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BIZCHINA / Weekly Roundup

Fighting the medical wolves in sheep's clothing

By Wang Ying (China Daily)
Updated: 2007-04-27 09:27

"Lack of professional ethics and poor management are some of the major
problems facing Chinese hospitals," Vice-Minister of Health Huang Jiefu
said at a national meeting on medical management last year. The country
has more than 18,000 hospitals, most of which are non-profit making
facilities. But "many of them have abandoned the basic principle of
'serving the people with heart and soul' in recent years" for the lure of
the lucre, Huang said.

"Unfair competition and irregularities have messed up the medicine and
medical equipment market," Huang said. "There are many small medicine and
medical device makers in the country, making it hard to monitor the
market."

China has more than 7,000 registered pharmaceutical firms compared to
less than 20 in the US. In 2005 alone, the Chinese authorities approved
10,008 new types of medicines, about 100 times more than the developed
countries.

"The dearth of government funds is partly to blame for the unhealthy way
in which some hospitals have developed, and the irregularity in the
medicine and medical equipment market has worsened the situation."

About 93 percent of the income of hospitals in the country comes from
medical service charges. The rest comes from government funds, according
to MOH figures.

Since doctors' salaries are directly linked to the sale of drugs under
the existing system, many of them have become medicine vendors. And the
pharmaceutical firms exploit this situation by offering handsome
kickbacks to them if they sell their medicines or devices, which
sometimes are sub-standard.

No wonder, stories about astronomical medical bills hit the headlines so
frequently. Take Zhu Shaoxia's case as an example. The 78-year-old died
of a heart ailment two years ago in Shenzhen People's Hospital in South
China's Guangdong Province after being admitted there for four months.
Zhu's medical bill amounted to a whopping 1.2 million yuan ($156,000).

His relatives were heart-broken after losing a senior member of the
family, but just to make sure everything was okay with the bill they
decided to check it. To their horror, the bill was full of weird entries.
For instance, doctors had drawn blood from Zhu 26 times in one single
day, a feat that could not be explained. As if that was not enough, there
were 15 entries for different treatments, including an
electrocardiography after Zhu had been declared dead by the doctors.

Health authorities probed the case and ordered the hospital to pay back a
quarter of the charges to Zhu's relatives.

The hospital seems to have a knack for the impossible. Late last year, it
sent a bill to a patient surnamed Sun, which showed he had received
medical treatment for 27 hours a day.

Hospital president Zhou Hanxin was removed from his post earlier this
month after the media exposed the over-billing and weird cases.

But the number of such cases is expected to decline once the MOH enforces
the Prescription Management Regulation from May 1. The regulation will
make it mandatory for all hospitals to set up a prescription appraisal
system and delink medical workers' income from prescriptions. Improper
prescriptions will be published in a public bulletin to regulate doctors'
behavior. Also, to ensure more transparency, all the prescriptions have
to have the common names of the drugs, instead of just the chemical ones.

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