaipo, and then to Beijing, all the way to catch the exam, in exchange for "overwhelming and generous."

　　In March 1949, when the CPC Central Committee set off for Beijing from Xibaipo at the eastern foot of Taihang Mountain, Comrade Mao Zedong said: Today is the day to go to Beijing to catch the exam.

　　In July 2013, the General Secretary of the Supreme Leader came to Xibaipo, standing at the height of history and times, and profoundly pointed out that the "rushing for exams" faced by the party is far from over.

　　Taking the exam all the way is also exploring all the way. From a single spark to the potential to start a prairie fire, and then to the two answers of "cave question", the Communist Party of China (CPC) has developed into the largest Marxist ruling party in the world.

　　"In the past 100 years, our party has been committed to the happiness of the people of China, the rejuvenation of the Chinese nation, the progress of mankind, the harmony of the world, the public interest in the world, and the right path in the world. This is the greatest confidence of our party in its historical self-confidence. It is also the historical confidence of our party to unite and lead the people to move forward." At the end of 2021, the Political Bureau of the Communist Party of China (CPC) Central Committee held a special democratic life meeting on the study and education of party history. The Supreme Leader General Secretary stressed, "Today, we can say that the Communist Party of China (CPC) has lived up to history and people’s choices."

　　In the past 100 years, the party has handed over an excellent answer to the people and history. Now, with the unity of the Party, the people of China have embarked on a new road to achieve the goal of the second century of struggle.

　　Pass the big exam: all our achievements have been made through the joint efforts of the party and the people.

　　The great rejuvenation of the Chinese nation cannot be achieved easily by beating gongs and drums. Two angles provide us with an observation perspective.

　　Space: Looking at the domestic general trend, China’s development faces new strategic opportunities, new strategic tasks, new strategic stages, new strategic requirements and new strategic environment, and the risks and challenges to be dealt with, contradictions and problems to be solved are more complicated than before. Looking at the international trend, the great changes that the world has never seen in a century have accelerated its evolution, and the characteristics of changes in the world, times and history are more obvious.

　　Time: the five years since the 19 th National Congress of the Communist Party of China are extremely unusual and extraordinary; In the 10 years of the new era, the risk challenges we have encountered are high in wind and high in waves, sometimes even stormy waves, and various risk challenges come one after another, with unprecedented complexity and severity.

　　COVID-19 epidemic is not only a crisis, but also a big test. We adhered to the principle of putting people first and life first, and carried out people’s war, general war and blocking war against the epidemic, which protected people’s life safety and health to the utmost extent, and made overall plans for economic development and epidemic prevention and control and achieved the best results in the world.

　　Only a nation that can unite and struggle can have a future, and a political party that can unite and struggle can be invincible. The greatest happiness in the world is to strive for the happiness of the people. We strengthened our confidence, faced difficulties, fought one battle after another, and took one exam after another. All our achievements were made through the joint efforts of the Party and the people.

　　On January 30th this year, General Secretary’s speech at the 2022 Spring Festival group meeting was inspiring: "As long as more than 1.4 billion people in China always hold hands and look forward to the future together, as long as more than 95 million people in the Communist Party of China (CPC) always look forward to the future together with the people’s hearts, we will certainly be able to continue to create amazing miracles on the new road of catching the exam."

　　Facing the exam with confidence: The most fundamental thing is to do our own thing well.

　　"Being safe without forgetting danger, being alive without forgetting death, and governing without forgetting chaos", our party was born out of internal and external troubles, grew up in hardships and setbacks, and grew stronger in overcoming risk challenges. It has always had a strong sense of hardship and risk, and always prepared for the exam with a sober and firm attitude and a rainy eye.

　　"A hundred years of change, one thing comes out, one gray rhinoceros and one black swan." During the inspection tour in Hainan from April 10th to 13th this year, General Secretary of the Supreme Leader mentioned, "A revolutionary elder once said such a thing, &lsquo; Always uneasy &rsquo; . I listened to it very resonantly. "

　　At the end of April, the General Secretary presided over the the Political Bureau of the Communist Party of China (CPC) Central Committee meeting, which emphasized that leading cadres at all levels should have a sense of responsibility of "always worrying" in their work, take responsibility, be realistic and pragmatic, and prevent all kinds of "black swan" and "grey rhinoceros" incidents.

　　Not sleepy lies in early consideration, not poor lies in early preparation.

　　In January, 2019, General Secretary of the Supreme Leader analyzed the major risks in eight fields, such as politics, ideology, economy, economic and trade struggle with the United States, science and technology, society, foreign work and the Party itself, and put forward clear requirements at the opening ceremony of the special seminar for leading cadres at the provincial and ministerial levels.

　　At the end of last year, at the Central Economic Work Conference, the General Secretary said earnestly: "I often sound the alarm. I am ringing the alarm bell to make everyone alert and be prepared for danger in times of peace. "

　　See the micro-knowledge, prevent the micro-duration, understand the foresight of the "mast top", and show the foresight of governing the country.

　　At this seminar, the general secretary stressed that the whole party must enhance its sense of hardship, adhere to the bottom line thinking, strengthen its will to fight, enhance its fighting skills, adapt to the situation with correct strategic strategies, cultivate new opportunities and open up new opportunities, and rely on tenacious struggle to open up a new world of career development. The most fundamental thing is to do our own thing well.

　　Do your own thing well, go your own way, look forward to a new way to catch the exam, step on the rough road, fight hard and start again.

　　Coordinator: Cui Shixin

　　Planning: Du Shangze

　　Written by Kuang Xixi

　　Editor: Xu Cheng

　　Image source: Xinhua News Agency (photo: Ju Peng, Xie Huanchi, visual: Bi Xiaoyang)