Although it's too early to evaluate the effects of Beijing's medical care reform, the first three weeks' trial since April 8 seems to have met people's expectations. The main goal of the landmark medical care reform is to change the unhealthy practice of hospitals' "covering their expenses with medicine revenue".
Two major goals of the latest reform are to abolish the price markup of drugs and examination fees in public hospitals and other establishments that provide medical care, as well as to replace the hospital registration and diagnostic fees with medical service fees. The first goal is aimed at reducing the outpatient fees by about 5 percent, which might produce immediate results as long as the measure is strictly implemented.
According to Beijing Municipal Commission of Health and Family Planning, in the first two weeks since the launch of the latest reform, the total amount accumulated through the drug sunshine purchasing platform was 2.87 billion yuan ($416.55 million), which means the combined savings of patients during the period was 240 million yuan, or 8.4 percent of the total drug expenditure.
The second goal, however, is not limited at raising the doctors' incomes in order to do away with the model of "covering expenses with medicine revenue" of hospitals. An important goal of the move is to make patients adopt the hierarchical medical system so as to optimize the healthcare resources.
The new medical service fees are not simply an increase in the traditional medical registration and diagnostic fees, as they differ from one hospital to another. In the general outpatient departments of Beijing's top public hospitals, the medical service fees varies from 50 yuan (of which 40 yuan is paid by the basic medical insurance company) to 100 yuan.
Preventing the waste of quality healthcare resources is a big challenge for the medical care reform. In big cities, people generally tend to go to top public hospitals even if they have a cold. Since the earlier medical registration and diagnostic fees were relatively cheap and the difference in the cost of consulting a specialist and a grassroots junior doctor was less than 10 yuan, the patients' choice was reasonable.
Therefore, the authorities have rightly used the new medical service fees to achieve patient distribution. According to Beijing Municipal Commission of Health and Family Planning, in the past fortnight the number of emergency treatments in Beijing's top hospitals fell by 13 percent on a year-on-year basis, while in grassroots community medical treatment centers, they increased by 8.3 percent.
But despite the medical authorities claiming that hospitals no longer cover their expenses with medicine revenue, the healthcare reform still has to solve many problems. One of these problems is the unchanged number of patients visiting specialized hospitals, especially the top ones. Media reports say the number of patients seeking treatment in Beijing Cancer Hospital's outpatient department in the first week since the launch of the reform was similar to that in the same period last year. That such patients are "insensitive" to the change in medical service fees indicates another significant issue: insufficient and unbalanced healthcare resources nationwide.
Known as the "national medical treatment center", Beijing attracts most non-local patients than any other city from across the country because it has many top quality healthcare centers and resources. As a city which has the highest number of top-level hospitals and excellent doctors, Beijing draws 700,000 non-local patients to its hospitals every day according to the National Health and Family Planning Commission's estimates in 2013.
And since most of these patients seek good-quality medical care for serious illnesses, they are less sensitive to the change in medical service fees for local patients, which should prompt policymakers and reformers to make more efforts to provide good quality healthcare across the country in order to meet the general public's demand.
The author Wang Yiqing is a writer with China Daily.
