Private Healthcare in China
   2013-05-14 09:14:36      Web Editor: Luo Chun

By Stuart Wiggin

Private healthcare in China comes at a premium. With a growing demand for higher levels of service and patient care, those who are able to afford it often opt for treatment in private hospitals. Beijing was the location of the first foreign invested hospital in the country, in the form of the Beijing United Family Hospital (BJU), which opened in 1997 with the intention of catering to the capital's small but growing foreign community. Roberta Lipson, co-founder of Chindex International, the operator of BJU and other United Family Healthcare hospitals around the country, was instrumental in the establishment of foreign style hospitals in the country. Lipson has a unique perspective on the growth of private sector healthcare alongside the development of China¡¯s public healthcare system.

CHINATALKS spoke to Roberta Lipson, a long term resident of Beijing (since 1979), to gain her insights into the development and growth of the country's private healthcare system. "Coming from the West and having the opportunity to bring information from what was going on in the western world, I felt I had an obligation to find the place where I could make the biggest contribution," Lipson told CHINATALKS, as she explained how she became involved in China's medical industry.

"Having just come from a job in the medical industry in the US I had a sense of what the state of the art was there. And when I began to explore what was going on in Chinese healthcare, I realized I had a calling to make sure that the Chinese medical community could be informed of the technology that was available and what was going on in healthcare in the west," Lipson noted. The business that she set up, Chindex International branched out from purely being involved with medical hardware to providing medial services through UFH hospitals.

The path that led to her setting up BJU via Chindex International was the result of a realization that good healthcare did not just revolve around hardware, with Lipson noting, "I felt that there was more that we could bring in terms of a philosophy of patient care, in terms of a level of service, a concept of respect for patients at the center of the process." Lipson and Chindex International approached the Ministry of Health around 1991 but were met with skepticism in terms of their business proposal. "It was a big surprise that anybody would be interested in healthcare as a business in China at that time. For a very long time, almost two years, nobody would take this concept seriously," Lipson recalled, explaining that it wasn¡¯t until 1992 when several people from the healthcare authorities showed an interest in the concept after having completing advanced courses in hospital administration and public health in the United States.

By 1994, Lipson says that it appeared as if they would be able to put their idea into practice, and by 1997 they had government approval and the money needed to build what turned out to be a very small facility in Beijing which catered mostly for foreigners. As Lipson stated, at the time "Chinese people never had a concept that it was possible to have a choice in healthcare and go out of the public system." Since 1997, BJU has continued to grow and the patient pool has gone from 98 percent foreigners to roughly a 50/50 split between Chinese patients and foreign patients.

However, treatment at a UFH hospital comes at a premium. Meanwhile, public healthcare in China is considered reasonable if not strong by many of those who use it; so the obvious question is what are people paying for when they go private? Lipson spoke out about the differences between public and private healthcare in China. "The burden of having to take care of that many people restricts [public] hospitals from charging very much money. So, they have to keep healthcare at sort of a basic level. I'm not speaking about technologically from a basic level, but in terms of the environment, in terms of the convenience, in terms of the time that a patient gets to spend with the doctor. So if you're a Chinese patient accessing the public hospital and you don't have a choice, and the government is paying for 60% of it, many, many people will be happy and satisfied with that."

But as Lipson explained, that burden of taking care of such a large number of people ultimately leads to bottlenecks in the system which can have a negative impact upon the delivery of treatment. "To see a specialist at a top hospital you probably have to get up in the middle of the night and wait online. Although the government is trying very hard and [is] very dedicated to pushing through an appointment system, it hasn't happened in most of the counties. In order to access what patients might think are the best hospitals or the best practitioners, they have to line up. Maybe they'll line up for a long time and still not get to see the doctor that day."

Furthermore, the management system within Chinese hospitals is designed specifically to deal with the large numbers of patients that they receive. However, this system, which at times appears almost factory-like, is not always conducive to delivering timely treatment and often lacks the personal touch. "The Chinese system is, as the US system used to be, extremely super specialized," Lipson explains, "So, doctors are trained from an early point in their career about a specialty. To have a doctor that really understands the whole picture, psycho/social picture, physical picture and puts it all together for you is something very hard to find in the Chinese system."

And yet, many public hospitals have been attempting to cash-in on the demand for higher levels of service by offering VIP services. Official government policy dictates that public hospitals should cease to continue developing their VIP services on the understanding that public hospitals have an obligation to take care of the basic needs of the masses and that if people want to seek out higher levels of service they should do so via the private system. But for those public hospitals that do continue to offer VIP services, Lipson noted that VIP services within public hospitals still fall under the public system as noted above. "If you have a room in a private ward, you're still relying on a public system." Lipson added, "it's still that super specialized system, so you¡¯re subject to which department has admitted you [and] if your situation becomes more complex you need to hope that they will call in other specialists and act as a team. It's very difficult to have really great teamwork in that very big public venue where there's a great tradition of specialization."



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