Beijing puts public before profit with health reform blueprint
Josephine Ma and Zhuang Pinghui 7 April 2009
Beijing has released the long-awaited blueprint on health care reform in an attempt to turn a profit-obsessed medical system into a public service.
The 13,000-word reform plan underscores the responsibility of the government in ensuring accessible and affordable public services to all 1.3 billion people on the mainland.
Its short-term goal is to provide basic insurance coverage to 90 per cent of residents; provide affordable medicines; and establish a network of rural and urban clinics by 2011.
While the blueprint contained few new policies, it set the tone for medical reform in coming years.
The plan said: “The government’s responsibility in the basic health care system will be strengthened and the government should step up its responsibility in planning, financing, serving and supervising to guarantee the non-profit nature of public health care and promote equality.”
The aim is to provide a comprehensive system offering basic health care, drugs and medical insurance by 2020. Supporting documents are expected to be released in the coming months, according to analysts.
Zhong Nanshan, director of the Guangzhou Institute of Respiratory Disease and a government consultant, said: “There will be a national health care conference in April and I think more concrete details as to how the reforms should be implemented will be released after the meeting.”
Public hospitals and medical institutes will be the mainstay of health care providers, while the government will “appropriately” increase the proportion of private hospitals. The plan stated the government would encourage private and charity hospitals, but no details were given.
One of the key tasks is to turn cash-hungry public hospitals into public hospitals in the real sense.
Public hospitals, although owned by the government in name, became obsessed with profit-making after the previous round of medical reform in 1992. This resulted in soaring medical bills and much public anger.
A Xinhua commentary said yesterday the medical system became too market-oriented under the open-door policy.
“Although more beds are provided to patients, and while the technology of hospitals and quality of doctors were greatly enhanced through competition ... it also resulted in a decline in fairness and efficiency.”
The blueprint appears cautious about reforming hospitals, but bold steps will be taken in building rural and community clinics.
On medical insurance, the central government hopes to narrow the huge differences in benefits that are provided by various medical insurance schemes, and gradually extend coverage to outpatient services. The blueprint also pledges to resolve problems hindering rural migrant workers from enjoying medical insurance, such as allowing them to transfer their insurance accounts when they move cities.
In an attempt to boost the role of commercial medical insurance, the government will promote the practice of buying medical insurance from commercial insurers.
In terms of cutting costs, the government has made a list of basic drugs, and their manufacturers will be appointed by the government through public bidding. The central government will set the price range for basic drugs, and provincial governments will fix prices within the ranges. The prices of basic medical services provided by hospitals will also be decided by the government.
But Huang Jianshi, dean of continuing education at Peking Union Medical College, said it was more important to overhaul the distorted price system of charging excessively for medicine while keeping the values of medical consultations and services unreasonably low.
The government also promised to strengthen its supervisory role in insurance and hospital operations. A major criticism of the government is poor supervision of hospital operation and the integrity of medical practitioners, as many hospitals are owned by the authorities.
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Beijing puts public before profit with health reform blueprint
Josephine Ma and Zhuang Pinghui
7 April 2009
Beijing has released the long-awaited blueprint on health care reform in an attempt to turn a profit-obsessed medical system into a public service.
The 13,000-word reform plan underscores the responsibility of the government in ensuring accessible and affordable public services to all 1.3 billion people on the mainland.
Its short-term goal is to provide basic insurance coverage to 90 per cent of residents; provide affordable medicines; and establish a network of rural and urban clinics by 2011.
While the blueprint contained few new policies, it set the tone for medical reform in coming years.
The plan said: “The government’s responsibility in the basic health care system will be strengthened and the government should step up its responsibility in planning, financing, serving and supervising to guarantee the non-profit nature of public health care and promote equality.”
The aim is to provide a comprehensive system offering basic health care, drugs and medical insurance by 2020. Supporting documents are expected to be released in the coming months, according to analysts.
Zhong Nanshan, director of the Guangzhou Institute of Respiratory Disease and a government consultant, said: “There will be a national health care conference in April and I think more concrete details as to how the reforms should be implemented will be released after the meeting.”
Public hospitals and medical institutes will be the mainstay of health care providers, while the government will “appropriately” increase the proportion of private hospitals. The plan stated the government would encourage private and charity hospitals, but no details were given.
One of the key tasks is to turn cash-hungry public hospitals into public hospitals in the real sense.
Public hospitals, although owned by the government in name, became obsessed with profit-making after the previous round of medical reform in 1992. This resulted in soaring medical bills and much public anger.
A Xinhua commentary said yesterday the medical system became too market-oriented under the open-door policy.
“Although more beds are provided to patients, and while the technology of hospitals and quality of doctors were greatly enhanced through competition ... it also resulted in a decline in fairness and efficiency.”
The blueprint appears cautious about reforming hospitals, but bold steps will be taken in building rural and community clinics.
On medical insurance, the central government hopes to narrow the huge differences in benefits that are provided by various medical insurance schemes, and gradually extend coverage to outpatient services. The blueprint also pledges to resolve problems hindering rural migrant workers from enjoying medical insurance, such as allowing them to transfer their insurance accounts when they move cities.
In an attempt to boost the role of commercial medical insurance, the government will promote the practice of buying medical insurance from commercial insurers.
In terms of cutting costs, the government has made a list of basic drugs, and their manufacturers will be appointed by the government through public bidding. The central government will set the price range for basic drugs, and provincial governments will fix prices within the ranges. The prices of basic medical services provided by hospitals will also be decided by the government.
But Huang Jianshi, dean of continuing education at Peking Union Medical College, said it was more important to overhaul the distorted price system of charging excessively for medicine while keeping the values of medical consultations and services unreasonably low.
The government also promised to strengthen its supervisory role in insurance and hospital operations. A major criticism of the government is poor supervision of hospital operation and the integrity of medical practitioners, as many hospitals are owned by the authorities.
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