Government and Policy

China pledges affordable medical service

Updated: 2011-03-09 10:21


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BEIJING -- After having an abortion, the woman just wanted to obtain Chinese herbal medicines to improve her health, but she didn't expect that the visit to a renowned hospital would cost her a month's salary.

Earning 1,600 yuan a month, He Jixiang (not her real name), 25, was from Quwo county in north China's Shanxi Province. Following the abortion, a relative recommended she see a famous doctor in a hospital in Taiyuan, Shanxi's capital.

However, the doctor, surnamed Zhang, refused to give her a prescription. "She asked me to do a type-B ultrasonic test and maternity test in a nearby private hospital first," He recalled. The tests cost her 500 yuan.

After seeing the results, Zhang prescribed numerous drugs, costing another 500 yuan.

"Plus, with the expenses for traffic and accommodations the trip cost me an entire month's salary, and I doubt if the drugs were necessary," He complained.

In fact, He's complaint mirrored the problems faced by many patients.

"It is very common among doctors to earn profits from prescribing unnecessary medications," said Wei Zhonghai, head of the hospital affiliated with the Traditional Chinese Medical University in Shanxi.

"Officials pay more attention to the profits of hospitals while supervision of the morality of doctors was often empty words," he said.

In a circular on Monday, the Chinese government vowed to take measures to make public hospitals use those basic medicines listed by the state and adopt public bidding procedures for the purchase of medicines  as a step to control the cost of medical services.

Such a move was welcomed by experts.

"We have been talking about reform in public hospitals for years, but this time the circular pointed out a direction," said Dr. Li Ling, a professor with the China Center for Economic Research with the Beijing University.

To some extent, Li noted that patients were a "vulnerable group" with insufficient information.

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"They are not familiar with medicines. They would take whatever the doctor prescribed to them, without knowing whether there were substitutions,"  she said.

As a result, Wei said that some doctors would deliberately choose expensive medicines so they might receive a kickback from drug companies.  "This affected younger doctors who were likely to follow suit,"  he said.

A sales representative from Changzhi city of Shanxi told Xinhua, on the condition of anonymity, that factory prices for a bottle of deep sea fish oil was 15 yuan, but it was later sold to patients for 200 yuan.  "For each bottle of the oil prescribed, the doctor could earn about 30 yuan as a kickback,"  he said.

Further, prescriptions for expensive medicines slowed the development of the drug industry.

Uzhitu, vice chairman of the Finance and Economic Committee of the National People's Congress, found during his research covering 42 hospitals in 12 cities that as many as 342 kinds of medicines were in short supply .

Most of the medicines were inexpensive, 211 of these were sold for below 30 yuan, and 130 medications, or 61.6 percent, cost below 10 yuan.

Chen Shuzhang, vice director of drug administration of Jinzhong city in Shanxi believes that profits from  basic medicines were small and producers were reluctant to manufacture them.

"The new regulation could be an incentive for the development of basic drugs," he said.

However, Li Ling doubted the regulation could be enforced.

"We must eliminate the profits gained from drugs from doctors' incomes,"  she said.

Lan Shengmin, a doctor in his 50s with the Cancer Hospital, complained that with a salary of 2,000 yuan a month, he had almost no holidays during the year.

"I always work till eight or nine in the evening, and sometimes the whole night," he said.

"When I am sleeping at midnight, I am sometimes awakened by phone calls."

Pressure was another problem.

"Our work is special, because we are responsible for the life and death of people."  He noted that in his hospital, a young doctor even became depressed after a medical dispute.

"I would not allow my son to be a doctor," he said resolutely.

Li Ling suggested that the sense of happiness of doctors be raised so they might  "think for the patients."

"Their income should be increased and their housing conditions should be improved. When the cost of violating rules in the industry is high and doctors feel that their work is decent and respectable, they will monitor their own behavior," she said.


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