When online classes replace classrooms, can college students still study hard?

First, the question: How has online class changed the study and life of college students?

In interviews with teaching deans, academic leaders, professional leaders, department heads, teaching teachers and students from different universities and disciplines, it is found that the teaching environment in colleges and universities has changed significantly. Respondents generally believe that since 2020, there have been "uncertainties" in the higher education environment in China, and the teaching quality is at risk of decline, all pointing to a hot issue-"the difficulty of online courses":

On the one hand, teachers are struggling to adapt to the changes in media technology, and the time and energy for preparing lessons are prolonged, and the teaching effect is not significant; On the other hand, students are good at using the function of media technology and find many "process loopholes", which makes it more and more obvious to avoid class.

The emergence of this phenomenon is obviously different from the "online class substitution theory" generally considered by the society.[1]That is, there is cognitive asymmetry among observers, managers, participants and practitioners. Around this problem, the author conducted a two-year field survey, and through in-depth participatory observation and interviews, from the dual dimensions of objective reflection and subjective experience, explored the "hidden problems" of online teaching and learning under the background of deep media. Based on this, this paper reflects on the potential defects of college students’ online learning and provides solutions from the practical level.

"it(online class)Like mobile games, it is easy for students to transfer from offline teaching space to online.But how difficult it is to’ ask them’ to return to the tropic of cancer and reach the original offline state of attending classes."(teacher ZYJ).

This view has almost become the consensus of college teachers in recent years, and it is often discussed in anger. Guo Jianbin and other communication scholars put forward that "online classes have become audio-visual education.(learning)A contemporary form of "[2]Modern science and technology have infiltrated people’s daily life, formed the basic elements of people’s daily life and transformed daily life from the inside.[3].

From a certain point of view, online classes have challenged the educational methods handed down for thousands of years in the era of Confucius and Plato, and have been widely recognized. The reason is directly related to the barrier problem of "time-space communication" that needs to be solved urgently in public health emergencies. However, when the pain dissipates, its "side effects" gradually begin to appear."Online classes are a dose of’ painkillers’, and it can’t completely replace offline classes after all."(teacher HH).

"Although I have graduated, I feel that I really haven’t learned anything in these two years of online classes."(student WD). Judging from the current macro trend of higher education teaching, although online classes have some disadvantages, online classes still become an important part of daily teaching methods and become the "sword of Damocles" in the daily practice of higher education.

In 2020, the Ministry of Education emphasized that "suspension of classes and non-stop learning" is not a simple online class "[4]. In 2022, "Several Opinions of the Ministry of Education and Other Five Departments on Strengthening the Teaching Management of Online Open Courses in Colleges and Universities" clearly put forward detailed opinions on strengthening the teaching management of online open courses used by colleges and universities to identify credits, among which special reference was made to irregular learning behaviors such as "brushing classes", "substituting classes" and "brushing exams".[5].

As early as 2013, online courses represented by massive open online course rose in China.Before 2020, it has always been used as an "auxiliary method" to improve the quality of teaching, and offline teaching has always occupied the mainstream.When the frequency of online classes is increasing, a very basic question is placed in front of us: what is the significance of universities as "physical spaces" for students? What’s the difference between full-time and part-time jobs? Is online class really a suitable teaching method for universities?

These questions come together to form the "dilemma of online courses" that higher education workers and college students have been discussing hotly in recent years, and they are all tied together on the "wheel of Vransky"-"accelerated driving system"(corresponding to the technical platform on which online courses rely)Not only does the function occur externally,It also enters the individual, and he(Teachers and students in online classes)Will be driven by the idea that they might miss something.The result is the feeling of being tied to a wheel that turns faster and faster. "[6].

The fundamental reason behind "the difficulty of online classes" is that the public ignores the life dimension of media technology and human subjectivity. "The audience is actually an actor embedded in the context of daily life.(actor), regardless of information acceptance or interpretation behavior is carried out in daily life practice "[7]. This urgently requires us to reflect deeply.In addition to providing convenience for college students, what else does online class bring?

Second, the research design

This study mainly uses the method of participatory observation and in-depth interview to conduct field research. From March 2021 to March 2023, on the one hand, the author gained the subjective experience of "online class" through five online courses and 40 online listening and evaluating classes, and sorted out the "intuitive problems" found during "online class"; On the other hand, around the topic of "how to treat online classes", 63 teachers and students in colleges and universities were interviewed one after another, and on the basis of confirming the objective existence of the above-mentioned "intuitive problems", the individual causes and solutions were explored.

In addition, the prerequisite for becoming the interviewee of this study must be the use of.(class or lecture)The "online class" time is not less than one semester. The basic information of 5 courses and 63 interviewees is shown in Table 1.

In addition to the online participation in course observation, all interviews are conducted in a "face-to-face" and semi-structured way. The interview scenes include daily communication, after-class interaction, teaching meetings, supervision and inspection, student discussions, inter-school exchanges and targeted interviews.

Through the experience of "online class" and course experience told by 63 college teachers and students, this paper tries to find the crux of "online class difficulty", and looks for ways and methods to solve "online class difficulty" from the multiple dimensions of interviewer’s individual psychological motivation, behavioral feedback, after-class feeling and habit formation. The naming method of interviewees refers to academic practice and is marked with "identity+initials", such as student DXY, teacher HH and supervisor CGS.

Third, the change of habit: the alienated learning style under the logic of technology

Media technology has completely realized Marx’s "good wish" of "destroying space with time" more than 100 years ago, but "fetishism is actually linked with" symbol-thing ",which has been evacuated from its substance and history and reduced to a symbol of difference and a microcosm of the whole difference system"[8]People are obviously ignored and alienated for years.

For college students, the manifestations of alienation are reflected in many aspects of learning style, such as:Material media such as mobile phones and tablets have become necessary stationery. Punching in and receiving words have become the core indicators of listening carefully, and the sense of ritual in the classroom as a public space no longer exists …For college students, this learning style is an instantaneous passive requirement, and it is also a continuous subtle influence. With the passage of time, a stable teaching habit has naturally formed, and the alienated learning style has also become a habit.

1. Internet and its hardware equipment as "necessary stationery"

Online classes are a socialization process, which is an important part of Elias’ explanation that "life is a’ networking phenomenon’".[9]. Then, from the perspective of functionalism, "social values can be passed on to the youngest members of society without any problem, and these members will then reproduce them."[10]. In the scene of online classes in colleges and universities, the socialization process is media, and its social value is the convenience of learning brought by the materiality and availability of media. Obviously, mobile phones, computers and Wi-Fi have become "necessary stationery" for college classes.

Mediating learning style is the trend of the times,Others have been mediated, and I have no reason not to be mediated. I can get my degree certificate, and I don’t care if media will affect my knowledge acquisition. "(student DXY).

Through various channels, the author found the "online teaching notices" issued by 11 universities in various periods.When the educational administration issues the online teaching notice, it does not give too much consideration to the students’ equipment conditions, and often acquiesces that students can meet the basic material foundation of online classes.Regard related equipment as an "existing" and "necessary stationery". The academic affairs departments of each school will focus on maintaining technical communication with several mainstream online class platforms to meet the adaptability of students’ different "stationery" in order to achieve everyone’s "online class" as much as possible.

What’s important is that in terms of course effect tracking,Most educational evaluation departments do not consider the problem that students’ teaching feedback is "difficult to judge intuitively".Obviously, both students and educational administration departments have failed to clarify the logical relationship among "going to class", "going to class" and "having a good class", and they only focus on the "technical service" of online classes, ignoring the question of whether online classes are sustainable.

At the same time,This kind of "technical service" also brings great challenges to the "auxiliary management" within the family.In the communication with some college counselors and teaching secretaries, it is known that some students’ parents are often "very concerned" about the compensation for the differences in hardware equipment between students, and even think that "if the online class equipment is worse than others, the children will lose at the’ starting line’ of the university"(counselor LBW)The formation of these ideas has brought a certain economic burden to the students’ families.

First, the economic conditions of students’ families are quite different, not all students.(especially freshmen)They all have the infrastructure needed for online classes, and students in remote areas need to meet their teaching needs by borrowing computers, surfing Wi-Fi and meeting Internet cafes. Second, students buy electronic products with "bootleg goods", and buy new, higher-equipped and more functional electronic products on the grounds of online classes, so as to meet the needs of future behaviors other than learning, such as comparison, drama chasing, games and live broadcast.

Students’ "wandering" maintains a "delicate balance relationship" between schools and parents, bridging the information gap between parents and schools, so as to achieve the purpose of students’ individual behaviors such as updating electronic products. It can be seen that the main power of "auxiliary management" within the family is gradually transferred to students, and it is becoming more and more difficult for both home and school to guide students’ behavior, consciousness and concept.

2. "On-line, punching in and receiving" have become the three major KPIs for students’ assessment.

"Roll call" is a necessary part of curriculum education, and its premise is the "presence" of the educated "body", which proves that the educated and the lecturer are in the same time and space at this moment through question and answer. In the context of online classes, "punching in" instead of "roll call" becomes a substitute index of learning participation, which is the "implosion" point of the course teaching structure.[11], opened a new wave of "simulacra order"[12]Among them, "online" as status and "received" as feedback become the main ways to maintain this order.

Starting from the concern of Baudrillard’s simulacra theory, the relationship between the virtual and the real in the online class environment has become blurred, and the most intuitive performance is obviously inIts "spatial attribute" has been greatly weakened.. Among them, the "space" is redefined, and the live broadcast software in hardware equipment provides students with a "virtual presence" of "digital flesh", which is indirectly displayed by the names or images in the live broadcast software "member list", forming an individual self-enclosed "subspace", while only the "member master list" composed of all the students attending the class and the instructor can form a complete "space" in the true sense.

Then, when "online, punching in and receiving" become the three KPI’s of students’ assessment, can the "presence" in the form of button symbols in "subspace" accurately reflect students’ listening state and classroom order? Obviously, this question needs a big question mark.

"Early eight.(Course at 8: 00 am)Many people will choose’ hang up’.Now who doesn’t answer a’ to’ in the QQ group and continue to sleep back? "(student SY)

On the one hand, for college students who have not developed fixed and good study habits, the assessment method of "on-line, punching in and receiving" has fetal defects, which can not cover the loophole of "sub-space" established by them to help them "be present in disguise" and give them the opportunity to sleep late or even skip classes.

On the other hand, through investigation,Most teachers are not aware of this problem,They even think that the symbol "received" in the platform can replace the actual "interaction" as a unified way to feedback the learning effect, and "online" can also replace "present" as a universal criterion. Even some teaching supervisors, educational directors and dean of teaching often pay special attention to the proportion of "online", the record of "punching in" and the frequency of "interaction".

In the long run, this form of "effect evaluation" has become one of the indicators to assess the quality of teaching, which has become a "punching task" for college students; For teachers, it seems that whether students have learned knowledge is no longer so important.

In view of the above problems, the online class platform has also blocked relevant loopholes at the technical level to prevent the occurrence of "disguised presence". howeverThe technical "patch" of the online course platform seems to never defeat the lazy "magic" output by college students in the "subspace".

"Many learning platforms.(e.g. learning skills, etc.)Later, there was a real-time punching function, and even you could accurately locate your geographical coordinates, frame the punching time and online time. No matter how precise the technology is, it’s useless. I can ask my brother to sign up for my account. My brother listens to me, so I don’t have to get up early at all. "(student LXY).

From the student’s point of view, the problem of "alienation" brought by media technology is not only as simple as "pretending to be present", but also provides convenience for students to implement "policies above and countermeasures below" in operation. As can be seen from this,The technical patch of the online class platform actually further intensifies the conflict between two different roles in the classroom.

Through interviews, it is not difficult to find that, fundamentally speaking, the "space" in college students’ cognition is not the same concept as the space that teachers think: for teachers, "space is the classroom, and students must be physically present".(teacher JH); For college students, "school"(space)In my heart, it is not just a classroom, it is a space for public life, not just learning. "(student HYY). As a result, when teachers constantly use "online, punching in and receiving" to restrain college students’ bodies, they are actually drifting away from Marx’s beautiful wish of "destroying space with time".

3. Pay attention to the concept of transmission of education and ignore the concept of ritual of communication.

The two habits of emphasizing materiality as "necessary stationery" and virtuality as "punching KPI" have gradually been accepted by all contemporary university teachers and students. However, from the root point of view, this alienated learning style is actually related to the change of educational values.

The interaction among materiality, virtuality and values forms a logical closed loop of the change of college students’ study habits, showing a spiral upward trend, which further consolidates the dependence of college students on online courses. Among them, the change of educational values is mainly reflected in the fact that the subject of education regards online teaching only as a kind of knowledge "transmission" rather than a kind of "ceremony".

Combined with the viewpoint of American communication scholar james w. carey on communication concept,Online classes should spread not only the "concept of transmission" as real knowledge, but also the "concept of ceremony" as educational environment.[13]. Therefore, from the perspective of sociology of education, we have to pay attention to a thorny issue, that is, the "controversial root point" of online courses is not in the teaching process, but that the difference between "linear model and field model" is ignored in teaching concepts.[14].

In the field of educational communication, media and ceremony can be understood as three relationships: the ceremony of class, the way of class ceremony itself being ritualized, and the scene that "the media may become a ceremony or a collective ceremony itself"[15].

At present, the so-called ritual view of online classes is a kind of "media’s own ritual" proposed by Kurdley.[16],This shift of ritual field has gradually moved away from the true concept of educational ritual and lost the pure pursuit of knowledge dissemination.Specific in the classroom, will focus on alienation into three forms:

First,The relationship between teachers and students becomes single,It is easy for college students to form the wrong cognition that they have a "knowledge employment relationship" with their teachers. Some students said, "The teacher at the other end of the screen is like an AI, giving people the illusion that they are listening to the paid broadcast of knowledge."(student ZNN).

Second,Instantaneous, frequent and intense teacher-student interaction in the classroom becomes rare.For example, "I have questions about what the teacher said in class. Because the system has set up a ban on all staff, I can only leave messages in the message area, but many teachers don’t have the habit of taking care of the message area, so they can’t get feedback in time."(student YC).

Third, the group relationship between students in each course is in a weak connection state.The emotional connection between them is weaker than offline.For example: "After taking public elective courses, we still don’t know each other, and we can’t recognize our classmates when we see them offline."(student KYQ).

Then, for students, Golding’s so-called "the ceremony of attending classes and the way of attending classes are ritualized" cannot be perceived. It was too late when some educators found that "the ceremony of media itself" and "the ceremony of teacher-student construction" were obviously separated, which not only indirectly explained why students proposed that "it is better to go directly to the knowledge-paying website for online classes".(student ZNN)Question, also found it.Conceptual factors leading to the decline of online teaching quality.

Fourth, the consequences of alienation: the reverse suspension of students’ learning power

Compared with the past, the relationship between college students and teaching teachers, thesis tutors and teaching assistants has not become closer because of the development of media technology. On the contrary,The relationship between teachers and students is more alienated.

As Raymond Henry Williams said, the essence of this relationship alienated by the media is "alienation", which means alienation and alienation, and it is manifested as "widely feeling that people are alienated from society"[17]. We need to treat this phenomenon as a "brand-new relationship". "Alienation is a relationship that lacks relationship … According to this view, alienation is not completely irrelevant, but it is a relationship in itself, but it is a flawed relationship."[18].

Therefore, the final result of learning alienation has gradually evolved into an "inversion" of teachers’ and students’ power, showing a suspended state, which is reflected in four aspects: first, technical empowerment has laid a material foundation for the alienation of teachers’ and students’ relationship; second, bad study habits have provided environmental soil for the breeding of lying consciousness; third, the deviation of online course evaluation standards has further contributed to the formalism of collusion between teachers and students; and fourth, the misplaced student-oriented concept has provided an excuse for the lack of curriculum management.

1. Technology empowerment makes it possible to alienate the relationship between teachers and students.

"Teacher-student relationship affects students’ classroom participation, academic performance and learning motivation"[19]It is also the premise of giving full play to the value of teaching and educating people.[20]. However, during the investigation, the author found that almost all the respondents mentioned a common point: "We are tired of using mobile phones now.And the teacher(student)The relationship is also very similar to the’ zombie friends’ in WeChat."(Teachers JCS, QSQ, LX; Students YR, ZYL, CQ, etc.).

This "abnormal" way of communication has laid a hidden danger for the maintenance of the relationship between teachers and students in the future. From the perspective of college students’ media use and their psychology, college students can fully feel it in their daily study."social media burnout"I don’t have much energy to keep effective communication with every teacher.

According to the author’s investigation, college students need to take 8.88 courses and take 19.8 credits each semester on average. Different courses have different QQ groups and WeChat groups, and different courses may also use different online course software. There are group assignments in each class, and it is necessary to form a "group group" when flipping the classroom. College students are tired of "building a group", "finding a group", "joining a group" and "grouping".whatIt is the phenomenon of "one class and many groups" and "one thing and one group" that occurs frequently.

Although media convenience gives college students full autonomy in class, they can decide whether to learn, with whom and how to learn, but "insufficient flow, insufficient electricity, insufficient screen and insufficient memory" constitute the new "four major problems" in the online class era, which has become the main reason for the current college students’ distraction.

When reflecting the above-mentioned situation of students’ scattered energy to many teachers, almost all the teachers interviewed were secretive about this phenomenon. They unanimously said: "I don’t have enough energy, and the situation is related to the electronic and trace teaching process, and I don’t have that much strength to solve this problem again. Perhaps the ability is not enough, and of course’ energy’ is not enough. "(Teachers LY, WHF, FQ, etc.).

From the perspective of media motivation and behavior, college teachers are eager to carry out "teaching reform" through the online class platform, trying to give students sufficient power in the teaching process.Its purpose is not for teaching effect, but to highlight "trace characteristics".This indirectly establishes the conditions for the alienation of students’ learning style and the alienation of teacher-student relationship.

The root cause of this phenomenon lies in the fact that the evaluation standard of teaching begins to focus on the construction of online platform courses, including the collation and evaluation of daily teaching ledgers, such as the list of course names, the filing of classroom assignments, the flipping of classroom videos, and the records of group discussions. These assessment indicators have prompted the teachers to constantly increase the "daily records" of the course through various technical methods in the online course platform, while the opportunities for "direct communication" between students and the teachers are gradually squeezed when students continue to complete various records.

"I don’t know why I do so much homework, and I don’t have time to think about why. I really feel that there is nothing substantial to improve our profession. However, do what the teacher says, and it is important to complete the task. "(student HYY).

In this cycle, the relationship between college students and teaching teachersFrom an intimate teacher-student relationship to a blunt "task relationship",Students’ learning styles are getting farther and farther on the road of alienation, and the actual effect of online courses is even more imaginable.

2. The idealized "lying flat" has become a popular study habit.

In general,In the network environment, people’s attention is in a state of suspension of concentration and dispersion.[21]In fact, this state is not conducive to students learning knowledge. Previous studies have shown that "in social relations, it is a kind of confrontational leveling to pursue low social interaction in reality and relative activity on the internet"[22]. When attention suspension and lying parallel are related, the media provides full convenience for college students to promote the "lying-down learning habit".

On the one hand, college students are infiltrated by the culture of lying flat, and subconsciously long for the comfort brought by lying flat; On the other hand, the online class platform provides a "convenient environment" for college students to lie flat, which has been influenced for a long time.It is difficult for students to return to the "real teaching environment".

"I forgot what the classroom looks like. Now Teacher J often draws me up to answer questions. I’m actually bored. I have already formed the habit of watching NBA live broadcast while opening the double screen in the morning class, and I can organize a group to watch the game in the dormitory. "(student GY).

"Because I like to be in a daze, I really enjoy online classes. I stare at the screen for a long time and the teacher can’t find it at all."(student HYY).

The above problems and phenomena have already become a kind of "daily life" among college students, and spread among college students like a plague.This further strengthens the college students’ perception of "powerlessness, meaninglessness and self-alienation" in campus life.[23].

In addition, some young teachers also have a "lying-flat mentality" towards online classes, which is easily discovered by students, thus indirectly weakening the enthusiasm of college students for online classes and promoting the continuous consolidation of their lying-flat habits. For example:

"Young teachers have a very strict KPI for evaluating professional titles and talent assessment. The micro-course competition is a shortcut, so it is not so voluminous. It is difficult to highlight the level of practical teaching. Young teachers can get a teaching award with a little effort in micro-courses, and the assessment will be passed. In addition, online classes are also convenient to be lazy, for example, it is difficult for students to find out if they don’t open the screen to read the manuscript; Sometimes you can record it yourself and send the video to the class group. I don’t need to care if the students watch it or not. "(Young teacher HX).

It can be seen that under the atmosphere of "you lie flat, he lies flat and everyone lies flat", the teaching quality of online courses can be imagined. However, lying flat is a "bad habit" that broke out in the online class era, but it is difficult for students, teachers and teaching supervisors as participants to detect each other, which further breeds "learning deception", "teaching deception" and "assessment deception".

The key to the problem lies in the fact that the teaching ledger can’t directly display the teaching effect under the technical empowerment, and the harm caused by lying flat is unknown to the "players" who are deeply involved in it and can’t be supervised. In the long run,Teachers’ lying flat and the defects of supervision further aggravate the "trend" of students’ lying flat.It is becoming more and more difficult to guide students to return to the road of "studying hard".

3. "Strive for strength" is not as good as "fooling around" to become a group consensus.

Under the dual influence of the alienation between teachers and students and the principle of lying flat, more and more college students realize that teachers’ evaluation criteria for students during online classes cannot be directly linked to the learning habit of "striving for strength". Offline, teachers can intuitively see who is sitting in the first row, who is taking notes and who is listening carefully. The realistic space can not only give motivated students the opportunity to show their learning attitude,It can also give students with poor self-control ability a sense of oppression in the environmental atmosphere and promote the formation of a benign teaching ecology in offline classrooms.

However, in the online class platform, students’ usual performance is difficult to observe and measure, and the learning atmosphere is more relaxed than that in the offline class. "Students like online classes, and the atmosphere is very relaxed. You can be at home, in the dormitory, and no one knows when you are lying down. Because we don’t show our faces, we girls can also avoid the time of makeup. It feels similar to offline classes, and online assignments can be found online, which makes it very easy to fool teachers. "(student XWW).

In the long run, the "bad mentality" inherent in a college student group will become more and more serious: students no longer pay attention to the performance in the usual classroom,And put almost all the focus on the final surprise review preparation,It has become the consensus of some college students that "striving for strength" is not as good as "fooling around".

After a long period of classroom investigation and course experiment, it is found that some students and teachers have gradually formed an organic "fishing group", and the two tacitly maintain the existing online teaching relationship, which is embodied in a subtle "collusion": as long as teachers do not fail students, students do not give teachers low marks in teaching evaluation, and the relationship between them can last and be stable for a long time. For the above purposes, teachers also make full use of the convenience of online course resources, reducing the input of lesson preparation energy.Transfer the right to "control quality" to students.

"A teacher’s classroom work is actually copied from others, and it is easy to find it online. We like this kind of learning to’ not embarrass’ our teacher."(student ZYF).

"Teacher S of Zhejiang University has a set of mature classroom assignments, so it’s no trouble to lead them in, otherwise I will spend a lot of time setting various topics."(teacher ZSJ).

Although this problem will also occur when teaching offline, due to the fact that many teachers constantly enrich the resource library of online class platform in the online class era, it becomes easier and more common to copy courseware, and the problem of "fooling and crossing jobs" at the teaching end becomes more and more serious. When the syllabus, teaching plan and courseware all come from the same channel, the characteristics, adaptability and richness of the course will be greatly reduced, and the enthusiasm of students will also be greatly affected. Under the subtle "collusion" relationship, teachers and students are well aware that "online classes are just a fool’s job", but no one comes to the point. For college students, the feeling of attending classes is just like what they say:"I feel that I went to a TV university."(Students ZYQ, CC, etc.).

4. Students’ selfish departmentalism is constantly misinterpreted.

With the continuous deepening of higher education reform and the continuous expansion of teachers in colleges and universities, the concept of teacher education can not keep up with the pace of reform in time, and teachers’ understanding of student-oriented is lagging behind and biased. On this basis, the concept of hysteresis has affected its teaching practice and gradually penetrated into students’ daily study and life.

Generally speaking, "the academic standard is transferred to the contemporary university practice of students’ subject development" is a generally recognized trend of higher education reform.[24]That is, "to meet people’s needs as the starting point, to develop people’s personality and improve their quality in an all-round way, and to realize people’s all-round sustainable development as the destination"[25]. Student-oriented should be carefully planned on the macro educational curriculum system.[26]However, in the specific online teaching practice,Teachers often only serve, satisfy and cater to students’ needs in the way of education, which further consolidates the inversion of students’ power and the recognition of different chemical habits.

Through investigation, it is found that more and more college teachers’ cognitive deviation from student-oriented is more common, especially in the process of online classes. For example, lecture courses are often not fixed in time. In order to facilitate students, teachers arrange lectures at Tencent meetings, and the interactive atmosphere of students’ lectures is not enthusiastic compared with offline; For various reasons, graduating students forced their tutors to have online tutoring, but the tutors, because of their feelings, agreed to online tutoring even though they knew that the online tutoring was not effective.

"In recent years, many young doctors have been recruited by college teachers. They are inexperienced.Students tend to bargain only with young teachers.Many teachers have just changed from student status, and they are easy to empathize, so they began to reduce the frequency of roll call, reduce the amount of classroom work, and lower the examination standards. "(supervising CGS).

In the long run, students gradually lower their self-standards, from "masters" to "grandfathers", and the control of classroom power is almost out of control.

"The training program requires graduate students to attend more than 6 lectures in the hospital to get corresponding academic credits, but there are many lectures in the college every year. When the seventh session is held, there are not many students coming. Informing students to attend lectures is often very uncooperative, and they all say that they can attend six full lectures and don’t want to listen to one more. They think that the lectures are not attended by them, but the lecturers and teachers are embarrassed, and it is impossible for the college to give them credits. Some students even said,’ I’d like to see if Mr. C won’t give me credit or graduate because we won’t attend our later lectures.’ "(teachers CZW, LCF).

This shows that,Student-oriented doctrine has gradually evolved into a kind of "indulgence" at present.The daily teaching work composed of a series of elements, such as teacher-student relationship, teaching management and curriculum evaluation, has been subverted, and students’ attitude and enthusiasm towards learning has quickly faded. As a college teacher said: "The’ beautiful’ feeling of offline teaching can never be returned."(teacher ZYJ).

V. Discussion and Enlightenment: Ways and means to solve the "difficulty of online courses"

Although there are many students who actively seek learning communities and strictly maintain "good time management and self-monitoring ability" in the Internet age, the proportion of groups is not in the majority, and they have also had a crisis of trust in online learning methods.[27]. Most people can feel that the development of media technology represented by online classes ignores the pursuit of college students’ life dimension and the observation of human subjectivity, and it is difficult to ensure the learning effect and quality of students. This is the crux of the current "online class dilemma" and an indisputable fact.

To solve the "difficulty of online courses", we need to solve it in the following three key dimensions: first, in policy, we should insist on taking teaching content as the foundation, methods as the core and technology as the supplement; Second, in concept, cultivate students’ pursuit of real life dimensions and open up the space-time cognition of campus life; Third, measures should be taken to correct students’ study habits and concepts and correctly integrate into university life.

1. Use media technology as a supplementary means to serve daily teaching.

To solve the problem of alienation of college students’ group learning, the most basic link lies in the further standardization of management dimension.Reverse "technology worship" at the level of educational administrators and teaching practitioners.The solution of this problem is the prerequisite to solve the "difficulty of online courses".

The survey found that many front-line teachers have long realized that the fundamental way to solve the problem of online courses must be through "management mechanism reform".But for ordinary front-line teachers, this "bottom-up" reform road is often full of thorns.

"As a teacher of journalism and communication, I know that the alienation brought by this media technology is subtle, and we are always on the alert for’ technical acculturation’. However, students and colleagues have been internalized, and teaching managers have also been internalized. Then there is nothing we can do. We must adapt to this set of standards and actively seek internalization. "(teacher ZSJ).

Obviously, the chain of acculturation is formed from top to bottom, that is, "educational administrators" influence "teaching practitioners" and then "educated people", and students as educated people have almost no right to "resist acculturation". Therefore, the first condition of "breaking the game" is to break the worship of online classes "from top to bottom" at the conceptual level. Take technology as a supplementary means of daily teaching, solve the "material problem" brought by electronic products as a necessary learning tool and the "virtual KPI puzzle" of "online, punching in and receiving" as an assessment standard, change "teaching from technology to" technology serving people ",and strengthen college students’ perception of daily life and integration with the real society.

In addition, taking technology as an auxiliary teaching method indirectly solves the problem that teachers spend too much energy on learning online course software, expanding online course functions and enriching online course resources, which is helpful to reshape teachers’ professional instinct of cultivating and pecking at course content. When teachers focus on the optimization and perfection of teaching content, and always insist on taking teaching content as the foundation and improving quality and efficiency in connotation construction, the learning style, learning consciousness and learning state of college students will change accordingly, and the teaching effect will return to the original state.

2. Strengthen students’ awareness and perception of the real space.

During the online class,College students’ perception of the real world is reduced,It is easy to form the illusion that "online classes are universities". Therefore, actively remolding college students’ "sense of reality" and "sense of space" has become the core and key to solve the "difficulty of online classes".

"Spatial alienation in the digital media era is mainly manifested in two aspects: First, remote presence not only damages the ability of digital media subjects to feel and understand real scenes, but also weakens people’s ability to empathize with space. Second, remote presence can neither completely replace face-to-face interpersonal communication, nor eliminate loneliness. "[28].

This needs to guide the space consciousness of college students from two aspects. First, cognitively, highlight the consciousness of "classroom". It should be a three-dimensional "house", all the "people" and "things" associated with the curriculum.(including desks, platforms, blackboards, projections, and even air conditioners, monitors, clocks, etc.)Together is an inseparable organic unit in the classroom, and both are indispensable. At the same time, as an extended space connecting the dormitory and the classroom, such as canteens, lakes, grasslands, avenues, shuttle buses, bike-sharing, etc., which pass by after class, are also important components of the course content. As an intermediary between the course and the world, they construct the college students’ ability to perceive and empathize with the real space.

Second, in action,Cultivate the awareness of face-to-face communication between "students and students" and "students and teachers" in the course.In face-to-face communication, people can get a lot of interpersonal information by observing what a person says and does, so as to reduce uncertainty.[29]Compared with CMC mode which relies on the media intermediary of online course platform, it greatly reduces the cost of communication. On the premise of online class as an auxiliary teaching tool, we should adopt the usual assignments such as group Presentation and online topic debate to stimulate communication and dialogue among students, so as to optimize the communication mode. Supplementary training in this way can gradually improve the classroom learning atmosphere, efficiency and effect of college students.

3. Reshape positive and healthy values and benign teacher-student relationship.

It is found that online classes not only increase the hardware cost of using technology and the energy consumption of making virtual accounts for college students, but also provide convenience for college students to lie flat and develop a foolish learning attitude. This further hinders the formation of college students’ positive and healthy values and the maintenance of a benign teacher-student relationship. The key link to solve the "difficulty of online courses" lies in solving these two problems.

Positive and healthy values and benign teacher-student relationship complement each other, and their interaction is the foundation for college students to build mature learning consciousness and cultivate good study habits.

On the one hand, the inversion of teachers’ and students’ power in the online class environment needs to be reversed, and the relationship between teachers and students in the university classroom should return to a two-way dialectical relationship: "This two-way dialectical relationship arises from teachers’ restrictions on students’ action boundaries and students’ resistance, and teachers restrict students’ action boundaries with institutional control."[30]. By regaining the command of classroom discipline, teachers can completely solve the problems of students’ reluctance to open videos, using signal difference as an excuse, copying and pasting homework and so on.

On the other hand, make full use of internet technology as an auxiliary platform to provide sufficient guarantee for supplementary counseling, exercise communication and emotional exchange after class. In this context, technology is no longer an excuse to be lazy and a reason to let go of water, but a "technical supplement" to improve the quality of courses and educational methods, which is conducive to reshaping active and healthy learning concepts and providing full possibilities for the paradigm iteration of college students’ learning methods. The effective solution of the consciousness of lying flat, fooling and crossing jobs in the technical side, the teacher side and the student side can not only alleviate the alienation of the relationship between teachers and students, but also guide students’ learning concepts to return to the track of healthy competition.

More importantly, the positive and healthy values and the benign relationship between teachers and students have always been the "invisible soil" for China’s higher education. The "tree of college students" can grow in fertile soil, which is extremely important and precious for every college student who is full of expectations for the future.

references

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[2] Guo Jianbin, Gao Ruoyue. How many days is always a person facing the screen "lectures"-the communication interpretation of "doing nothing" behavior in online classes [J]. Journalist, 2023 (3): 71-81.

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[12] Zhou Jiteng. From virtual socialization to social virtualization-the change of simulacral order in network society triggered by "meta-universe" [J]. hebei academic journal, 2022,42 (5): 188-195.

[13][ America] James W. Kerry. Communication as Culture: Essays on Media and Society [M]. Ding Wei, translated. Beijing: Renmin University of China Press, 1989: 14.

[14] Guo Jianbin. Understanding and expression: an interpretation of Kelly’s concept of communication ceremony [J]. China Media Report, 2006 (3): 50-59.

[15]Chaney D. The Symbolic Form of Ritual in Mass Communication[M]// Golding P,et al.,eds., Communicating Politics:Mass Communications and the Political Process. New York:Holmes & Meier Publishers,1986:117.

[16]Couldry N. Media Rituals:A Critical Approach[M]. London and New York:Routledge,2003:29.

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[19]Pianta R C,Hamre B K,Allen J P. Teacher-Student Relationships and Engagement:Conceptualizing,Measuring, and Improving the Capacity of Classroom Interactions[M]// Christenson S L,Reschly A L,Wylie C,eds.,Handbook of Research on Student Engagement. MA:Springer,2012:365-386.

[20] Ding Yuting, ZhangChang, Li Ranran, et al. The mechanism of positive common experience to promote the relationship between teachers and students: the intermediary role of emotional connection [J]. Journal of Psychology, 2023,55 (5): 726-739.

[21] Cao Zhiwei, Zhu Yun. Perceptual suspension: emotional generation, participation logic and communication mechanism of Olympic network audience [J]. journal of shanghai university of sport, 2023,47 (3): 12-25.

[22] Lu Wenting, Zhang Lin, Mou Yi. The construction of flat culture in the digital age: based on the perspective of youth subculture [J]. Journalist, 2023 (6): 70-85.

[23]Seeman M. Alienation Motifs in Contemporary Theorizing:The Hidden Continuity of the Classic Themes[J]. Social Psychology Quarterly,1983,46(3):171-184.

[24] Wang Yijun. The proposition and significance construction of "freedom of development" in contemporary universities [J]. higher education development and evaluation, 2021,37 (1): 6-19+113.

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[26] Wan Ailian. Changes in China’s undergraduate teacher education curriculum system in the 40 years of reform and opening up [J]. Journal of Hebei Normal University (Education Science Edition), 2018,20 (3): 27-32.

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This article comes from WeChat WeChat official account:ID:china-youth-study (ID: China-youth-study), Author: Cao Zhiwei (Lecturer, School of Journalism, Nanjing University of Finance and Economics)

Ten Questions and Ten Answers on the Reform of Medical Insurance Account: How to Protect the Benefits of Retirees by Outpatient Mutual Aid

  At the beginning of this year, many places began to start the reform of employee outpatient mutual aid security. This system, which concerns the interests of 354 million medical insurance participants, requires that the payment of benefits be tilted towards retirees. By the end of 2021, there were 93.24 million retired employees in the basic medical insurance system for employees.

  At present, 31 provinces, autonomous regions, municipalities directly under the Central Government and Xinjiang Production and Construction Corps have issued documents to improve the mutual aid guarantee mechanism for local employees’ medical insurance clinics. Among them, many provinces and cities stipulate that the outpatient payment limit and payment ratio of retirees are higher than those of on-the-job employees.

  Even so, among the public opinions received by local medical insurance departments, retirees think that "after the reform, the level of treatment has decreased due to the reduction of the amount of personal accounts", accounting for the majority.

  In the policy explanation, the medical insurance departments in many places clearly stated that after the reform, the personal accounts of most insured persons will be reduced in the current period. At the same time, they also used specific data and cases to explain to the public that for retirees who suffer from chronic diseases at their own expense, the benefits of outpatient mutual aid far exceed the reduction of personal accounts, often by reducing hundreds of yuan, reimbursing thousands or even thousands of yuan.

  Medical insurance bureau, Hunan Province, said in "Interpretation of Policies on Improving Personal Accounts of Retired Workers" that the outpatient mutual aid mechanism is to use the law of large numbers to resolve the risks of social groups. The number of personal accounts for medical insurance is different from that of individuals at present, but in terms of system, mutual aid guarantee has a more risk prevention function. Workers’ medical insurance is not only a personal account and general outpatient co-ordination, but also a series of policies such as outpatient treatment of chronic and special diseases and hospitalization treatment, which constitute a complete security system.

  A few days ago, CBN interviewed many experts in the industry on the hot issues of personal account reform of medical insurance that the public cares about. Experts generally believe that the medical insurance personal account has completed its historical mission for more than 20 years and its limitations are gradually becoming prominent. It is the general direction to gradually replace the personal account with outpatient mutual aid according to the principle of "rights replacement".

  This is a reform that affects the whole body. In the long run, the insured will benefit from the reform, but in the short term, the interests of some people will be damaged. How to improve the supporting mechanism to make the insured more sense of acquisition is a key issue that must be paid attention to in the next step of reform.

  CBN also learned from relevant departments that some targeted measures are being introduced one after another, for example, in order to facilitate patients to enjoy treatment nearby, support patients to settle accounts and dispense medicines in designated retail pharmacies with prescriptions, enjoy the same reimbursement treatment as those in medical institutions, and explore the inclusion of qualified "internet plus" medical services in the scope of protection to improve the convenience of enjoying treatment.

  Q: At the beginning of this year, the reform of outpatient mutual aid was launched in many places. In some areas, retirees reported that the funds in personal accounts of medical insurance were reduced, which affected the daily cost of buying medicines. The reform of outpatient mutual aid is inclined to the elderly, but why do the elderly think that their interests are damaged?

  Zhu Minglai (Director, Health Economy and Medical Security Research Center, Nankai University)The original intention of this reform is to hope that the sick and the elderly with poor health can have more benefits, rather than harming their interests.

  It is believed that only a part of the elderly people have their interests damaged, which does not mean all the elderly people. Different groups of people have different demands. At present, people who feel that their interests are damaged are mainly elderly people who usually have minor illnesses. The funds in personal accounts can cover their daily expenses for buying medicines and seeing a doctor. If the funds in personal accounts decline, it will have an impact on their daily medical payment; However, for the elderly who suffer from chronic diseases, need to take medicine for a long time and go to the clinic for medical treatment, the funds in his personal account are not enough. According to the previous policy, after spending the funds in his personal account, the outpatient expenses have to be paid at his own expense. Therefore, for the elderly with higher outpatient expenses, the benefits will not be damaged, but a higher reimbursement level will be obtained.

  It is also mentioned in the policy interpretation of "Detailed Rules for the Implementation of Wuhan Employees’ Basic Medical Insurance Outpatient Mutual Aid Security" that the insured Zhou, a retired person, is 68 years old, with an annual pension income of 50,000 yuan. Before the reform, his personal account was transferred to 2,400 yuan every year. Suffering from cerebral infarction, I went to the outpatient department of a tertiary hospital for medical treatment. This year, I incurred a reimbursable expense of 7,150 yuan. If I reimbursed according to the outpatient co-ordination policy, excluding the threshold fee of 500 yuan, I can reimburse (7,150-500) yuan * 60% = 3,990 yuan according to the reimbursement ratio of 60% in tertiary hospitals. Although Zhou’s personal account was less than 1404 yuan after the reform, he enjoyed more than 2586 yuan.

  twoQ: In April 2021, the State Council issued the guiding opinions on the reform of outpatient mutual aid, and the local authorities received many public opinions when formulating implementation rules and popularizing policies. For example, the Hunan Provincial Medical Insurance Bureau said that the public opinions received recently focused on reflecting that "the level of treatment after the reform has declined", especially for retired employees whose original personal accounts were included in the annual level of more than 2,900 yuan. In your opinion, what problems do retirees’ concerns about the reform of outpatient mutual aid reflect?

  Lou Yu (Professor, School of Civil and Commercial Economics, China University of Political Science and Law, Director of Institute of Social Law)Since the basic medical insurance system for employees was fully implemented in China in 1997, personal account has been an important medical insurance system. Not only have many structural systems become path-dependent, but the reform of one of them will "affect the whole body", and in the short term, the reform will harm the interests of some people. How to make reasonable compensation for those who have lost interests is also a major event related to the success or failure of the reform.

  The reform plan of outpatient mutual aid is to reduce the funds remitted by retired insured persons into their personal accounts every month, and the saved funds are used for outpatient serious illness co-ordination. This plan is in line with the development direction of medical insurance, and its original intention is very good, but it is very important to consider the details comprehensively in implementation, which may affect the insured persons’ acceptance of the reform and the effect of the reform. The first thing is that publicity must be in place. After all, personal accounts have existed for more than 20 years. Although the nature of their personal property has not been written into the law, it has formed a basic consensus in the whole society. Secondly, supporting measures must be kept up in time, such as increasing the allocation of common diseases drugs in primary medical institutions, making insured people run less, improving the convenience of the system and reducing personal burden.

  threeQ: Some netizens said that "the personal account has been transferred less, ‘ Lose money ’ ",for individuals, medical costs will increase because of this reform?

  Liao Zangyi (Associate Professor, School of Politics and Public Administration, China University of Political Science and Law)Generally speaking, for individuals, their medical costs will not increase because of this reform. Everyone should calculate both small accounts and big accounts. After the reform, the overall planning fund has been strengthened, and after illness, it can be reimbursed through the overall planning fund. Everyone helps each other and the protection will be more adequate. It is necessary to calculate both immediate accounts and long-term accounts. Everyone is old and sick sometimes. Although young and healthy people don’t see many doctors now, the economic risks brought by diseases exist for a long time. Everyone should also look at the difference between income mechanism and insurance mechanism rationally. Under the big framework of social medical insurance, the funds in personal accounts are "medical expenses", not salary income or welfare. When people are old and sick, it is always limited to rely on personal accounts and personal accumulation. All of them need solid and sustainable medical insurance to realize social mutual help and help to resolve the disease risk, and they will benefit from this reform in the long run.

  Guangdong Medical Insurance Bureau mentioned a case in the Q&A on the reform of outpatient mutual aid guarantee mechanism, which showed that Hua Jie, a retired employee, paid more than 480 yuan for lung CT in November 2022, and paid for it in full. After the implementation of outpatient mutual aid in Guangzhou, Sister Hua recently went to the hospital for CT and found that she only had to pay more than 140 yuan for the same project, and the overall fund paid 70%.

  According to the calculation of Hunan Medical Insurance Bureau, after the reform, the maximum payment limit of the on-the-job employee pooling fund is 1,500 yuan, and the maximum payment limit of the retirees pooling fund is 2,000 yuan. In 2021, the province’s annual per capita personal account fund income was 1,727 yuan/person, and the personal account fund expenditure was 1,438 yuan/person. At present, the payment limit determined by the general outpatient co-ordination policy, plus the amount transferred from the personal account, can basically meet the outpatient medical needs of the insured.

  Four questions: China’s personal accounts have existed for more than 20 years. Why should we start the reform of outpatient security including personal accounts recently?

  Lou Yu:The original intention of the medical insurance personal account system design is to hope that the insured can share the risk of outpatient expenses through long-term accumulation, that is, pay more to the personal account when they are young, but not when they are old, and the medical insurance account is used to pay for outpatient expenses. However, this original intention has not been well realized in practice: the insured people tend to be short-sighted, and a large amount of funds have accumulated in their personal accounts, which has caused high moral hazard, which not only doubled the pressure of supervision, but also limited funds in each insured person’s account, which can only be used to pay small outpatient expenses, and the high outpatient expenses cannot be paid, which is also inconsistent with the principle of "ensuring the big but not the small" in medical insurance, and unfair to insured patients who really need to rely on the medical insurance system to solve high expenses. Therefore, there are many criticisms about personal accounts in medical insurance practice, and all sectors of society are actively seeking reform plans for accounts.

  Once any system is fixed, it will be very difficult to reform, because any reform is a redistribution of interests. It is easy to reform a specific system, but a comprehensive and comprehensive evaluation of the system and a systematic solution to the problem test the wisdom of the reformers. No matter from the medical insurance practice in China or the system implementation in other countries, it is difficult for a purely accumulated personal account to play the role of the law of large insurance numbers, and it is impossible to share the disease risk and help the funds in a larger scope. It has reached a social consensus that personal account funds should be used for the overall planning of high outpatient expenses, which should be the general direction of reform. However, this reform needs a systematic system design, and necessary supporting measures must be introduced in time to reduce the proportion of medical insurance account allocation.

  Five questions: The reform of outpatient co-ordination is a systematic project, in which reducing the funds allocated by personal accounts should be the simplest to operate, but if the supporting policies can’t keep up, there may also be cases of damage to rights and interests. In your opinion, the outpatient mutual aid system should really protect the interests of the insured, which supporting reforms are indispensable?

  Zhu Minglai:I think one of the important reasons why some retirees are concerned about the reduction of personal account funds is that some supporting policies have not kept up in time. The biggest supporting policy of outpatient mutual aid reform is medical care and medicine, such as the accessibility of medical services. Some elderly people have reported that things that could be solved by taking medicine and swiping cards at pharmacies are now going to the hospital. If he does not trust the first-and second-level hospitals, he may have to queue up for a long time at the third-level hospitals. And sometimes when you get to the hospital, the hospital may be short of medicine, and you have to go to the pharmacy to get medicine. This will add a lot of burden to the elderly in running errands.

  This is also the direction to further improve the supporting policies. Specifically, efforts can be made in three aspects: First, support patients to settle accounts and dispense medicines in designated retail pharmacies with external prescriptions, enjoy the same reimbursement treatment as in medical institutions, and give full play to the convenience of designated retail pharmacies. The second is to explore the inclusion of qualified "internet plus" medical services in the scope of protection, so as to improve the convenience of enjoying treatment. The third is to explore and promote the circulation of electronic prescriptions to better solve the needs of drug purchase settlement.

  Six questions: The level of economic development and welfare varies from place to place, so does the level of outpatient co-ordination. If the overall level of outpatient service in a region is relatively low, can it make up for the welfare loss caused by reducing the funds in personal accounts?

  Liao Zangyi:Local governments will encounter some difficulties in establishing outpatient co-ordination. First, the medical insurance information system should keep up, and all designated pharmacies in the co-ordination area should be opened to ensure that patients can enjoy real-time settlement without manual reimbursement. Secondly, medical insurance supervision and intelligent audit should keep up. After the outpatient service is improved, many people will definitely try their best to gain benefits by reselling drugs, which puts forward higher requirements for the refined management and intelligent monitoring of medical insurance.

  For the welfare loss that may be caused by the low level of overall planning, we can start from three aspects. First, after the implementation of the outpatient mutual aid system, the deductible line for outpatient reimbursement should be appropriately reduced, and the proportion of reimbursement can be appropriately increased. This needs to be dynamically adjusted by the medical insurance department through actuarial science to effectively enhance the people’s sense of gain; Second, the coverage of outpatient mutual aid should be improved, from the existing two diseases, renal dialysis, outpatient radiotherapy and chemotherapy, etc., and gradually expanded to most diseases can enjoy reimbursement treatment to reflect fairness; Third, we can refer to the guarantee policy of hospitalization treatment. If the insured person’s annual outpatient expenses exceed a certain proportion, it can be classified as large medical expenses, and should be guaranteed twice or matched with the corresponding bottom-up mechanism.

  Seven questions: Many retirees are used to going to designated retail pharmacies to buy medicines. After implementing outpatient mutual aid, what support measures are there for designated retail pharmacies?

  Zhu Minglai:The reform puts forward that the drug guarantee service of qualified designated retail pharmacies should be included in the scope of outpatient service, and the payment of the overall fund should be extended to qualified designated medical insurance pharmacies, with the purpose of facilitating patients to submit reimbursement nearby and reducing the cost burden. Insured patients can only use personal accounts to pay for drugs purchased at designated retail pharmacies. After the reform, they can use personal accounts or enjoy reimbursement from the overall fund with external prescriptions. According to the relevant data, since the implementation of the reform, the scale of personal accounts used in designated retail pharmacies has increased, which also shows that pharmacies have benefited from the reform measures such as personal accounts helping families and expanding the scope of personal accounts.

  However, we can’t ignore the violation of laws and regulations in the operation of designated retail pharmacies. For example, it is very common for some city pharmacies to use medical insurance funds to pay for health care products and daily necessities. We must strengthen supervision over this kind of misappropriation and application of medical insurance funds.

  Eight questions: after the implementation of outpatient mutual aid, will it increase the number of hospital outpatients and labor costs?

  Liao Zangyi:In the short term, it may increase the number of outpatients in hospitals, such as many minor illnesses such as colds and coughs. Before the reform, many patients will carry on and recover by their own immunity, which can save money after all. After the reform, considering that medical insurance can be reimbursed, some people will have the mentality of "not spending money and not spending money", and there is indeed a risk of increasing the number of hospital outpatients and labor costs in the short term, but with the passage of time, after the market gradually returns to rationality, this phenomenon will gradually fall back to the state before the reform.

  Question 9: What is the nature of the funds in the medical insurance personal account?

  Lou Yu:According to the Decision on Establishing the Basic Medical Insurance System for Urban Workers promulgated by the State Council in 1998, the combination of social pooling and individual accounts is the basic principle of basic medical insurance for employees. The principal and interest of individual accounts are owned by individuals and can be carried forward and inherited. This is the basis for the general public to believe that the legal nature of personal accounts is personal property. However, this decision has a low legal rank, and it is not an administrative regulation with external legal effect. It is only a normative document for building a medical insurance system within the administrative organs of people’s society, and it has only guiding significance for the provisions on the nature of individual accounts. The Social Insurance Law promulgated in 2010 didn’t stipulate the unified account as the financing principle of basic medical insurance, and didn’t stipulate the legal nature of individual account, which is considered that legislators don’t recognize the financing rules and payment methods of individual account, leaving enough room for future reform.

  Question 10: The Social Insurance Law promulgated in 2010 did not mention the personal account of medical insurance. Does it mean that the general direction of future reform is to replace the personal account with the outpatient mutual aid guarantee mechanism?

  Liao Zangyi:The general direction of future reform can consider gradually reducing personal accounts until they are cancelled. On the one hand, gradually reduce or stop the proportion of unit contributions to individual accounts; On the other hand, gradually abolish the regulation that individual contributions are transferred to individual accounts, and include individual contributions in the overall fund, such as establishing outpatient mutual aid system. Although there may be great resistance in actual operation, in fact, some areas have already tried this method and achieved good results.