Pharmaceuticals

Wed, 03/03/2010 - 12:41

In this week's guest column, Quan Yun, a doctor from Jinan Traditional Chinese Medicine (TCM) Hospital in Shandong Province, discusses the guidelines for the trial public hospital reform issued in late February this year. Translated from the original Chinese by Yu Chenxi and Zhao Yimin.

Shanghai. March 3. INTERFAX-CHINA - In recent years, support for the public hospital reform has risen significantly, becoming a key focus of China's health care policy.

Public hospitals, initially established by the government to ensure public welfare, have increasingly functioned as business entities on the back of insufficient government investment. The profit-oriented mode of operations in public hospitals consequently created a bottleneck in the development of public hospitals.

To date, the guidelines for the trial public hospital reform issued on Feb. 23 this year have provided the best answer to the question of how the government will keep medical expenditures low and also improve health care services at the same time.

1. Does the public have to worry about price hikes of health care services in hospitals?

The public does not have to worry about price hikes because government investment will be a key economic support to hospitals. The guidelines officially announced that the government will work to abolish hospitals' heavy reliance on drug revenue. Drug price markups as a source of hospital income will be eliminated. In the future, the sources of income for hospitals will comprise of medical service fees and to a larger extent, government subsidies. 

2. Do doctors have to worry about their income?

The guidelines listed 16 pilot cities to carry out the trial public hospital reform. Following the reform, it can be expected that China's public hospitals will become less profit-oriented and be more centered on public welfare.

With the removal of drug price markups, the government will raise medical treatment fees in hospitals and more importantly, increase government investment and subsidies in public hospitals as a key measure to ensure that public hospitals protect public welfare and guarantee doctors' income. In my opinion, this would be the right thing to do.

3．Will the public hospital reform threaten the survival of private hospitals? 

One of the aims of the health care reform is to improve the level of public welfare offered by public hospitals so that more of the general public can afford to seek treatment in public hospitals.

According to the guidelines, private hospitals will receive relatively similar treatment as public hospitals although naturally the government will grant lesser financial support to private hospitals. The guidelines also mention that the government will make way for private hospitals to provide public health services and will accordingly subsidize private hospitals in return. The government will also further expand the tax preferential policies targeted at private hospitals in the meantime.

In my opinion, the reform will introduce new challenges to private hospitals but this will be beneficial in the set up of an efficient health care infrastructure as it prevents the distribution of medical resources to incompetent private hospitals. The reform will also enable the better administration and supervision of medical services as well as regulate competition among hospitals.

4. Will waiting time at public hospitals be prolonged after the public hospital reform?

There are concerns that as the reform will encourage more persons to seek treatment at public hospitals, the already-limited medical resources will be stretched and result in longer waiting times for treatment.

As I see it, the public should not be overly worried about this. First, the health care reform by itself is a means for China's public hospitals to explore ways to grow into a more advanced health care infrastructure. In addition, the guidelines have helped to clarify the roles of all levels of public hospitals as well as stipulate that the central and provincial governments will be responsible for the set up of national and provincial medical centers for the diagnosis and treatment of difficult-to-treat and severe diseases, medical research and education.

Besides, the total number of public hospitals in China, currently standing at 14,000, will be increased after the health care reform. An important development trend in China's health care system will be to direct patients with minor ailments to community health institutions while patients with severe diseases will be treated at large hospitals.

The above is a personal opinion piece by the author. Its publication in no way implies that Interfax shares the views expressed in the article.