introduction to the chinese medical ecosystem
TRANSCRIPT
Introduction To The Chinese Medical
Ecosystem
For Wellness333.com Specialists
YC Xia www.wellness333,com
Chinese Medical Ecosystem in Brief
Structure
Main Actors
Coverage
Financing
More……
Medical Service in China – Structure
Principally a network of hospitals each bear a national grading based on level of facilities, functions, technology advancement and specialties: I, II, III –reviewed periodically
Mostly public with increasing number of private institutions, few individual clinics
Continuous evolution and reform of the medical regime
Government supervision and centralized guidelines
Provincial implementation with certain autonomy
Medical Ecosystem in China – Main Actors
Hospitals & Doctors
Health Bureau
Pharmaceuticals Companies
Patients
Aid Station & Clinics
Drug Administration
Medical Service in China – Coverage 1
Basic medical coverage
o 全民基本医保≈Sécurité Sociale en France≈Medicare & Medicaid
Implemented not until 2012
One patient paid 30000 € of medical expense in 2009 for leukemia treatment, her medical coverage started in 2010 and received 15000 € reimbursement
Medical Service in China – Coverage 2
Private medical insurance offers exist, especially for
critical illness
Mostly capped for reimbursement amount, patients always
need to pay a portion
Reimbursement level varies according to regime for both
private & public
Medical Service in China – Financing Model
• Medical institutions receive limited public subsidies due to
fiscal burden
• 50% of total medical expenses on medication (vs. 20% in
other countries)
• Extremely low consultation charge <1 € to 10 €
• Funding model: 以药补医 (Medicine sales subsidize consultation)
Breakeven Insufficient public funding
Government permitted additional
income channels
Medical Service in China – To Improve
Medical service providers improperly leverage information
asymmetry advantage over patients
– Over-prescribe medication
– Advise costly treatments that are not strict necessity
Overall low satisfaction from patients both low and high
income, increased accidents and conflicts
Doctor-Patient mistrust cooperation
Medical Service in China – Doctors Dilemma
• Doctors - overwhelming majority state employed at public
hospitals
• Low base salary(<1000€) + variable bonus + commission on
prescribed medicine and additional income from surgery
which represent major portion
• Medical responsibility insurance has just started to develop,
most doctors bear their own accident risk --pay out of their own
pocket for accident settlement
How We Fill the Gap
Peer pressure does help improve treatment –experience
showed over 52% patients had their treatment modified after
obtaining a second medical opinion
Clear and structured audit trail of doctor/patient exchange
Provide impartial and tailored second medical advice –
empower the patient and his family
What Patients May Expect
Doctor, don’t hesitate to give frank advice!
Is my treatment
appropriate?
Do I need this operation
now?
What is the secondary effect of this medicine?
Can it be a medical
accident?
……
……
Key Elements of Patient/Doctor Exchange
Doctors are experts in diseases
Patients are experts of their own body