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Lu et al. responded to criticisms that general practice in China failed to perform a gate-keeping role, by stating that \virtually impossible to establish in the presence of a diversity of payment schemes including government insurance, employer-paid insurance, private insurance, community-based insurance (mostly with only part reimbursement), and out-of-pocket payment. Training and pay have not presented problems. The system of payment of GPs is similar to that of hospital practitioners - a basic salary supplemented by bonuses according to performance. In popular hospitals and busy specialties, these bonuses may be up to ten times the basic salary, whereas some hospital doctors may receive only the basic salary. Likewise, GPs get a basic salary, which is topped up from patients' fees and prescriptions. Thus there are clear incentives to improve quality, hence attracting more patients and increasing income. The desire of newly-trained doctors to work in cities will ensure there will be an unlikely shortage of GPs for the foreseeable future.
There are several important problems facing health policy-makers. First, a system that keeps basic wages low, but allows doctors to make money from prescriptions and investigations, leads to perverse incentives and inefficiency at all levels. Second, as in many other countries, to develop systems of health insurance and community financing which will allow coverage for most people is a huge challenge when the population is aging and treatments are becoming more sophisticated and expensive. Several different models have been developed across the country to attempt to address the problems.
An example of a reform model based on an international partnership approach was the Basic Health Services Project. This was implemented between 1998 and 2007 by the Government of China in 97 poor rural counties in which 45 million people live. Its aim was to encourage local officials to test innovative strategies for strengthening their health service to improve access to competent care and reduce the impact of major illness. In particular it supported county implementers to translate national health policy into strategies and actions meaningful at a local level.
d. Your idea on a better health care system Answers to this question may vary.
Unit 5 Dead Poets Society (1989)
II. Questions for Thoughts
The following answers are given only for reference, and the students are encouraged to present their own understandings of or opinions on these questions.
1. Why do parents try to send their sons to the Welton Academy? What are the four pillars of the Academy? The Welton Academy, with a history of 100 years, is regarded as the best preparatory school in the United States. A large percentage of its graduates can go to the Ivy League and such an accomplishment makes the parents believe that if their sons can study in this school, they will surely become successful men as others expect. The school authority believes that such a reputation is the result of its dedication to the four pillars of the school: “Tradition,” which means love of school, country, and family; “Honor,” which means dignity and the fulfillment of duty; “Discipline,” which means respect for parents, teachers, headmaster; and “Excellence,” which means the result of hard work, the key to all success, in school and everywhere.
2. Who is introduced at the school opening ceremony as a new teacher? John Keating, a new English teacher, is introduced to the students. He was a star student at the Welton Academy, and before he comes to teach at Welton, he spends several years teaching at Chester School in London.
3. Why does Mr. Perry ask his son Neil Perry to drop some of the extracurricular activities? What tone does he use when talking to his son? Why? Mr. Perry believes those extracurricular activities will divert his son’s attention on study. He wants Neil to work hard and enter the medical school as he expects. He talks with Neil in a very authoritarian tone. He believes his son is still too young to know better and is in no position to make his own decision unless he fulfills the family’s high expectations of him.
4. What suggestions do the other boys put forward then? How does Neil act on it? The other boys encourage him to do what he likes doing and speak out his mind in front of his father. Neil does not take their advice seriously because he knows all the boys are just saying and none of them has the courage to say no to their fathers.
5. What is the general classroom teaching at Welton like? Are the