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          Medical woes need co-ordinated efforts


          2006-03-13
          China Daily

          The national campaign against commercial bribery can help bring down drug prices by checking for irregularities during medicine sales. This is good news for a public that has been complaining loudly about soaring healthcare costs.

          However, to promote the country's much-needed healthcare reform, efforts to standardize distribution of medicines are not enough. The policy-makers should also come up with bold measures to reorganize the hospital system and develop medical insurance.

          By listing the medicine trade as one of the main targets of the ongoing fight against commercial bribery, the Chinese Government demonstrated how seriously it is taking the issue.

          The country has adopted centralized bidding to make procurement of pharmaceuticals more transparent, and drug prices cheaper. The pricing authorities have also launched 17 rounds of price cuts covering more than 1,500 kinds of medicine. But in recent years, people have found that medical cost has become even more unaffordable.

          Commercial bribery is one of the factors that have undermined the government's attempts to slash medical costs. Many pharmaceutical companies have resorted to bribery to gain undue favours from hospitals through which a better part of their products are sold. Statistics from the Ministry of Commerce reveal that in the medicine trade alone, 772 million yuan (US$95 million) could be involved in kickbacks each year, accounting for almost 16 per cent of the industry's tax revenue.

          Combating commercial bribery can force both pharmaceutical companies and hospitals to behave in line with professional ethics, while jettisoning unnecessary costs incurred during medicine distribution.

          Such a national campaign is definitely needed. But commercial bribery is just one of the root causes of people's disappointment with the country's healthcare reform.

          When talking about China's healthcare reform, we cannot ignore the mounting financial pressure on hospitals. Though public hospitals constitute the overwhelming majority of all hospitals in the country, government expenditure unfortunately makes up a small proportion of the country's spending on healthcare. For hospitals, this means that they have to charge the patients more both to make their own ends meet and raise the income of their staff.

          Morally, we could denounce those doctors who over-prescribe for kickbacks from pharmaceutical companies. The current campaign against commercial bribery signals the government's zero tolerance of such malpractice.

          Yet, in view of the growing demand for medical resources as the country gets wealthier and older, we can ill afford to focus merely on improving the moral standards of medical staff.

          The more pressing problem is how the healthcare system can be properly financed. And to answer that question, the government should first make clear its goal of healthcare reform: What level of medical service will the country's healthcare system provide? At what cost? And who is going to pay for it?

          China, as the world most populous country, must pay particular attention to the efficiency of distribution of medical resources.

          The Chinese Government's recent call to develop community hospitals is a welcome start to reorganize the hospital system to serve the people more effectively.

          Nevertheless, to facilitate such a change of roles played by different hospitals, extra investment is a must, be it by the government or private investors.

          However, commercial medical insurance has yet to be boosted to meet demand beyond the basic medical service social healthcare insurance covers.

          In short, cutting down drug prices is not the goal. For the campaign against commercial bribery to succeed in advancing overall healthcare reform, co-ordinated measures targeting other problems should follow immediately.

           
           
               
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