Introduction To The Chinese Medical

Ecosystem

For Wellness333.com Specialists

YC Xia www.wellness333,com

Admin@Wellness333.com

Chinese Medical Ecosystem in Brief

Structure

Main Actors

Coverage

Financing

More……

Medical Service in China – Structure

Principally a network of hospitals each bear a national grading based on level of facilities, functions, technology advancement and specialties: I, II, III –reviewed periodically

Mostly public with increasing number of private institutions, few individual clinics

Continuous evolution and reform of the medical regime

Government supervision and centralized guidelines

Provincial implementation with certain autonomy

Medical Ecosystem in China – Main Actors

Hospitals & Doctors

Health Bureau

Pharmaceuticals Companies

Patients

Aid Station & Clinics

Drug Administration

Medical Service in China – Coverage 1

Basic medical coverage

o 全民基本医保≈Sécurité Sociale en France≈Medicare & Medicaid

Implemented not until 2012

One patient paid 30000 € of medical expense in 2009 for leukemia treatment, her medical coverage started in 2010 and received 15000 € reimbursement

Medical Service in China – Coverage 2

Private medical insurance offers exist, especially for

critical illness

Mostly capped for reimbursement amount, patients always

need to pay a portion

Reimbursement level varies according to regime for both

private & public

Medical Service in China – Financing Model

• Medical institutions receive limited public subsidies due to

fiscal burden

• 50% of total medical expenses on medication (vs. 20% in

other countries)

• Extremely low consultation charge <1 € to 10 €

• Funding model: 以药补医 (Medicine sales subsidize consultation)

Breakeven Insufficient public funding

Government permitted additional

income channels

Medical Service in China – To Improve

Medical service providers improperly leverage information

asymmetry advantage over patients

– Over-prescribe medication

– Advise costly treatments that are not strict necessity

Overall low satisfaction from patients both low and high

income, increased accidents and conflicts

Doctor-Patient mistrust cooperation

Medical Service in China – Doctors Dilemma

• Doctors - overwhelming majority state employed at public

hospitals

• Low base salary(<1000€) + variable bonus + commission on

prescribed medicine and additional income from surgery

which represent major portion

• Medical responsibility insurance has just started to develop,

most doctors bear their own accident risk --pay out of their own

pocket for accident settlement

How We Fill the Gap

Peer pressure does help improve treatment –experience

showed over 52% patients had their treatment modified after

obtaining a second medical opinion

Clear and structured audit trail of doctor/patient exchange

Provide impartial and tailored second medical advice –

empower the patient and his family

What Patients May Expect

Doctor, don’t hesitate to give frank advice!

Is my treatment

appropriate?

Do I need this operation

now?

What is the secondary effect of this medicine?

Can it be a medical

accident?

……

……

Key Elements of Patient/Doctor Exchange

Doctors are experts in diseases

Patients are experts of their own body