China’s Naked Government Experiment Could Work for Hospitals, Too

Article: China’s Naked Government Experiment Is Revealing, By Stan Abrams, blogger/founder of China Hearsay talking about article in China Daily, Township officials list all spending, By WANG HUAZHONG (China Daily)

Officials, in a Sichuan township, have initiated a public accountability experiment, posting their personal expenditures for the first two months of the year online.  Netizens have dubbed the effort China’s first case of ‘Naked Government’. AKA, transparent government.  The Sichuan township’s efforts are significant because the officials, so far, have been very open about their spending.

Besides exposing the high level of expenditure, which often hold the potential for abuse of public assets, the official website of Baimiao town, Bazhong city, is also reporting breakdowns of town’ budgets and officials’ salaries.

In China, officials reportedly spent at least 120 billion yuan ($18 billion) in 2004 on private use of government vehicles, extravagant dining and wining, as well as frequent trips abroad – all charged on government accounts. Premier Wen Jiabao said in February that this kind of spending “should be and can be controlled” through transparency and democratic monitoring.

Stan Abrams points out that though the reporting is not perfect, the very fact that Baimiao town is reporting how much they spend on dining – 65 percent of their spending in the first two months of this year – is something worthy of our attention.

For that item alone [dining expenditure disclosure], the whole program is worth it. Lots of people will rightly start asking why that sort of expenditure is necessary for local government officials. This is not new information, but now it has been quantified. Seems like kind of a big deal to me.

It seems like a big deal to me, too.  Here’s the healthcare angle.  This precedent can and should be applied to China’s public hospitals.  All sources of revenue at the hospital should be disclosed, department by department.

Right now it is common practice for hospital departments to hold off on referrals to other departments that make more sense to the patient, resulting in patient overload within certain departments while other departments remain empty.  This patient hoarding is the direct result of something called the doctor’s allowance.  In the past I have defined it like this;

Essentially, departments within government hospitals are clearly demarcated into separate administration zones.  This extends to hospital accounts – almost every department has their own.  Every time someone gets treated within the department, a part of their payment goes into the department account.  At the end of the month a fraction of the funds earned by the department are given out to the doctors as an ‘allowance’ – basically, a sort of salary subsidy.

Public reporting of department earnings, along with the ratio of medical personnel to patients in those departments would help ease pressure on the health system by revealing to the public where the less burdened hospital departments.  Right now if I go to Chaoyang Hospital to see the ENT doctor, but there is a six hour wait to see that doctor, no one there will refer me to a clinic or hospital down the street, wanting to keep the funds for themselves.  If I could see, online, where there are less burdened ENT departments I could save myself several hours.

This makes sense to me.  What about you?