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香港去医院如何看病,与内地有什么异同

看病难,看病贵,是现实生活中一个沉重的话题,也是每一个人都必须面对的一个社会现实。当人们不幸遇到急性重大疾病或疑难怪症时,更是感受颇深。

其中,看病难,不仅对内地而言是个民生难题,即便是经过了数十年探索的香港,也不敢轻言解决了这一难题,但内地看病绝对要比香港贵。

在香港,市民如果在公立医院看重病、杂症,港府会直接提供医疗服务,费用则主要由政府买单;如果街坊看小病,就都去附近诊所解决,而且很实惠,病人也很信任医生;而到私立医院看病费用则高得惊人,但服务质量很好,这就让一些有钱人“心甘情愿”选择私立医院。

政府买单的医疗制度

香港的医院分为公立和私立两种。全港有31837张病床,超过90%集中在公立医院。只要是香港市民,不论贫富,都可以通过公立医院解决疾病。

那么,到公立医院就医,费用又如何?香港医院管理局主席胡定旭曾表示:“内地看病绝对要贵过香港!”
这是实情,根据规定,香港市民在公立医院就诊,CT免费;感冒之类的小病,政府负责63%;需要看专科门诊的病,政府负责95%,而最高规格的手术如肝移植,都是政府全包。不仅如此,住院期间的一日三餐,也都由医院免费提供给病人。

数据显示,香港公立医院住院病人占病人总数的85%,门诊病人只占15%;而私立医院恰好相反。这个差别恰好明确了公立和私立医院各自的分工和定位:公立医院的宗旨是,先提供给急需的市民使用,主要以收治大病、重病、急病为主,门诊病人不是其主要服务对象;而私立医院则因为方便、快捷,服务周到,颇受门诊病人的青睐。
在香港,并没有医疗卫生费用的报销补偿制度。病人有三种选择,一是选择政府直接提供的医疗服务,二是社会上的慈善基金,第三种则是商业医疗保险。
据统计,在香港的公立医院中,13%的住院、28%的门诊,正是社会上最贫困的10%。也许正是由于这种政府买单的医疗卫生制度解决了绝大多数港人的后顾之忧,而购买商业医疗保险的港人比例并不高,因为购买商业保险的大多数是有钱人,他们用高价购买快捷的医疗服务。

街坊看小病都去诊所

香港医生一般都有香港和英联邦等国多年的学习经历,且要在公立医院工作到政府规定的时间及经验后才有独立执牌开办诊所的资格,成为私家医生。执业后每年都必须完成一定的研究和工作量,并通过政府及相关管理机构的考核才能继续行医。

“很喜欢公立诊所,方便又便宜。”家住亚皆老街的阿婆对公立诊所赞誉有加,“平时都在公立诊所看病,除非有了大病,才去公立医院。”

据阿婆介绍,香港的公立诊所一般都比较靠近居民区,主要是为附近的街坊服务,如果得了小病,街坊也一般在这里解决。

“像我这种时间充裕、只是偶尔出点小症状的人来这里看病很实惠,连坐公交都免了。”阿婆拿着手里的病例说,“诊所去得多了,医生对我的身体状况一清二楚,所以去这里看病特别放心。”
与阿婆不同,家住湾仔的上班族徐先生则很少去公立诊所看小病,在他看来,偶尔感冒伤风请私家诊所的医生上门服务非常方便,“小病嘛,花上七八小时去公立医院当然划不来,看私人诊所是贵了点,但是小病也花不了多少钱,一个感冒100元左右,负担得起,服务态度又不错。”

私立医院收费高但服务好

对于香港的有钱人来说,为了不排队等待,就会选择私立医院,代价就是高昂的费用。据称,在私立医院最怕的就是给人做检查,医生的出发点不是为病人好,而是看哪个项目最能赚医生钱。
香港一家外资药企的经理透露,“以开胸的手术为例,一般在香港的公立医院,一个开胸的手术费大概在5万元(港币,下同),加上其他的费用,大概需要十几万。病人如果住院一周,也就只需要支出700元。”“但如果病人选择私立医院,手术费就得50万元左右。”
在九龙医院看病的一位女士,还说起了自己在私立医院“挨宰”的经历。“当时想验血和做个腹部的B超,医生很专业,也非常有说服力,马上就说服我住院,做肠镜、胃镜等,最后一加起来,医疗费竟然超过了4万。”她说,“医院是要求医生给病人说明医疗费该收多少的,而他只字未提。你说有多黑!”

“不过,每个护士的态度都非常好,带着亲切的笑容,而且跟医生的那位秘书护士,对各项事情、各个病人的情况都有非常好的记忆力,做事有条不紊。床铺也非常干净整洁,摸上去应该是防螨虫的寝具。”女士补充说,“也许这就是有些人明知私立医院收费高,但仍然选择去的原因吧。”

医生有严格规范

受益于香港医疗体系的,除了病人还有医生。在香港,只有正式的注册医师才有资格行医,而成为注册医师并不容易,通常需要医学院毕业后完成12个月住院医师的培训,并通过一项资格考试。
因从事高技术、高强度、高风险的工作,医生的薪酬标准普遍很高,是典型的中产阶级。初级医师的月薪约有4万元,高级医师翻倍,而顶级顾问医师的月收入能有20万以上,最顶级的外科医生甚至周薪百万,而香港普通工薪族的平均月薪只有15000元,远低于公立医院初级医师的收入水平。
公立医院医生属于公务员编制,有固定年薪,有可预期的丰厚退休金,均由政府全额支付工资。同时受到廉政机构的监控,违者将受到停牌、取消退休金甚至追究刑事责任的处罚。
而医生的晋升,主要是依据职业道德、临床实际工作能力和医学继续教育经历,对申请者在学历、科研能力、论文发表数量等方面并不做特别的要求。对这种评价方式,一位大陆医生非常认同:医生是一种很注重实践的工作,而香港的评估方式,“一方面有效减少了医师的综合压力,另一方面倡导医师将有限的精力专注于自己医疗水平和实际工作能力的提高。”

融洽的医患关系

在香港看病仅仅是不贵吗?一位在香港生活过的内地居民表示:“香港医疗不是因为看病不贵而著称,其实真正和内地的区别是,他们对医生和医院大体是信任的。”

这种背景下,香港的医患关系比大陆融洽得多,一位年轻的香港医生谈起自己医生资格考试时遇见的“考官病人”:医院的资深医生在考试前会询问自己科室近期曾接诊过的一些典型病人,是否过来帮忙考一下新医生。而通常,病人们都会很爽快地同意,还感到非常荣幸,因为,“很高兴能帮助医师们提高医疗水平,帮助更多的人。”
为什么能达到这种信任?作为香港医管局的主席,胡定旭曾毫不忌讳地回答,“政府应加大投入”,“真的是钱的问题”。香港公立医院的经费主要源于特区政府的税收,由政府通过一年一度的财政预算提供。
对于内地医疗机构的另外一些顽疾,比如“红包”或药品提成,胡定旭认为,“内地也要首先提高医生的工资,跟药脱钩。”这似乎也是香港医生普遍的想法,一位香港的年轻医生就认为,大陆医生“也许是因为工资太低了”。这在香港是不可想象的,为了几个小钱而冒着丢掉一份体面职业的风险,犯不着。

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