Chinese medical service and medical education in urgent need of reform in the context of public welfare-based medical reform

After six years' medical reform, about 7.8 billion person-times of medical service has been achieved by 2014, and the number of persons covered by basic medical insurance for urban employees, basic medical insurance for urban residents, and new rural cooperative medical insurance exceeded 1.3 billion, of which the coverage ratio reached as high as over 95%, establishing the largest basic medical security network in the world. In 2015, the reform of medical and healthcare systems focused on the reform of county-level public hospitals and solutions to the issue of compensation for medical cost through drug-selling profits, which further emphasizes the public welfare nature of medical service. It remains unknown whether the medical institutions and the human resources cultivated by medical colleges are capable of coping with such a challenging reform in the context of major reform throughout the whole medical sector, and the complicated situation of economy and society, and especially the complicated doctor-patient relationships. Apart from imperfections of the policies on the reform of medical and healthcare systems, weak enforcement of laws and regulations, and lax social management, the medical science itself and biomedical mode show their structural defects, and have difficulty in adapting to market economy. The right to information, of choice and of life and health of patients are constrained by a mechanical biomedical model, and many conflicts between doctors and patients arise consequently. In the long term reform of medical and healthcare systems, new measures will be taken continuously, to form an optimized medical model integrating biology, psychology, and sociology, and apply the optimized model to medical service and training of medical personnel. In addition, reform in the following four aspects becomes urgent. First, public hospitals should improve their management efficiency as soon as possible. Specifically, public hospitals should improve their comprehensive management level, including personnel management, medical management, department management, operation management, doctor-patient relationship management, law affairs management, scientific and educational management and logistics management. The current reform targeting county-level public hospitals is a systematic and comprehensive reform which focuses on management system, operation mechanism, service price adjustment, personnel and salary, and medical insurance payment and aims to move beyond the compensation system for medical cost through drug-selling profits, which is to be undertaken in all public hospitals in cities in 2017 as planned by the state. Apparently, active participation of the professional management personnel and key medical staff of hospitals, sufficient managerial knowledge and management ability of the aforesaid personnel, and service-oriented management and support by the government and authorities are indispensable for effectively carrying out the reform. Since traditional Chinese medical education has many short-