A new round of medical reform in China is in full swing with unprecedented momentum. Separation of medicine, separation of management and operation, reform of hospital operation mechanism, abolition of drug markup, addition of medical service fee, pharmaceutical service fee, reform of compensation mechanism of public hospitals, multi-disciplinary practice of doctors, encouragement of diversified running of medical services, establishment of family doctor system, triage of multilevel healthcare system …… and so on. Health care reform pilots around the country are being adapted to local conditions, multiple channels, multiple directions, multiple forms of trying to approach the same goal that people have been waiting for a long time: it is not difficult or expensive for patients to get medical treatment, and doctors’ labor is worthwhile! However, wherever the reform initiatives seem to have to face the cruel reality that has been formed for a long time – on the one hand, the legitimate income of Chinese doctors is generally very low, on the other hand, the patient’s money in the pocket but often be “robbed” empty! Tension between doctors and patients, assaults on doctors, medical malpractice, kickbacks, large prescriptions, large checks and other unhealthy medical events to doctors and patients continue to drag to the impossibility of a “win-win” way out. Where does the problem lie? Is it the lack of morality between doctors and patients or the defects of the system policy? How to improve the legitimate income of Chinese doctors? And how to save the patients from the crisis of trust in doctors? In this healthcare reform that concerns all people, the government, doctors, and even patients, no one can stay out of the picture! In the past decade, the Chinese government’s commitment to healthcare has been remarkable. In 2003, a series of lessons learned from the SARS outbreak have become valuable assets in the development of China’s healthcare program, while the battle against SARS has been a major victory and a rallying point for the nation’s spirit. According to a report entitled “National Health Service Survey” in 2004, 44.8% of the urban population in mainland China did not have any medical insurance, and 79.1% of the rural population did not have any medical insurance. The real contradiction of “expensive and difficult to see a doctor” is becoming more and more prominent. In the same year, China launched the world’s largest direct reporting system for infectious diseases and public health emergencies, allowing infectious disease outbreaks to be reported from primary medical institutions to the Ministry of Health within 24 hours. In February 2006, the State Council issued the Opinions on the Development of Community Health to strengthen the construction of the urban community health service system, and on June 30, the State Council decided to set up the Inter-ministerial Coordination Working Group for Deepening the Reform of the Medical and Health Care System, led by the National Development and Reform Commission (NDRC) and the Ministry of Health, with the participation of the Ministry of Finance, the former Ministry of Personnel, and other departments – marking the beginning of a new round of medical care. -In October, Hu Jintao, General Secretary of the CPC Central Committee, presided over the 35th collective study of the Political Bureau of the CPC Central Committee, emphasizing the need to achieve the goal of basic health care services for all, to adhere to the public welfare nature of public health care, and to deepen the reform of the medical and health care system. Since then, the path of China’s healthcare system reform has become clear. In October 2007, the 17th National Congress made the provision of basic medical and health care services for all one of the important goals of building a moderately prosperous society and a harmonious socialist society in an all-round way, and clearly defined the important tasks and policy measures for the reform and development of health care in the next decade or so, thus pointing out the direction for health care work. On April 6, 2009, the Opinions on Deepening the Reform of the Pharmaceutical and Health Care System and the Recent Key Implementation Program on the Reform of the Pharmaceutical and Health Care System were formulated and released, and the eye-catching new health care reform program was unveiled.In August, the Opinions on the Implementation of the Establishment of the National System of Essential Drugs, the Measures for the Administration of the National Essential Drugs Catalogue (Provisional), and the National Essential Drugs Catalogue (Grassroots Level) were introduced, which meant that the The establishment of the national essential drug system was officially launched. On March 21, 2012, the State Council issued the Planning and Implementation Program for Deepening the Reform of the Medical and Health Care System during the Twelfth Five-Year Plan Period, proposing that by 2015, “the proportion of personal health expenditures to total health costs will be lowered to less than 30%, and the problems of difficult and expensive access to medical care will be effectively alleviated.” In June, the Three-Year Summary Report on Deepening Reform of the Medical and Health Care System was completed. The report pointed out that the new round of healthcare reform had comprehensively promoted five key reforms and fully completed the three-year healthcare reform tasks as scheduled.On August 30, the Ministry of Health, the Ministry of Finance and other ministries announced the Guiding Opinions on Carrying Out Major Disease Insurance for Urban and Rural Residents. The purpose of carrying out major disease insurance and reimbursing urban and rural residents for high medical expenses incurred as a result of serious illnesses is to solve the problem of “poverty caused by illness and returning to poverty because of illness”, which has been strongly emphasized by the public, so that the vast majority of the population will no longer find themselves in a difficult financial situation as a result of illness. In the central government’s health care reform, the general direction of the layout continues to be clear and perfect at the same time, all levels of government and health authorities, but also the pace of health care reform into practice is also speeding up. Beijing: the pilot separation of medicine, the abolition of 15% of the drug markup, the sale of drugs at the purchase price, while the abolition of the continuation of many years of 3, 5, 7 and 14 yuan registration fee and consultation fee, the addition of medical service fee, in accordance with the different grades of doctors, attending physicians, deputy chief physicians, chief physicians to well-known experts, physician service fee of 42, 60, 80 and 100 yuan, respectively, the health insurance unified report of 40 yuan. Shanghai: “Perfecting four systems and improving eight supports” is the so-called “four pillars and eight pillars”. Explore and improve the community medical and health service system based on the family doctor system. Guangdong: Setting a new goal for health care reform: “preventing poverty in serious illnesses, treating moderate illnesses routinely, and making minor illnesses affordable”. At the Guangdong Provincial Working Conference on Deepening the Reform of the Medical and Health System, Xu Shaohua, member of the Standing Committee of the Provincial Party Committee and Vice Governor of Guangdong Province, repeatedly emphasized that “the interests of the general public should be the basis for the promotion of the new health care reform”. In Shenzhen, as early as a few years ago, began to explore the public hospital corporate governance structure, not only to start the “separation of medicine, management separation, separation of government” and other required action and continue to promote, but also “Chinese medicine treatment of disease prevention health care system” and “family doctor responsibility system of community health centers,” and other optional action is also in the wonderful. Anhui: the implementation of the basic drug system as an entry point, the implementation of grass-roots medicine and health system comprehensive reform, in order to eliminate the “medicine for medicine” old system, the establishment of reflecting public welfare, mobilization of enthusiasm of the new mechanism as the goal of the reform. Through the integrated promotion of the management system, personnel, distribution, drugs, security system reform, and gradually solve the problem of grass-roots medicine and health system mechanism, to realize the return of the public welfare of primary health care institutions. Doctors voice “absence” and government-led health care reform voice in sharp contrast, from the provider of medical services, health care reform protagonist —— doctor’s voice but there is a certain degree of absence. This is an issue that must be brought to everyone’s attention and addressed. There is nothing wrong with “promoting the new healthcare reform in the interest of the people”, this is the goal we are pursuing. At the same time, it is inconceivable that without the voice and active participation of the “doctor body”, the healthcare reform can ultimately bring benefits to patients! How to play the role of doctors is an important issue. Shouldn’t we first consider that doctors’ interests will not be jeopardized in the new healthcare reform, so that the healthcare reform itself can be sustained? The results of the health care reform should ultimately be reflected in the doctor-patient relationship. The quality of service provided by doctors is not only related to the level of medical service to patients, but also to whether the health care reform can be substantially implemented. As a matter of fact, there are many deep-rooted reasons why doctors are reluctant to speak up and actively contribute to China’s healthcare reform. China’s long-lagging public hospital unit management from the system of doctors at all levels of the salary level is too low. According to a county-level doctors: a patient will be implemented for craniotomy “senior doctor”, into the operating room, the first thing you need to do is to come in outside the private barber, the patient’s hair all shaved, the barber with 15 minutes or so can earn 20 dollars. What about the doctor? If this surgery is pushed into the operating room after 12:00 p.m., brain surgery is done for three or four hours on the short side, or until the next morning on the long side, with four or five assistants and nurses. Does anyone know how much overtime is paid? It’s 10 bucks a surgery for overtime! Five dollars if the patient is wheeled in before 12:00 at night! Can you believe it? 20 bucks for a haircut isn’t very much but is the true value of the market. The$10 overtime pay for doctors was set by the government administration years ago, and it was set too low rather than doctors taking too much. It is conceivable that if this kind of institutional constraints under the value of shrinkage is always surrounded by doctors and not changed, doctors actively participate in the government-led health care reform will be expected? A professor of economics at the Guanghua School of Management said at a symposium: “For system reform, doctors’ salaries cannot be expected to be changed by the government. How much to raise the salary of doctors to make a proposal, if passed will be inconceivable! Not only is it politically unworkable, it is administratively unworkable, and it is financially intolerable!”” Everyone knows that doctors have low incomes, so how do you raise their pay? There must be institutional safeguards, and hope should never be pinned on relying on the administrative body to set your salary. The only way is to take the road already traveled by the world’s predecessors, to untie doctors and give them a space and platform for entrepreneurship. From the perspective of society as a whole, doctors have been pushed to the forefront of conflicts due to the long-standing problems of “difficult access to medical care” and “expensive access to medical care”. Coupled with the fact that some doctors do have indifferent attitudes towards patients, taking kickbacks, receiving red packets and other behaviors that are criticized by the general public, resulting in the evaluation system in society, the image of doctors than in the past, there has been a large drop or even evaluation of the negative side. To some extent, society lacks a deep understanding of the negative phenomenon. As one scholar said, could it be that so many doctors in China prescribing large prescriptions is a collective moral degradation? This social phenomenon cannot be explained by poor regulation or a collective moral decline. The only explanation is that there is something wrong with the system. In this context, not many doctors can come forward to articulate their interests and speak for health care reform, and even fewer doctors speak the truth! The reason is that they are reluctant to speak falsely if their voices are in line with the truth, and they will be bricked if they speak the truth. Simply keep silent the best! A scholar talked about: at present, the positioning of the public hospital doctors is the state management under the control of the institutions, our doctors carry two books in their pockets, one is the red book, one is the blue book. The blue book determines whether a doctor has the technical ability, which is what the whole world should have. There is also a red book, which does not allow a doctor to provide ambulance service outside the hospital without the consent of the unit. The institutional arrangement ties the doctor’s hands. Without untying this system, it will be difficult to implement all the so-called healthcare reform policies that encourage multi-disciplinary practice and rationalize the relationship between multi-level hospitals, and it will also be difficult to listen to the voices of real doctors. The “absence” of doctors’ voices not only reflects that doctors are afraid to come out to express their own interests, but also very likely to show a “negative” attitude towards healthcare reform, which on the one hand, will lead to a lower evaluation of doctors in the community; on the other hand, the doctors’ “negative healthcare” will ultimately be transmitted to the patients, and thus the victims will be the patients. It should be noted that the investment in human capital of doctors and the long cycle of its formation is almost unparalleled among all professions in the society, and the work of doctors is also known for its high intensity and high risk. Therefore, it is only natural that doctors should be allowed to earn a higher legitimate income. In most countries of the world, doctors are a decent profession in the society, respected and earning the highest income among all social classes. In our country, however, the social status of doctors is not only low, but their income is even lower than that of doctors in the IT and financial industries, as well as some monopolized industries and civil servants, which is disproportionate to the efforts and input they have made. The reason for the low legitimate income is actually very simple: IT is marketized, finance is monopolized, and doctors’ incomes are set by civil servants who have been restructured to be in line with international standards! The success of China’s healthcare reform could not have been achieved without government leadership at all levels. In fact, over the course of several years of healthcare reform, it has never been difficult to see leaders and medical directors at all levels, from the central to the local level, and it is they who have played the main theme of healthcare reform one after another. However, with the deepening of the health care reform, we should hear more from the main body of the health care reform —- doctor’s voice, that is the health care reform in the “Chinese voice”! We have reason to believe that the Chinese doctors “good voice” behind the playful come must be the government and doctors look forward to patient satisfaction.