role of private sector in nation's health care reforms
Alexander Wan: What would you like to tell our readers?
Allan Gabor, Pfizer: Pfizer is a pharmaceutical company with
strong global resources and capacities, and would like to build
partnerships among the public, private, and patient health sectors
to support health care reforms. We believe that emphasizing prevention,
wellness, early diagnosis and early treatment can keep disease
from many personal health care disasters. Pfizer China has provided
philanthropic patient education on disease awareness on many disease
categories, such as cardiovascular disease, mental disease, infectious
diseases, men's health, hepatitis B, and HIV/AIDS even though
we don't have products right now for hepatitis B and HIV/AIDS
in China. On average, there is savings of more than US$2 for every
US$1 invested in early prevention programs.
Li Zhongyuan, China Health Care Group: The primary responsibility
of the government should be to fix the basic healthcare coverage
in China. Given the wealth differentiation, the healthcare industry
should also encourage market-oriented premium health care services
to the section of Chinese population who can afford them. The
leading public hospitals should be permitted to engage in premium
health care services in co-operation with credible offshore players
in various forms. Public hospitals can only maintain their current
positions as centres of excellence in various specialities by
introducing contemporary health care ideas and practices and expertise
by working with high-end patients systematically. The government
should regulate public hospitals by encouraging and guiding them
to do the right things and help them deal with the budgetary reality
Anne Zhang, L'Oreal China: Settle on a practical hospital management
policy as soon as possible:
1. Open up the hospital operation system as soon as possible:
every hospital could have high charges for patients who want better
and private service. The government could have a special price
system for people who enjoy government medical insurance.
2. Decrease period of hospitalization and build a community medical
service centre system for common diseases.
3. Cutting drug prices is not the right way to lower the whole
package of medical fees.
4. The public bidding policy for drugs should not be controlled
by government - it increases the corruption in government.
Vic Lazzaro, China Care Group: Require all public hospitals to
provide emergency care. Such services should be paid for by the
government on a fee-for-service basis in a pre-determined rate
structure. All other services would be considered elective and
would be paid for by the patient and his insurance policy where
applicable. We should create a scale for determining the ability
to pay based on income, assets or other methodology to determine
who is medically indigent. It is the government's responsibility
to lead in this change process. However, the Chinese Hospital
Association should be asked to create a committee of prominent
hospital leaders to serve as a commission to assist the government.
David Jin, Philips Medical System: What I would like to say to
the Chinese Government is to make it a top priority and significantly
increase investment in the health care sector in order to build
an effective health care system based on the contributions by
both governmental and private sectors. I would like to see various
stake-holders in the process jointly contribute to a sustainable
growth model. Philips Medical Systems will definitely do its part
by working together with various stake-holders towards the healthy
development and long-term growth of China's health care sector.
Dr Jonathan Seah, Parkway Group Healthcare:
As the largest private hospital group in Asia, we strongly believe
that the development of private for-profit health services in
any country should be closely co-ordinated with the public non-profit
healthcare system. Properly executed, an effective private healthcare
system can help reduce or maintain the total health care expenditure
in a country.In Singapore, for example, where our company has
the majority market share of private health care services, the
total healthcare expenditure for the country is only around 3
per cent of GDP - and actual government expenditure constitutes
only about a third of that (about 1 per cent of GDP). As a comparison,
health care expenditure in the United States is around 12 per
cent, in Canada about 9 per cent, in the United Kingdon and Japan
about 7 per cent. This, however, can only happen when there is
a good understanding of what the different roles of the public
non-profit health care system and the private for-profit hospitals
are. In Singapore, an important part of this strategy is limiting
premium and elective services at public hospitals in order to
reduce costs for the non-profit health care system, as well as
to focus public resources on providing a good level of basic health
care to a larger segment of the population. Patients who desire
a premium level of care, or who seek elective services not considered
"basic medical care" are cared for by the private for-profit
healthcare system. Additionally, this system cannot evolve in
a vacuum, but has to be developed along with other elements of
the health care infrastructure.
Stanley Tam, MD, Harvard Medical School: What you are trying
to do to reform the health care system is extremely critical to
the health of the people and the eventual economic growth of China.
The most efficient and effective plan is to involve both the public
and private sectors, with clear guidelines and regulation governing
the role of public institutions in the areas of public health
and basic health care services, avoiding using public institutions
in for-profit efforts. To improve the over all health care system,
one must have clear metrics to measure any interventions, so that
we could build on prior experiences. The private sector should
be given freedom to operate under certain regulations so to benefit
the entire health care system.
Alexander Wan: Can you share with us the roles your company would
like to play in China's health care reforms? Tell us your experience
in other countries.
Allan Gabor, Pfizer: Pfizer is committed to supporting health
care reforms in both urban and rural areas in China. Pfizer China
has worked with the Ministry of Health to initiate an advanced
hospital management training programme at Beijing University.
The Advanced Hospital Management programme has exposed senior
hospital management personnel nationwide to innovative management
theories and practices to increase efficiency and effectiveness.
Pfizer China has supported a pilot rural co-operative health care
system in Yunnan programme to explore the best practices on health
care reform in rural areas. In the United States, we launched
A Healthy State health care management initiative in the state
of Florida, called "Healthy Florida" to support health
care reforms for ageing people.
Li Zhongyuan, China Health Care Group: We would like to nurture
the creation of a rational and viable private health care service
market in China by systematically introducing international expertise,
capital and technology. The core component of such work is working
with leading public hospitals and introducing advanced ideas and
management in a commercially viable way. We have worked with partners
in countries such as the United States, the United Kingdom and
Allan Choate, The Asia Foundation: With the support of the Pfizer
Foundation, The Asia Foundation (TAF) has launched two pilot projects
in China's rural areas called "New Rural Cooperative Healthcare
Scheme", in collaboration with the Ministry of Health.
In the first place, the scheme - with a co-payment structure
built in - is expected to fill an over-decade-long void of a health
care safety net in China's rural areas. Once the farmers participate
in the scheme, they pay an annual fee of 10 yuan into a pool (matched
by another 10 yuan subsidized by the provincial government and
the central government respectively) and are entitled to get medical
reimbursement. So, from the demand side (farmers) perspective,
the new scheme is revolutionary in that it helps cover farmers'
medical cost in an unprecedented manner. Our programme has integrated
the supply side reform (the reform of rural area hospitals, clinics,
and other service output performers) so that both sides work well
in parallel and contribute to the efficiency and sustainability
of the new scheme.
Alexis Vannier: PSA Peugeot Citroen: Since last year, we have
been deeply involved in road safety and education in China. We
have already created five Road Safety Think Tanks in different
major cities in China (Beijing, Chongqing, Wuhan, Guangzhou and
Xi'an). Every two months or so, we invite a leading Chinese or
international expert to give a lecture to these think tanks attended
by the media as well as the authorities and medical officials.
Stanley Tam, MD, Harvard Medical School: I am currently the president
and CEO of the new Huashan Pudong Hospital, the first Harvard
Medical School-affiliated hospital. I have been a veteran in the
Harvard medical community for many years. We intend to provide
high-quality health care to patients in every economic and social
class. We will provide valuable training and education.
(August 31, 2005)