Medical Reform

• Industry insiders are skeptical that NDRC’s planned policy initiatives will address the core issues of inflated drug prices.
• A doctor’s blog disclosing corrupt medical practices drew a record 170 million views within three months of posting, though with very few comments. Another story of a week-old infant given 189 medical tests prompted a commentary on the key factors giving rise to excessive medical care.
• An online survey found that 90% of respondents would give doctors red pocket monies in order to feel more secure about hospitalization or surgical procedures. A blog post claims that a provincial-level OB/GYN specialist can easily make 100,000 yuan per month from red pocket money alone.
• Shengmu County uses various monitoring schemes, including a donated database server, to maintain cost control of the universal health coverage program.
• Popular author Liu Liu thinks that greater understanding would help facilitate better doctor-patient relations, a perspective that coincides with the intention behind Beijing Health Bureau’s planned “A Day in the Life of a Doctor.” A Nanfang Weekend reporter, however, argues that system reform, not understanding, is needed for achieving better relations. The reporter’s view drew the ire of one reader who posted a comment criticizing the reporter and the media in general for fanning the already contentious doctor-patient relations.
• China tweaks villagers’ health insurance system to encourage timely outpatient healthcare (Link to English text)

Business & Initiatives

• TSKF is reported to be in discussion to enter the traditional Chinese medicine market segment.
• Peking University People’s Hospital Partners with IBM (Link to English text)
• Merck in Talks for China Partnership (Link to English text)
• The Price of Admission: 10 Medical Companies Suspected of Paying Bribes in Foreign Countries (Link to English text)
• IBM plans $100mln global healthcare initiative (Link to English text)
• Asia is hot destination for medical tourists (Link to English text)
• A Healthy Investment in China (Link to full English text)

Health & Awareness

• China’s AIDS activists face uphill struggle (Link to English text)
• Organ donations on the rise: Official (Link to English text)
• China lowers dairy protein levels to curb melamine (Link to English text)
• Hospitals providing nutritional advice to patients (Link to English text)
• Curing cancer one zap at a time (Link to English text)
• China OKs online buying of medication at 27 websites (Link to English text)

Public Health

• China surveys chronic disease prevention capabilities (Link to English text)
• China needs more GPs, suggests summit (Link to English text)
• China’s elderly population leapt in 2009: state media (Link to English text)

Additional News from the Greater China and Other Markets:

Hong Kong

• DH reaffirms commitment to promote breastfeeding (Link to English text)
• Hong Kong: Safe use of medicines containing lamivudine and telbivudine (Link to English text)
• Hong Kong: Safe use of topical products containing ketoprofen (Link to English text)

Taiwan

• Taiwan courts Chinese patients (Link to English text)
• Taiwan has best terminal care in Asia: Singapore’s Lien Foundation (Link to English text)
• A healthy industry (Link to English text)
• Healthcare robotics on the verge of taking off (Link to English text)

Singapore

• Singapore Outlines 10 Year Plan For Integrated Patient Care (Link to English text)
• Singapore Invests $10 Million For Senior Living Initiatives (Link to English text)

Korea

• Welcome to the Medical Device Space Samsung (Link to English text)
• Tale of two economies in Korea (Link to English text)
• Revolutionary Medical Dressing Uses Nano-technology to Fight Infection (Link to English text)
• Kiwi medicine joins forces with Korean tech know-how (Link to English text)
• Healthcare firms call for innovative policies (Link to English text)

Medical Reform

The 21^st Century Economic Herald reported that the National Development and Reform Commission is planning a series of policies aiming to reorganize the pharmaceutical pricing system:

• The policy initiatives are in response to reports of inflated medicine prices marked to include a profit margin f over 1000%.
• Industry insiders generally believe the planned policies would only address the symptoms of inflated drug prices rather than the core factors driving the prices.
• This is due to the fact that provincial authorities retain significant leeway to amend the drug reimbursement lists. Oftentimes, the provincial authorities may almost double the size of reimbursement lists from the national level.
• Moreover, the NDRC and its local subsidiaries only have the authority to set the price for 20 to 25% of medicines available on the market. This means that close to 80% of drug prices are set by the market, including those with exorbitantly high levels of profit margin.
• Link to full Chinese text.

Jiefang Daily commented on a doctor’s blog that drew over 170 million views within three month of its posting and urged the “silent majority” in the medical community to speak up:

• A Guangzhou doctor’s blog post commented on the death of a Peking University medical professor and revealed what is already common knowledge—the impatient attitude of medical professors, redundant tests, prescription abuse, and the deterioration of doctor-patient relations.
• Interestingly, only a dozen or so comments have been posted on the blog. One way to explain this unusual phenomenon is that the issues exposed are already too familiar and most are “too numb” to join the conversation. In fact, the writer stated in the post that although the medical reform intimately impacts doctors’ interests, “most doctors are not willing to speak up.”
• Over the past year of the new medical reform, although much has been done, the public’s frustration with the issues of medical costs and access has yet to be tangibly addressed. One of the reasons is the lack of participation and monitoring from the public and especially the medical professionals.
• The medical reform needs to allow the silent majority to actively express their views and become active participants and supporters of the medical reform.
• Link to full Chinese text.

The Beijing News published a commentary by an anonymous doctor on the news report that a week-old baby had undergone 189 tests within 79 hours, including tests for AIDS, syphilis, rheumatoid arthritis, and diabetes. This anonymous doctor wrote:

• While some tests are in accordance to medical requirements, the high number of tests within such a short timeframe questions the bottom line of medical ethics.
• Three factors may account for this practice of excessive tests:
  • With regulatory policies limiting the percentage of pharmaceutical sales in the overall hospital revenue, some hospitals are trying to narrow the gap by increasing the revenue from diagnoses and tests.
  • Strained doctor-patient relations has motivated doctors to err on the side of over-testing in order to minimize the risk of medical disputes.
  • The system of evaluating doctors’ performance based on their financial contribution has resulted in eliminating doctors who fail to achieve certain levels of revenue through prescription writing or diagnostic tests.
• Link to full Chinese text.

Life Times reported that a recent survey involving close to 10,000 netizens found 90% of the respondents would give doctors red pocket money in the event that a family member required surgery or hospitalization. Respondents indicated that they would feel more secure by giving the red pocket money:

• The survey found that 34.19% would give a red pocket in the range of RMB 500 to 1,000 and 26.45% would give over RMB 1,000. Some 54.1% indicated a willingness to give between RMB 1,000 – 5,000.
• As for the use of red pocket money, 32.19% believe that it “would improve the attitude of doctors,” and 29.65% believe that it would motivate doctors to be more diligent when conducting surgical procedures.
• According to a deputy director at a Beijing hospital, “very few doctors ask for red pocket money.” Most of the money is given by patients voluntarily. It is a practice that even doctors themselves engage in when they seek medical care.
• How can the practice be stopped? An assistant administrator of the China Medical Science Institute believes that when doctors are fairly compensated and have opportunities to maximize the value of their labor, the practice of red pocket money will be eradicated.
• Link to full Chinese text.

The New Express Daily followed up on a blog post claiming that “a provincial-level OB/GYN specialist easily takes home RMB 100,000 in red pocket money”:

• The post drew 540,000 views within a few days and received 2,778 comment posts. Some comments questioned the authenticity of the blog account.
• The New Express Daily reporter randomly selected 30 families that had new births in the last 10 years and found that exactly half of the families had given doctors gifts or red pocket monies. All of the monies and gifts were given voluntarily.
• Link to full Chinese text.

The 21^st Century Economic Herald reported on the challenges facing Shengmu to control medical costs under the county’s universal health coverage scheme. According to the report:

• Compared with 2009, the budget for universal health coverage has increased by 30 million yuan to reach 180 million yuan.
• The county has developed a comprehensive system for monitoring costs that includes various layers of inspection as well as using digital records to monitor hospital spending.
• A county official revealed that an IBM server worth 2 million yuan was donated. The server keeps track of patients’ medical records. The county is working on a monitoring program to track hospital spending on treatments. Hospitals found to have exceeded the limits will receive warnings or be disqualified as a universal coverage hospital.
• Link to full English text.

Nanfang Weekend interviewed author Liu Liu who just published a much-anticipated fiction book on doctor-patient relations:

• [Liu Liu enjoys significant national popularity following the airing of a TV series based on her book Snail Home. Premier Wen cited the TV program during an online exchange with the public.]
• According to Liu Liu, the book is based on her experience going “undercover” (with the hospital’s agreement) in a hospital for six months. During the interview, Liu Liu said that she hopes the book will offer an alternative view on solutions to improving doctor-patient relations—that of understanding doctors.
• Her account indicated her views on the need for greater understanding of the work challenges confronted by doctors, better patient education on health information, and additional support to help doctors to communicate with patients.
• Link to full Chinese text.

Xinhua Agency reported that the Beijing Health Bureau plans to invite 200 residents to participate in “A Day in the Life of a Doctor” in August. According to the report:

• The 200 residents will be posted in 71 jobs throughout 41 community health organizations.
• According to the bureau, the objective of the program is to solicit recommendations that will help improve the public’s trust of community hospitals and to alleviate patient demand for services in large hospitals.
• The bureau had launched a previous program involving 100 residents. The program helped hospitals improved services to promote better doctor-patient communications and relations.
• Link to full Chinese text.

A reporter of the Nanfang Weekend known for writing on doctor-patient relations reported his disagreement with author Liu Liu’s perspective on the issue. The reporter wrote:

• System reform, not understanding, is the critical factor needed for resolving the issue of strained doctor-patient relations.
• Liu Liu’s talk of “understanding” (for addressing the issue of strained doctor-patient relations) is a joke. The only way to alleviate patients’ frustration is to establish legal recourse to protect the rights of patients. If laws cannot do so, it is time to change the laws.
• The most important task is in establishing a system that eliminates bad doctors and rewards good doctors—not the other way around. The current system incentivizes doctors who take commissions on prescription writing and prescription abuse.
• China reports over a million cases of medical disputes per year, and in over 70% of these cases, patients have opted to “take on direct confrontation with the hospital.” Many of the problems are not related to “a lack of understanding” nor issues of medical cost and access. Based on [the reporter’s] experience, many of the cases may have involved criminal conduct in which a legal channel for resolution could not be found.
• Link to full Chinese text.

A reader’s commentary to the above report criticized the reporter for demonizing doctors and fanning already inflamed doctor-patient relations.

• Link to full Chinese text.

Business Initiatives

The Economic Observer reported that TSKF (Tianjin Smith Kline & French Laboratories, Ltd.) is planning to enter the traditional Chinese medicine consumer market:

• TSKF is in discussion with Tianjin Da Ren Tang on possible sales collaboration for traditional Chinese medicines.
• Other global pharmaceutical companies, including Pfizer and MSD, are all reported to have visited the Traditional Chinese Medicine Association, retained consultants to develop market entry strategies into the market segment, or have established intimate contacts with domestic suppliers.
• Following these global companies’ shift of strategy from patented medicines into generics and general medicines, industry insiders believe that these companies are seeking partnerships to further their reach into the general medicine market.
• Da Ren Tang in this case will provide the sales platform that TSKF needs to further its reach into the market segment. TSKF’s 1,000-person strong sales force will also eliminate the need for Da Ren Tang to build its own national sales network.
• Link to full Chinese text.