Further reform of public healthcare system needed a right orientation. Fortunately, the document published yesterday has come up with just that. The thrust of the document is to retain the public welfare nature of public hospitals and community clinics and to establish a healthcare security net covering all residents in both rural and urban areas.
The message is clear that efforts will be made to turn away from the past reform that most believe has resulted in expensive and inconvenient medical service for the general public.
Market-oriented reform in the past has prompted most public hospitals to place profits before quality service. As a result, prescribing expensive, more and unnecessary drugs for patients has become a common practice for doctors in many hospitals. Pharmacy dealers often give kickbacks directly to doctors who prescribe the medicine they sell.
In the document published for public opinion, separate accounts for both incomes from providing medical service and selling medicine and for expenditures of hospitals are suggested. This is considered necessary to make it impossible for hospitals to make money from selling medicine.
In addition, the healthcare department will draw up a list of basic drugs for common diseases. And their manufacturers will be chosen through public bidding and these basic drugs will be supplied to public hospitals in a uniform manner to reduce intermediate links, that tend to raise retail prices. And their retail prices will be decided also in a uniform manner. Community, township and village clinics will be required to prescribe drugs from the basic list. And even big hospitals will be required to prescribe a certain percentage of drugs from the list.
Inputs from the government to public medical institutions will be increased, according to the document. This will guarantee the medical workers are properly paid to have the incentive to provide quality service to patients.
What needs to be particularly mentioned are the efforts the government will make to establish village clinics and support county-level public hospitals. This is the way to fill the gaps in healthcare network in the vast rural areas, which have made it difficult for rural villagers to seek medical service for common ailments.
It is undoubtedly not easy for such a large country as China to provide all its citizens with satisfactory healthcare service and security. Nor is it so to have such a large-scale reform carried out to the letter in every link in every corner.
But defining clearly the roles for various units involved, including government health departments, watchdogs and public hospitals, can make a big difference to the success of this reform.
Only when we know who does what will we be able to locate where the problem lies whenever something goes wrong with the reform.
The document does provide clues that detailed divisions of roles, especially for relevant government departments, will be made to guarantee that the reform is pushed forward in concrete steps.
Hopefully, public opinions the publication of this document is meant to seek will provide better ideas for making detailed plans.
(China Daily October 15, 2008)