自改革开放后,中国的城乡医疗卫生体制已经发生了很大变化,最本质的变化就是医院从向国民提供医疗服务的公共事业机构转变成了赢利企业。这样的转变带来了许多严重的社会后果,使得“看病难”、“药费贵”成为我国城乡居民生活中最大的负担之一,政府也在探讨如何进一步推动我国的医疗卫生体制改革。本文从体制和医德两个角度来探讨当前我国医疗卫生体制中存在的各种现象,讨论新出版的一本有关医药推销回扣的调查报告所揭示的问题。 Since the reform and opening up, China’s urban and rural health care system has undergone great changes. The most fundamental change is that the hospital has transformed itself into a profit-making enterprise from a public utility that provides medical services to its citizens. Such a shift has brought about many serious social consequences, making it difficult to see a doctor or expensive drug to become one of the biggest burdens on the lives of urban and rural residents in our country. The government is also exploring how to further promote medical and health care in our country System reform. This article explores the current phenomena in the medical and health care system in China from the perspectives of system and ethics, and discusses the issues that are revealed in a newly published survey report on the rebates of pharmaceutical sales.