Beijing to test hospital reform

In the ongoing public hospital reform in China, Beijing's measures to introduce a medical care service fee is a test to fine-tune the structure of hospitals' incomes, experts said.

A patient undergoes treatment in the emergency room of the Armed Police General Hospital in Beijing this month. Zou Hong/China Daily

The fee, from 42 yuan ($6.70) to 100 yuan, depending on the qualifications of the doctor, would replace the current 5 yuan registration fee and 14 yuan consultation fee, according to local health authorities. Patients will be reimbursed 40 yuan under insurance policies.

Meanwhile, hospitals will be prohibited from selling drugs at a 15-percent markup, according to a slew of measures announced on Friday.

China's public hospitals have long relied on drugs sales as a major source of income, a practice that many say drives up overall medical costs and harms the doctor-patient relationship.

Under the new model, scheduled for trial in July, patients with medical insurance will pay at least 20 yuan to see a senior specialist first at Beijing Friendship Hospital.

To see a top specialist, the out-of-pocket cost will rise to 60 yuan.

A staff member at the hospital information office, speaking on condition of anonymity, said she was concerned the fee hike would affect a number of patients, especially those without insurance.

However, Han Xiaofang, head of the capital's medical reform office said: "The new medical care service fee better represents the value of physicians' work and will help improve the quality of medical care."

According to Han, the adjustment is part of the city's pilot medical reform programs. Beijing Friendship Hospital and four other hospitals will be testing different reform programs.

"The pilot program will be assessed later and might be scaled up to citywide," Han said.

Beijing Friendship Hospital will cut the 15-percent markup it charges on drugs — a decades-old practice that helped hospitals supplement the government funding they received, which covered only one-fifth of their operating costs.

"It's in line with the principle of public hospital reform, separating medical services from drug management and boosting doctors' income," said Wu Ming, director of the Health Policy and Management Department at Peking University. Wu is also a member of the expert panel for the Ministry of Health.

The potential economic losses will be compensated for by the medical care service fee, Han said.

Patients with public health insurance will pay only 2 yuan to see a general practitioner at Beijing Friendship Hospital, and 20 yuan, 40 yuan or 60 yuan to consult senior physicians and specialists.

The initiative will help to better utilize the city's limited medical resources, according to Wu.

"We set different prices for different doctors to optimize the resources," Han said.

Because of the low prices charged in the current system, people with minor ailments tend to consult specialists.