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63-479: The Chinese Medical Journal is an official publication of the Chinese Medical Association , co-published by Chinese Medical Association Publishing House and Wolters Kluwer Medknow . The journal publishes peer-reviewed English-language articles, covering technical and clinical studies related to health, as well as ethical and social issues in medical research. The China Medical Missionary Association

126-791: A bonus to physicians according to the hospital's operating performance and the physician's contributions. Physicians' salaries vary greatly. For those working at busy and well-known hospitals, their base salaries can be a few times as much as those of physicians working at low-ranking hospitals. Chinese hospitals are classified into three general levels, with level 3 at the top and level 1 at the bottom. Each level has sub-levels of A, B, and C. Some elite hospitals are even rated 3A+. For many physicians, in particular those at big hospitals, specialty hospitals, or hospitals with large reputations, physician incomes can be larger than regular hospitals. Physicians, and in particular, surgeons, can augment their hospital salaries by conducting surgeries at hospitals other than

189-614: A centrally-planned economy , many hospitals were managed as government agencies rather than medical service organizations. Hospitals did not have competition pressures. The management team usually did not recognize the importance of developing and retaining high skilled physicians. Administrative personnel were more powerful than physicians at a hospital. However, with the reform of the medical sector, Chinese hospitals are facing increasing competition from privately owned and foreign-investment-backed hospitals. Physicians are expected to enjoy higher legal income and better social status. To become

252-399: A combination of state-owned enterprises and central planning using the material balances method. The extent to which these economic systems achieved socialism or represented a viable alternative to capitalism is subject to debate. In orthodox Marxism , the mode of production is tantamount to the subject of this article, determining with a superstructure of relations the entirety of

315-462: A different job. The top three reasons that lead many physicians in Beijing to quit include: doctors are not well paid; hospitals are poorly managed; and there are not enough personal development opportunities. For a government-controlled hospital, the hospital is still operated and managed by a management team under the leadership of the president of the hospital, who is usually nominated and appointed by

378-661: A dominant private sector . Actually, mixed economies gravitate more heavily to one end of the spectrum. Notable economic models and theories that have been described as a "mixed economy" include the following: Socialist economic systems (all of which feature social ownership of the means of production ) can be subdivided by their coordinating mechanism (planning and markets) into planned socialist and market socialist systems. Additionally, socialism can be divided based on their property structures between those that are based on public ownership , worker or consumer cooperatives and common ownership (i.e. non-ownership). Communism

441-568: A given culture or stage of human development. In the May 1949 issue of the Monthly Review titled " Why Socialism? ", Albert Einstein wrote: I am convinced there is only one way to eliminate (the) grave evils (of capitalism), namely through the establishment of a socialist economy, accompanied by an educational system which would be oriented toward social goals. In such an economy, the means of production are owned by society itself and are utilized in

504-444: A government controlled hospital. But with the reforming of the medical service sector, both physicians and hospitals have more freedom in choosing each other. Young physicians usually have an employment contract with the hospital they work with, and a person can quit at will. The hospital can also lay off the individual if it is not satisfied with the employees performance or morality. It is not uncommon for physicians to quit and take

567-619: A hospital, but support workers are a problem. Some hospitals hire skill-less "underground" labors and after giving them some simple training use them as hospital support workers. These workers, mostly originating from rural areas, are poorly paid by those hospitals. To secure the quality of hospital services, Beijing recently has passed a regulation on training and hiring qualified hospital support workers. In Tianjin, China's third largest city, about 1,000 unemployed people have been trained by local authority and passed hospital support work test. These people returned to work as certified support staff of

630-571: A hotline has been set up to monitor physicians. In China, physicians are well respected, but as a group they are not at the top of the social structure of the country because their incomes fall in the middle class. According to a Ph.D. candidate at a U.S. Public Health School, who was a physician at a well-known 3A hospital in Beijing, like other junior physicians, she seldom received "red envelopes" from patients, and only senior physicians or physicians with fame would have such opportunities. The student said those senior physicians had become members of

693-707: A medical doctor, a person needs to study for 5 years at a medical school. For foreign or international students, the person needs to study for 6 years at the medical school, namely because the Chinese version is accelerated. Also, international students have to prepare for and take the Hanyu Shuiping Kaoshi for admission, and during med school, the Medical Chinese Exam. After graduation, the newly minted physician needs to complete 2–3 years of residency training, including training for subspecialty. Upon graduation,

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756-476: A number of big hospitals. One needs to study at a nursing school for around three years before being eligible to work as a nurse. Most nursing schools enroll middle school graduates (Grade 9) and senior high school graduates (Grade 12), and they run four-year and three-year programs respectively. A bachelor's degree in nursing has been available since late 1980s and early 1990s in China. Many medical schools including

819-565: A planned fashion. A planned economy, which adjusts production to the needs of the community, would distribute the work to be done among all those able to work and would guarantee a livelihood to every man, woman, and child. The education of the individual, in addition to promoting his own innate abilities, would attempt to develop in him a sense of responsibility for his fellow-men in place of the glorification of power and success in our present society. There are multiple components of an economic system. Decision-making structures of an economy determine

882-419: A pure socialist planned economy that involves different processes of resource allocation, production and means of quantifying value, the use of money would be replaced with a different measure of value and accounting tool that would embody more accurate information about an object or resource. In practice, the economic system of the former Soviet Union and Eastern Bloc operated as a command economy , featuring

945-427: A restriction, and some of them have tried all means to lure away prescription drugs buyer from hospitals. For instance, they offer to pay drug buyers half a dollar for each prescription the buyers brought to the drug stores. Normally a prescription is effective on the day it is issued, but it can be effective within three days of prescription under certain conditions. Physicians used to be hired as full-time employees at

1008-654: A small percentage of their monthly incomes. By 1901, China was the most popular destination for medical missionaries. The 150 foreign physicians operated 128 hospitals and 245 dispensaries, treating 1.7 million patients. In 1894, male medical missionaries comprised 14 percent of all missionaries; women doctors were four percent. Modern medical education in China started in the early 20th century at hospitals run by international missionaries. Today Universities, colleges and institutes, which make up China's higher educational system, offer four- or five-year undergraduate programs as well as special two- or three-year programs. To control

1071-399: A state-run-enterprise owned AAA hospital (the highest standard), and the acquisition was the first of this kind in China. The investment company plans to buy 10 hospitals in the next three to five years. In Fuzhou , the capital city of Fujian province, four government-owned hospitals have been sold to private investors. Nurses are normally well trained before being eligible for working with

1134-408: A valuation based on natural units), with business and financial decisions replaced by engineering and technical criteria for managing the economy. Fundamentally, this meant that socialism would operate under different economic dynamics than those of capitalism and the price system. Later models of socialism developed by neoclassical economists (most notably Oskar Lange and Abba Lerner ) were based on

1197-398: Is comparative economic systems , which includes the study of the following aspects of different systems: Capitalism generally features the private ownership of the means of production ( capital ) and a market economy for coordination. Corporate capitalism refers to a capitalist marketplace characterized by the dominance of hierarchical , bureaucratic corporations . Mercantilism

1260-513: Is a hypothetical stage of socialist development articulated by Karl Marx as "second stage socialism" in Critique of the Gotha Program , whereby the economic output is distributed based on need and not simply on the basis of labor contribution. The original conception of socialism involved the substitution of money as a unit of calculation and monetary prices as a whole with calculation in kind (or

1323-463: Is a wide range of proposed planning procedures and ownership structures for socialist systems, with the common feature among them being the social ownership of the means of production. This might take the form of public ownership by all of the society, or ownership cooperatively by their employees. A socialist economic system that features social ownership, but that it is based on the process of capital accumulation and utilization of capital markets for

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1386-661: Is abstracted and indexed in: According to the Journal Citation Reports , the journal has a 2011 impact factor of 0.864. Its 2022 Impact Factor is 6.100. Chinese Medical Association The Chinese Medical Association is the largest and oldest non-governmental medical organization in China. It was established by a group of medical professionals in 1915 with an aim to uniting medical professionals, upholding medical ethics and advocating social integrity. It currently counts over 430,000 members and 82 specialty societies. It publishes over 70 medical journals WA (including

1449-684: Is produced. An economic system is a way of answering these basic questions and different economic systems answer them differently. Many different objectives may be seen as desirable for an economy, like efficiency , growth , liberty and equality . Economic systems are commonly segmented by their property rights regime for the means of production and by their dominant resource allocation mechanism. Economies that combine private ownership with market allocation are called "market capitalism" and economies that combine private ownership with economic planning are labelled "command capitalism" or dirigisme . Likewise, systems that mix public or cooperative ownership of

1512-518: Is thus a system that allocates resources for exchange, production, distribution and consumption. The system is stabilized through a combination of threat and trust, which are the outcome of institutional arrangements. An economic system possesses the following institutions: There are several basic questions that must be answered in order for an economy to run satisfactorily. The scarcity problem , for example, requires answers to basic questions, such as what to produce, how to produce it and who gets what

1575-817: The Chinese Medical Journal ) , as well as a medical bulletin and a medical education magazine. The CMA plays a leading and active role in the nation's medical education, training and professional exchanges. From 1957, Peking Union Medical College is merged into the Chinese Academy of Medical Sciences as one single institution directly under the Ministry of Health , now the National Health Commission . At government-controlled hospitals, physicians are salaried employees. Salaries are based on working experience and professional level. Some hospitals also pay

1638-453: The healthcare department of a province , a city or a county . But for a private hospital or a publicly traded hospital, the ownership is the same as that of a private company or a public company. There are two types of hospitals in China – for-profit and non-profit . Profit-oriented hospitals may distribute their profit. Non-profit hospitals are government-owned, and will turn earnings into additional infrastructure or hand them back to

1701-545: The Basic Medical Insurance System. Only about 120 million to 180 million workers have some form of healthcare coverage that will pay for Western pharmaceuticals, according to industry analysts. Farmers, who make up the vast majority of Chinese, have no real coverage at all. The Chinese government used to cover up to 100% of medical fees for employees working with government agencies, state-owned enterprises, or educational organizations, but peasants didn't enjoy

1764-465: The School of Medicine of Beijing University offer five-year programs in nursing. Most hospitals are located at downtown areas due to people's reliance on public transportation in China. More than 80% of Chinese medical resources are concentrated in urban areas, and the rest in rural areas. The government, employers, and individuals pay for healthcare. In December 1998, a national medical insurance scheme

1827-803: The State-owned enterprise (SOE) and collective insurance. This system has reimbursed 100 percent of employees' medical costs, and 50 percent of family members' costs. The system has been funded, in name at least, by the enterprises. Hoping to reduce enterprise subsidies of all types, the State Council launched pilot reforms in 1994 of the two health insurance systems under its control. Begun in two midsize cities, Jiujiang, Jiangxi Province , and Zhenjiang , Jiangsu Province, and expanded to over 60 cities in 1997, this experiment has become national policy, applicable to domestic and foreign-invested firms. The two State health insurance systems would later be consolidated to be

1890-453: The aims of ameliorating market failures (see economic intervention ) or supplementing the private marketplace with social policies to promote equal opportunities (see welfare state ), respectively. In socialist economic systems ( socialism ), production for use is carried out; decisions regarding the use of the means of production are adjusted to satisfy economic demand; and investment is determined through economic planning procedures. There

1953-698: The allocation of capital goods between socially owned enterprises falls under the subcategory of market socialism. The basic and general "modern" economic systems segmented by the criterium of resource allocation mechanism are: Other types: Various strains of anarchism and libertarianism advocate different economic systems, all of which have very small or no government involvement. These include: Corporatism refers to economic tripartite involving negotiations between business, labor and state interest groups to establish economic policy, or more generally to assigning people to political groups based on their occupational affiliation. Certain subsets of an economy, or

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2016-730: The analysis that the working class was exploited by the party leadership. Instead of looking at nominal ownership, this perspective takes into account the organizational form within economic enterprises. In a capitalist economic system , production is carried out for private profit and decisions regarding investment and allocation of factor inputs are determined by business owners in factor markets. The means of production are primarily owned by private enterprises and decisions regarding production and investment are determined by private owners in capital markets . Capitalist systems range from laissez-faire , with minimal government regulation and state enterprise, to regulated and social market systems, with

2079-490: The basic medical insurance drug list, the State Scheme Drug List for Basic Medical Insurance, which is based on clinical need, safety and efficacy, reasonable pricing, ease of use, and the desire to maintain a balance between Western and TCM products. The basic medical insurance and at-work injury insurance of 2004 cover 832 traditional Chinese medicines, up from 415 of 2000; the number of chemical medicines covered by

2142-470: The basic medical scheme, which aims to control expenses on drugs, specifies drugs that are covered by the scheme and eligible for reimbursement. As the government-driven drug price regulation mechanism and the centralized tendering drug procurement program are only applicable to the drugs covered by the scheme, the scheme undoubtedly plays a crucial role in the development of the drug industry. The basic insurance plan does not reimburse expenses for drugs not on

2205-492: The basic plan. For example, for employees of foreign enterprises in Beijing hired through Foreign Enterprises Service Corp. (FESCO), foreign enterprises pay FESCO, and FESCO then buys insurance policies for these employees. The government also allows commercial health insurers to operate in China. In 2004, 119.41 million people had basic medical insurance. Revenues of basic medical insurance funds reached $ 91 billion, and payments were $ 74 billion. The qualified drug catalogue under

2268-526: The benefits of this scheme, which is considered a shortcoming of the social medical insurance scheme. The National Basic Medical Insurance Scheme ensures basic medical access by the public under the social security system. Individuals pay an annual insurance premium for their basic medical treatment entitlements. This scheme has replaced the previous government-funded labor insurance medical system. Foreign-invested enterprises are required to provide health insurance benefits, but are not required to participate in

2331-520: The combination of the various institutions , agencies, entities, decision-making processes, and patterns of consumption that comprise the economic structure of a given community. An economic system is a type of social system . The mode of production is a related concept. All economic systems must confront and solve the four fundamental economic problems : The study of economic systems includes how these various agencies and institutions are linked to one another, how information flows between them, and

2394-436: The course of history superior economic systems would replace inferior ones. Inferior systems were beset by internal contradictions and inefficiencies that would make it impossible for them to survive long-term. In Marx's scheme, feudalism was replaced by capitalism , which would eventually be superseded by socialism . Joseph Schumpeter had an evolutionary conception of economic development, but unlike Marx he de-emphasized

2457-544: The fifth largest market following Japan . AstraZeneca now ranks as the No. 1 foreign brand in terms of prescription sales in the Chinese market. Physicians control the distribution of prescription drugs. Some hospitals and clinics stipulate patients must buy prescription drugs from the hospitals or directly from the physicians who make the prescriptions. Such a restriction aims to prevent the loss of sales on prescription drugs to retailers, but retailing drug stores are unhappy with such

2520-762: The graduate must work as a resident physician for few years to be eligible to take a National Medical Licensing Examination (NMLE) for physician certification. This examination is conducted by the National Medical Examination Center (NMEC). Without approval of registration by the Ministry of Health one can not practice medicine in China as a physician or assistant physician. American type of residency training has not been implemented nationwide in Chinese hospitals though almost all hospitals require their physicians to be trained as resident for few years before promotion to attending. American type of residency program

2583-505: The high-income class. Like the student, many physicians, went abroad to study because they were not satisfied with their status. According to a 2002 statistics from Beijing Physicians Association, between 2000 and 2001, in Beijing about 2300 physicians resigned, and most of them went to work as sales representatives of drug companies. Some still practice medicine but work with privately owned hospitals rather than public hospitals. Influenced by

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2646-428: The indirect mechanism of the profit system where satisfying needs is subordinate to the pursuit of profit; and to advance the productive forces of the economy in a more efficient manner while being immune to the perceived systemic inefficiencies ( cyclical processes ) and crisis of overproduction so that production would be subject to the needs of society as opposed to being ordered around capital accumulation . In

2709-475: The insurance systems increase from 725 to 1031 from year 2000 to 2004, some of which are patent-protected drugs of Western companies. Sino-Generali Life Insurance, a joint venture between China and Italy companies, offers a commercial medical insurance that reimburses 80% of prescription drugs, with an annual maximum reimbursement of $ 1000 per policy. Before the reform of healthcare system, roughly 140 million workers and 60 million family members were covered under

2772-484: The meanings of the term "communism"). Many economic systems overlap each other in various areas (for example, the term "mixed economy" can be argued to include elements from various systems). There are also various mutually exclusive hierarchical categorizations. Economic systems is the category in the Journal of Economic Literature classification codes that includes the study of such systems. One field that cuts across them

2835-491: The means of production with economic planning are called "socialist planned economies" and systems that combine public or cooperative ownership with markets are called "market socialism". Some perspectives build upon this basic nomenclature to take other variables into account, such as class processes within an economy. This leads some economists to categorize, for example, the Soviet Union's economy as state capitalism based on

2898-400: The medical education standard the Chinese ministry of education set up a quality control regulation on medical education, this regulation specially for English medium undergraduate medical education. Economic system An economic system , or economic order , is a system of production , resource allocation and distribution of goods and services within a society . It includes

2961-506: The ones in which they are employed. Many physicians also receive commissions from prescribing prescription drugs and get " red envelopes " from patients (patients give money or gifts to their physicians for receiving treatment) or from sales representatives of drug companies. New regulations issued by the Health Ministry, however, remove physicians from the practice of medicine if they are found to have taken "red envelopes" from patients, and

3024-416: The particular goods, services, techniques of production, or moral rules can also be described as an "economy". For example, some terms emphasize specific sectors or externalizes: Others emphasize a particular religion: The type of labour power : Or the means of production : Karl Marx 's theory of economic development was based on the premise of evolving economic systems. Specifically, in his view over

3087-475: The plan. According to a news report, 44.8% of urban residents and 79.1% of rural residents have no medical insurance. } Many of people are private payers. They either cannot afford to buy medical insurance, or do not understand the value of medical insurance. In contrast to rural residents, urban residents have much better situation. Many employers have bought for their employees group or supplementary medical insurance, and employers deduct from employees' payrolls

3150-461: The policy. Starting from 2001, a new medical coverage plan took effect, marking the government's withdrawal from shouldering whole medical insurance burden. Under the policy, urban residents must join a government managed basic insurance coverage plan for urban residents and pay a certain amount of monthly fees based on their income levels, and up to 70% of their medical expenses can be reimbursed. So far around 100 million urban residents are covered by

3213-585: The remaining 15% going to drug stores. Stripping out the government's subsidies , all government-subsidized hospitals would have been in the red. This poor operating performance can be partially due to that non-profit hospitals have little incentive to control costs, given the government's subsidies. In 2000, a reform started to occur in the Chinese hospital system. Government owned hospitals are being restructured, some of them being sold to individual investors, and more and more private hospitals are founded. In 2004, Beijing Aikang Medical Investment Company bought

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3276-613: The respective government authorities. Non-profit hospitals also enjoy preferential tax treatment and several government subsidies. They also get low-cost financing from the government for their capital investment. By the end of 2002, China has 306,000 healthcare and medical organizations, 63,858 of which are hospitals and clinics, 219,907 of which are nursing homes and 22,270 fall into other categories. Among them, only 1% are for profit, although all non-profit hospitals and clinics also rely on profits of selling drugs and treatments. Drug sales from hospitals account for 85% of total drug sales, with

3339-406: The role of class struggle in contributing to qualitative change in the economic mode of production. In subsequent world history, many communist states run according to Marxist–Leninist ideologies arose during the 20th century, but by the 1990s they had either ceased to exist or gradually reformed their centrally planned economies toward market-based economies , for example with perestroika and

3402-425: The social relations within the system (including property rights and the structure of management). The analysis of economic systems traditionally focused on the dichotomies and comparisons between market economies and planned economies and on the distinctions between capitalism and socialism . Subsequently, the categorization of economic systems expanded to include other topics and models that do not conform to

3465-606: The term neo-colonialism to the power imbalance between multi-national corporations operating in a free market vs. seemingly impoverished people in developing countries . There is no precise definition of a "mixed economy". Theoretically, it may refer to an economic system that combines one of three characteristics: public and private ownership of industry, market-based allocation with economic planning, or free markets with state interventionism. In practice, "mixed economy" generally refers to market economies with substantial state interventionism and/or sizable public sector alongside

3528-437: The traditional dichotomy. Today the dominant form of economic organization at the world level is based on market-oriented mixed economies . An economic system can be considered a part of the social system and hierarchically equal to the law system , political system , cultural and so on. There is often a strong correlation between certain ideologies , political systems and certain economic systems (for example, consider

3591-440: The training process in a specialty hospital or in a subspecialty at a general hospital. Some medical experts have called for a standardized training and testing system for specialty physicians in accordance to American system. The classification of specialties at a Chinese hospital is similar to that at a U.S. hospital. According to BCG's prediction in 2002, China's prescription drug market is expected to reach $ 24 billion and become

3654-549: The use of economic inputs (the factors of production ), distribution of output, the level of centralization in decision-making and who makes these decisions. Decisions might be carried out by industrial councils , by a government agency, or by private owners. An economic system is a system of production, resource allocation, exchange and distribution of goods and services in a society or a given geographic area. In one view, every economic system represents an attempt to solve three fundamental and interdependent problems: Every economy

3717-411: The use of notional prices derived from a trial-and-error approach to achieve market clearing prices on the part of a planning agency. These models of socialism were called "market socialism" because they included a role for markets, money, and prices. The primary emphasis of socialist planned economies is to coordinate production to produce economic output to directly satisfy economic demand as opposed to

3780-797: Was established in Shanghai in 1887. It started publishing The China Medical Missionary Journal the following year. The association was renamed later as the Chinese Medical Association and in 1932 merged into the National Medical Association of China. The China Medical Missionary Journal then merged into the English part of the National Medical Journal of China to become the Chinese Medical Journal . The journal

3843-441: Was launched by the State Council. By end of 2002, most of the county or above level cities had joined the scheme and covered a population of about 100 million. Social Insurance Fund Administration Centre, a department of the Ministry of Labor and Social Security, oversees this insurance system. Currently, this system only focuses on employees of enterprises at or above township level. Those in remote or less developed areas cannot enjoy

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3906-469: Was launched in some University affiliated hospitals. These students will complete their MD study and have to pass the national certification test during the residency. There are general hospitals and specialty hospitals. A medical graduate rotates through several departments and then assigned to a specialty department according to his or her strengths and the hospital's needs. Specialty physician usually are attendings who specialized in certain specialty during

3969-463: Was the dominant model in Western Europe from the 16th to 18th century. This encouraged imperialism and colonialism until economic and political changes resulted in global decolonization . Modern capitalism has favored free trade to take advantage of increased efficiency due to national comparative advantage and economies of scale in a larger, more universal market. Some critics have applied

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