Need for qual­ity health­care na­tion­wide

China Daily (Canada) - - VIEWS -

Although it’s too early to eval­u­ate the ef­fects of Bei­jing’s med­i­cal care re­form, the first three weeks’ trial since April 8 seems to have met peo­ple’s ex­pec­ta­tions. The main goal of the land­mark med­i­cal care re­form is to change the un­healthy prac­tice of hos­pi­tals’ “cov­er­ing their ex­penses with medicine rev­enue”.

Two ma­jor goals of the lat­est re­form are to abol­ish the price markup of drugs and ex­am­i­na­tion fees in pub­lic hos­pi­tals and other es­tab­lish­ments that pro­vide med­i­cal care, as well as to re­place the hospi­tal regis­tra­tion and di­ag­nos­tic fees with med­i­cal ser­vice fees. The first goal is aimed at re­duc­ing the out­pa­tient fees by about 5 per­cent, which might pro­duce im­me­di­ate re­sults as long as the mea­sure is strictly im­ple­mented.

Ac­cord­ing to Bei­jing Mu­nic­i­pal Com­mis­sion of Health and Fam­ily Plan­ning, in the first two weeks since the launch of the lat­est re­form, the to­tal amount ac­cu­mu­lated through the drug sun­shine pur­chas­ing plat­form was 2.87 bil­lion yuan ($416.55 mil­lion), which means the com­bined savings of pa­tients dur­ing the pe­riod was 240 mil­lion yuan, or 8.4 per­cent of the to­tal drug ex­pen­di­ture.

The sec­ond goal, how­ever, is not lim­ited at rais­ing the doc­tors’ in­comes in or­der to do away with the model of “cov­er­ing ex­penses with medicine rev­enue” of hos­pi­tals. An im­por­tant goal of the move is to make pa­tients adopt the hi­er­ar­chi­cal med­i­cal sys­tem so as to op­ti­mize the health­care re­sources.

The newmed­i­cal ser­vice fees are not sim­ply an in­crease in the tra­di­tional med­i­cal regis­tra­tion and di­ag­nos­tic fees, as they dif­fer from one hospi­tal to an­other. In the gen­eral out­pa­tient de­part­ments of Bei­jing’s top pub­lic hos­pi­tals, the med­i­cal ser­vice fees varies from 50 yuan (of which 40 yuan is paid by the ba­sic med­i­cal in­sur­ance com­pany) to 100 yuan.

Pre­vent­ing the waste of qual­ity health­care re­sources is a big chal­lenge for the med­i­cal care re­form. In big cities, peo­ple gen­er­ally tend to go to top pub­lic hos­pi­tals even if they have a cold. Since the ear­lier med­i­cal regis­tra­tion and di­ag­nos­tic fees were rel­a­tively cheap and the dif­fer­ence in the cost of con­sult­ing a spe­cial­ist and a grass­roots ju­nior doc­tor was less than 10 yuan, the pa­tients’ choice was rea­son­able.

There­fore, the author­i­ties have rightly used the new med­i­cal ser­vice fees to achieve pa­tient dis­tri­bu­tion. Ac­cord­ing to Bei­jingMu­nic­i­pal Com­mis­sion ofHealth and Fam­ily Plan­ning, in the past fort­night the num­ber of emer­gency treat­ments in Bei­jing’s top hos­pi­tals fell by 13 per­cent on a year-on-year ba­sis, while in grass­roots community med­i­cal treat­ment cen­ters, they in­creased by 8.3 per­cent.

But de­spite the med­i­cal author­i­ties claim­ing that hos­pi­tals no longer cover their ex­penses with medicine rev­enue, the health­care re­form still has to solve many prob­lems. One of these prob­lems is the un­changed num­ber of pa­tients vis­it­ing spe­cial­ized hos­pi­tals, es­pe­cially the top ones. Me­dia re­ports say the num­ber of pa­tients seek­ing treat­ment in Bei­jing Cancer Hospi­tal’s out­pa­tient depart­ment in the first week since the launch of the re­form was sim­i­lar to that in the same pe­riod last year. That such pa­tients are “in­sen­si­tive” to the change in med­i­cal ser­vice fees in­di­cates an­other sig­nif­i­cant is­sue: in­suf­fi­cient and un­bal­anced health­care re­sources na­tion­wide.

Known as the “na­tional med­i­cal treat­ment cen­ter”, Bei­jing at­tracts most non-lo­cal pa­tients than any other city from across the coun­try be­cause it has many top qual­ity health­care cen­ters and re­sources. As a city which has the high­est num­ber of top-level hos­pi­tals and ex­cel­lent doc­tors, Bei­jing draws 700,000 non-lo­cal pa­tients to its hos­pi­tals ev­ery day ac­cord­ing to the Na­tion­alHealth and Fam­ily Plan­ning Com­mis­sion’s es­ti­mates in 2013.

And since most of these pa­tients seek good-qual­ity med­i­cal care for se­ri­ous ill­nesses, they are less sen­si­tive to the change in med­i­cal ser­vice fees for lo­cal pa­tients, which should prompt pol­i­cy­mak­ers and re­form­ers to make more ef­forts to pro­vide good qual­ity health­care across the coun­try in or­der to meet the gen­eral pub­lic’s de­mand.

The au­thor isawriter with China Daily. wangy­iqing@ chi­

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