China Healthcare Reform; More Sun, Less Bear with a Flashlight

Dan Harris of China Law Blog  is hosting a guest post on China Healthcare by Micah Schwalb who has his own blog, Boulder2Beijing.

Micah generously links to several of our posts during the course of his article.    I implore you to read his post - it is very good.  Then read my response, which is in the comments section of the China Law Blog article, and is also reproduced below.

Micah,

Thank you for writing this article, and for linking up.  I have a few additions I’d like to share.

On the healthcare reforms;

You correctly point out that the Chinese healthcare plan is no cure, but I do think that the efforts of China’s health reformers are more “true day light” and less “bear holding a flashlight in the tunnel”.

Although 20 dollars may seem like a paltry sum, this is nearly 20 times what many rural Chinese residents used to receive each year, per family.  It is also enough to pay for several doctors visits per year: payments for a check up cost as low as 10 yuan per person in many hospitals.

You are correct about the sometimes lesser trained doctors in rural areas but it bears pointing out that a lack of top-notch rural physicians is a problem everywhere in the world and China’s problems are by no means  unique.  If this plan does, by some miracle, manage to even partially solve that problem, China would emerge as a hero of public health planning.

They will not.  One thing you did not mention – and I believe it really gets at the Achilles heal of the healthcare reforms – is that the question of doctors’ status is never addressed. In today’s China status in society is based on the amount of money one earns – doctors still receive state salaries.  To compensate for their diminished societal horizons, they extort patients through an elaborate system of red envelope payments, hoarding of patients in already overcrowded departments, and over perscribing of medicine (again, not just a China problem).

But, more importantly, the doctor’s view placement in the health system as the all important indicator of status within their profession.  This means that good doctors, and even many bad ones, see the rural clinics not only as a career dead end, but also as a dead end for the continued social rise of themselves and the families they represent.

For more go here.

On opportunities for business;

Just one qualification – though the insurance market will eventually open, it is still too early to call private insurance a true opportunity.  Depending on how quickly the Chinese Insurance Regulatory Commission wraps its brain around how to regulate private insurers, AND private healthcare institutions, private insurance in China is going to become a true opportunity in 5+ years.  Until then, insurers have to comfort themselves with just planting a flag in China and waiting for signs that the market is opening.