Leporello έγραψε: 13 Φεβ 2020, 15:34
Υπάρχει και άλλη ερμηνεία του φαινομένου, που επιβεβαίωσε και ο Aquarius: ότι στην Hubei πεθαίνουν επειδή δεν έχουν επαρκή νοσηλεία, λόγω κατάρρευσης τους συστήματος. Στην υπόλοιπη Κίνα που υπάρχει νοσηλεία, η θνησιμότητα είναι όσο και στον υπόλοιπο κόσμο, άρα δεν είναι πιθανόν να κρύβουν νεκρούς. Ισως συμβαίνει και συνδυασμός των αιτιών, δηλαδή και να έχει καταρρεύσει το σύστημα νοσηλείας στην Hubei και να υπάρχουν περισσότεροι ασθενείς απ'όσους ανακοινώνονται.
Σχετικά με τους αναρρώσαντες, όσοι φέρονται να έχουν αναρρώσει στην Κίνα είναι το 9,9% των ασθενησάντων, ενώ στον υπόλοιπο κόσμο 12,9%. Υπάρχει διαφορά, αλλά όχι σε τάξεις μεγέθους. Δυστυχώς, δεν υπάρχουν στοιχεία γιά την Hubei χωριστά
ΣΙγουρα οταν εχεις δεκαδες χιλιαδες περιστατικα σε μια επαρχια ειναι λογικο το συστημα υγειας να εχει καταρρευσει...Αλλα υποτιθεται οτι η Κινα με 1.4 δις πληθυσμο, εκατονταδες χιλιαδες αν οχι εκατομυρια γιατρους και κομμουνισμο θα πρεπε να ητανε σε θεση να μεταφερει γιατρους απο αλλου.
Επισης υπαρχει και μια αλλη λεπτομερεια για την Κινα που δεν εχει ειπωθει..Η Κινα εχει τεραστια εσωτερικη μεταναστευση (πανω απο 100 εκατομυρια). Οι μεταναστες αυτοι δεν εχουνε τα ιδια δικαιωματα και προσβαση σε κρατικη περιθαλψη οπως οι ντοπιοι. Αποτελεσμα ειναι να λειτουργει μαυρη οικονομια στο θεμα τηςν υγειας σε μεγαλη εκταση.
Τωρα με τον ιο αυτα τα εκατομυρια των παρανομων πολυ δυσκολσ θα αποκτησουνε προσβαση στα νοσοκομεια. Οποτε τα στοιχεια που δινουνε για αριθμους κρουσματων και νεκρων απο τον ιο βασιζονται μονο σε κρουσματα σε μονιμους κατοικους..
Οσοι εσωτερικοι μεταναστες εχουνε μολυνθει απο τον ιο και δεν εχουνε περιθαλψη δεν καταγραφονται στις στατιστικες..Και φυσικα σε αυτους τα θυματα μπορει να ειναι και χιλιαδες..
Αυτοι οι εσωτερικοι μεταναστες μπορουνε να αποκτησουνε περιθαλψη σε νοσοκομειο αν πανε πισω στον μονιμο τοπο καταγωγης. Αλλα τοτε θα μεταφερουνε τον ιο και εκει..
Τα νουμερα πoυ εδωσε ο whistleblower για 1 εκατομυριο κρουσματα και 50 χιλ νεκρους μπορει να μην ειναι και τοσο φανταστικα..
Εδω αποσπασματα για την προσβαση στην υγεια στην Κινα.
6 CURRENT IMPLEMENTATION CHALLENGES
Over the past two decades, the Chinese government has made sustained efforts to improve access to health care for the whole population and support disadvantaged population groups. Medical insurance schemes have rapidly expanded and, according to official reports, today more than 95% of Chinese citizens are covered by at least one insurance scheme; given the sheer size of the country and its population of nearly 1.4 billion people, this is a remarkable achievement, heralded as the “largest expansion of health insurance coverage in human history” (Yu, 2015, p. 1145). Increasing investments from the central government in basic public health services, available free of charge to all Chinese citizens, have further contributed to an intensification of preventive and curative care in the communities (Yang et al., 2016). Yet gaps remain in the ability of the national health system to provide affordable care to internal migrants and thus to achieve a truly universal health coverage, defined by the World Health Organization as “ensuring that all people can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship” (World Health Organization, 2010).
One important challenge is associated with employment status. By law, all workers employed in the formal sector are eligible for the UEBMI, which provides the most comprehensive package of benefits compared with the other mainstream health insurance schemes (the NRCMS and the URBMI) and was associated with higher reimbursement rates and higher utilisation of health facilities (Chen et al., 2017; Li et al., 2017). However, as documented in the annual survey of migrant workers, the majority of internal migrants (63.3% in 2016) are engaged in temporary works based on informal agreements with no labour contract (NBS, 2017). As such, they are not entitled to social and health benefits in the workplace, including medical insurance. Furthermore, even those who have a formal labour contract often decide to opt out from the UEBMI (and other social protection schemes), due to limited benefits and the need to pay higher insurance premiums (Jiang, Qian, & Wen, 2018). Indeed, despite an increase in the uptake of the UEBMI, in 2014 this scheme covered only 26.4% of internal migrants (Chen et al., 2017). As described earlier, a number of cities, such as Shanghai and Chengdu, have initiated special insurance schemes for migrant workers that can cover those employed in the informal sector. However, enrolment in these schemes is largely dependent on the employers, many of whom are reluctant to pay insurance contributions, especially for workers who are recruited on a short‐term temporary basis (Müller, 2016). In Shanghai, for example, the Migrant Worker Health Insurance system achieved only 36.5% coverage, even though membership was mandatory for all migrant workers (Zhao, Rao, & Zhang, 2011).
The other two health insurance schemes, the NRCMS and the URBMI, are also inadequate to protect internal migrants, given the persistence of the hukou system. In 2014, it was estimated that the majority (66.6%) of internal migrants were enrolled in the NRCMS (Chen et al., 2017); however, subsidised care under the NRCMS is still provided only in designated health facilities in the county of household registration; thus, health expenditures incurred by rural migrants in urban destinations are usually not reimbursed. For example, a survey in Sichuan and Hubei provinces found that only 35% of migrants with the NRCMS received reimbursement for inpatient care (Qiu et al., 2011). Additionally, as Chen et al. (2017) pointed out, many migrants choose to return to their hometown when they need health services due to limited support in the receiving areas—a strategy that can cause delays in seeking medical care and increase treatment costs. Similarly, eligibility to the URBMI is tied to the local hukou, despite efforts and policy guidance to promote portability of insurance schemes (doc‐14 2009). In some counties and municipalities, pilot programs have been introduced to facilitate the integration of the URMCS and the URBMI, such as the Urban–Rural Citizens' Cooperative Medical Insurance scheme in Jiaxing City (Müller, 2016). Yet integration is difficult to achieve nationwide because insurance schemes are subsidised partly by local governments with variable capacity for funding and administrative support as well as differing costs of care in urban and rural areas (Mou et al., 2013). Many migrants are also unaware of available options or may face formidable challenges in navigating the complexity of rules and procedures that are required to transfer insurance schemes or household registration (Qiu et al., 2011). As a result, in 2017, it was estimated that only 25.7% of internal migrants were enrolled in a health insurance scheme in the place of migration, although an increase over time can be observed (Figure 1).
image
Figure 1
Open in figure viewerPowerPoint
Internal migrants with medical insurance in the place of migration (2008–2017). Data source: National Bureau of Statistics (stats.gov.cn)
Lastly, many local health departments have insufficient capacity to provide all internal migrants with the full package of basic public health services. Although specific health programs for internal migrants have been developed, fiscal transfers to local authorities for public service provision are generally based on the number of hukou residents. Thus, many counties or municipalities lack sufficient resources to implement public health programs, especially in cities where non‐hukou migrants account for a large share of local residents and the local economy is less developed. For example, in keeping with guidelines from the central government (doc‐25 2016), local health departments have introduced health education programs for migrant workers, usually delivered through lectures at factories and other work places. However, as documented in interviews with health sector managers in Tongchuan and Xi'an, a lack of adequate funding and qualified health staff often constrains the ability of local health providers to deliver these programs (Zheng, 2015).
In sum, challenges remain to the provision of equitable health care for migrant workers, resulting in high out‐of‐pocket expenditures and unequal opportunities in access to health care (Mou et al., 2009; Peng et al., 2010; Sun et al., 2010). Notably, a recent study in Jiangsu province found that, compared with local residents, migrants were five times less likely to attend prenatal examinations, three times less likely to have postnatal visits, and less likely to attend health education during pregnancy (Gu et al., 2017). There are, of course, differences within and across provinces, depending on local resources and different implementation strategies. In Kunshan City, for example, a comprehensive package of benefits was developed to attract migrants and thus redress shortages in the local workforce that is needed to support the booming local industry (Kunshan Municipal People's Government, 2010). However, such benefits are not available in other places, especially in the central and western parts of the country, where local authorities have less incentive to attract and retain migrant workers and local resources to implement equalisation programs are generally lower. Inequities also exist within the same urban destinations, depending on the nature of the employer and the employment agreement. Although state‐owned enterprises are more likely to offer formal employment contracts and associated benefits (Nielsen et al., 2005), migrant workers have little or no entitlements in the many underground sweatshops, where compliance with regulations is less monitored and working conditions are often more hazardous (Weiyuan, 2010).
https://onlinelibrary.wiley.com/doi/ful ... 2/app5.294"Έκαστος τόπος έχει την πληγήν του: Η Αγγλία την ομίχλην, η Αίγυπτος τας οφθαλμίας, η Βλαχία τας ακρίδας και η Ελλάς τους Έλληνας".
σιγα το δυσκολο να κοροιδεψεις μια γυναικα.
