3. Please talk a little bit about the current situation of medical liability risk-sharing mechanism in China and the main challenges it faces?

Since 2000, Shanxi province, Beijing, Shanghai, Shenzhen and other cities have been issuing documents to promote medical liability insurance. In 2007, the former Ministry of Health, the State Administration of Traditional Chinese Medicine and China Insurance Regulatory Commission jointly issued a notice to actively promote medical liability insurance. A document called “Strengthening mediation in medical disputes,” which was issued in 2010, called for health administrative departments at all levels to organize public medical institutions to get medical liability insurance and to encourage and support other medical institutions to get medical liability insurance. Our research showed that medical liability risk-sharing mechanism comes in three main forms. The first is medical liability insurance, which is purchased by medical institutions. Once there is a medical incident, the insurance company pays for the damages. In 2013, more than 6,000 medical institutions rated at second-level or higher, had medical liability insurance, accounting for 60 percent of second- and third-level medical institutions in China. The second is establishing a medical risk fund. Health administrative departments in some cities in Fujian province and Jiangsu province organized local medical institutions to jointly establish a medical risk fund. Hospitals in the same program put money into a special fund to be used as settlement in case any hospitals in the program need to pay for medial accidents due to malpractice. The third is targeting high-risk surgeries. Hospitals will ask patients to buy medical accident insurance, which can serve as a supplement to the other two forms of insurance. Medical liability insurance also faces challenges. First, medical institutions are not very eager to purchase medical liability insurance. There are many hospitals still to be covered. Second, the design of medical liability insurance needs to be further improved. Medical liability insurance in China is still at an early stage. More people who understand medicine, insurance and actuarial science are badly needed. Third, insurance companies, which offer medical liability insurance, need to improve services. The procedure to take out insurance is too complicated.

4. The guideline also calls for further promoting medical liability insurance. Do you have a detailed plan on how to do that?

First, we must unify our thinking and raise awareness. The building of medical liability risk-sharing mechanism is critical in terms of building a harmonious doctor-patient relationship. It is also important for the promotion of health services. Second, further improve medical liability insurance. The guideline asks further improvement on medical liability insurance contracts and terms in order to make the insurance product more popular among medical institutions. Bring in professional and trained people to control risks and provide better services. It is also important to provide different insurance products to meet the different needs of different medical institutions. Third, include more medical institutions in medical liability insurance programs. Call for local health planning administration departments to promote medical liability insurance to make sure medical institutions, especially public medical institutions, purchase such insurance. By the end of 2015, all level-three public hospitals, the top level, in China should have medical liability insurance. About 90 percent of level-two hospitals should sign up for such insurance by the end of 2015. Explore establishing a medical risk-sharing mechanism that is suitable for grass-roots medical institutions. Fourth, enhance the convergence of mediation and insurance compensation. Support insurance agencies to get involved in the process of handling medical malpractice as early as possible. Make mediation play a bigger role. Combine mediation and insurance together to handle medical disputes.