Tengchong Women and Children’s Hospital sets up text message platform

 According to Yunnan Health Department’s healthcare reform office on 26 February, Tengchong Women and Children’s Hospital in Yunnan set up a text message platform in 2011. The hospital sends two messages every month on perinatal care, maternal and infant care, and hospitalized delivery subsidies to pregnant and lying-in women. To date, the platform has sent more than 230,000 text messages, benefiting more than 16,000 pregnant and lying-in women.

III Reporter’s investigations

Bottleneck on medical consortium By China Comment magazine, 26 February

The medical consortium headed by Zhengzhou Central Hospital affiliated with Zhengzhou University and covering 45 cross-regional medical facilities was established on Nov 17, 2012. It was called a groundbreaking move for main hospitals to live up to their social responsibility. Recently, reporter from China Comment magazine confirmed its advantages through in-person visits. The model of “first diagnosis at community level, graded diagnosis and treatment, separating chronic conditions and emergency care, and two-way referral systems” has made it easier for patients to seek treatment, and benefit hospitals at various levels and further our nation. As of January 25, 458 people have gone through the two-way referral system in the consortium, among which 375 are referred back to lower-level hospitals . But there are still some unresolved problems in the consortium. First, funding and technology support need to be secured. Second, relevant policies are yet to be established. For example, according to health insurance policies, the deductible amount (the minimum money incurred on patients before social security payment kicks in) and the compensation mechanism vary with medical institutions at different levels. Every time patients change hospital, they have to pay the deductible amount by themselves. So, if a recovering patient is transferred to a hospital at a lower level, the extra deductible fee will set off against the reduced costs, which dampens their interest in transfer, and thus undermines the meaning of the consortium’s existence. Third, the multi-site practice for doctors within the consortium also needs relevant policy support.

IV Media remarks

China should apply DRGs

By 21st Century Business Herald, 26 February

In China, Controlled totals is a current strategy to contain medical costs and health insurance spending. However, the method will cause hospitals to pass the buck or use drugs and consumables outside the reimbursable catalogue of health insurance, when there are no fundamental changes in medical service compensation and incentive system for medical staff. Yang Yansui, director-general of Tsinghua University’s Employment and Social Security Research Center, said that currently doctors support themselves by making money through practicing, so the government can spend less; controlled total is imposed on hospitals so health insurance fundmay shoulder less pressure. This shows that China’s medical service and health insurance management is far from sophisticated, which calls for the payment mode of Diagnosis Related Groups (DRGs). The country is experimenting with DRGs but faces great resistance. In 2012, DRGs was carried out in three hospitals in Beijing, which brought medical costs down by 12 percent. But only a comprehensive implementation of the DRGs can truly affect medical behaviors and righteously make up for doctors. DRG promotion needs relevant government sectors to give up their individual benefits, take joint action, and gain support from hospital management and staff, patients and the public.

“Pay after treatment” should be a result of successful healthcare reform

By Time Weekly, 28 February

A media survey showed that more than 90 percent of the public are looking forward to the “pay after treatment” policy.

Zhu Hengpeng, director of the Public Policy Research Center of CAS’s Institute of Economics, said that the policy involves complex factors, and should be a result of successful healthcare reform.

 To achieve pay after treatment, economic development should reach a certain level, and then healthcare reform follows. For cross-regional health insurance compensation, Zhu said that commercial insurance should be brought in to realize cross-regional settlement. The country should set a par on basic health insurance, and everything above par should be considered supplementary, which the commercial insurance will cover. In this way, most patients won’t have to pay to see a doctor and only a few of them need to offer a deposit as guarantee. Commercial insurance will cover serious diseases as well. The ultimate goal is that everyone can afford to see a doctor, but not everyone can enjoy the best medical services. Once the social welfare system is good to a fault, it will give rise to leeches.