Hospital reform for health of the nation
- Source: Global Times
- [01:54 February 05 2010]
- Comments
Fear of being sick is shadow haunting almost every Chinese, despite the continuing rise in individual income.
Medical expenses can easily bankrupt a family. Worse, people have lost confidence in the medical services provided by public hospitals.
The consensus is that the medical reform initiated in the 1990s was a failure. A new round of reform will kick off this year with pilot projects being conducted in 16 select hospitals nationwide.
This month the State Council stressed that public hospital reform should stick to the direction of "being public," which seems to hint at the desire to correct the profit-driven orientation of the previous medical reform.
During the previous reform, public hospitals were encouraged, as business entities, to seek profits.
It was believed that profits would be incentives to expand availability of medical services. The proportion of government funding has been steadily declining over the years. In the mean time, with privately-run hospitals being restricted, public hospitals remain the only option for a majority of Chinese.
When hospitals become profit-driven, doctors begin sacrificing their mission of serving patients. Over-prescription of drugs and taking bribes both from patients and pharmaceutical representatives become routine. Affordable but effective medicines disappear from the hospital pharmacy and small clinics are threatened with extinction. The result is soaring medical expenditure beyond the means of the majority.
Like other sectors, public hospitals are affected by deteriorating services due to inadequate supervision and loss of moral responsibility. And the media is not short of miserable stories such as a patient being sent to a funeral house alive because the family couldn’t afford the hospital bill.
When patients cannot afford to access basic medical treatment and have to wait for death passively, it is a blot on the economic miracle the government proclaims with such pride.
Providing universal coverage of basic medical care is the obligation of every state. The tricky part is how the program should be run. Should it be run by the government or left to market forces?
The US approach, which relies on commercial insurance companies to fund the healthcare system, has left a large section of the population uncovered. Yet public hospital systems have to solve the problem of maintaining efficiency and fairness, while keeping costs under control.
In the public hospital reform guidelines released by the State Council Tuesday, hospitals will be banned from deducting a percentage from medicines sold. Eventually, payments for medical treatment and government funding will become their main source of sustenance. Hospitals are already crying hoarse about the huge deficit they will run into and are asking for a massive subsidy.
Hospital reform is a challenge to the government. Yet, to delay or avoid reform is not an option.
