Lei Jufang: Reforming the medical insurance system is a prerequisite for improving doctor-patient relationships.

　　On March 7, Lei Jufang, a member of the National Committee of the Chinese People's Political Consultative Conference and Chairwoman of Qizheng Tibetan Medicine, said in an exclusive interview with a reporter from China Securities Journal that she recommends the government increase its support for grassroots organizations establishing rural hospitals and revise the current medical insurance system to lay the groundwork for harmonious doctor-patient relationships.

　　Lei Jufang said that the current medical situation for village doctors in vast rural areas is such that the more remote and underdeveloped the region, the greater the shortage of doctors and medicines. As a result, village doctors tend to have lower levels of professional education and lack adequate medical facilities. It’s quite common for local residents to fall into or relapse into poverty due to illness, and one of the main reasons why minor illnesses often become serious conditions is precisely this lack of timely medical care.

　　Lei Jufang pointed out that, given this situation, several civil and charitable organizations have already voluntarily invested funds and manpower to build traditional medicine schools and train rural doctors in remote and ethnic minority areas, as well as to establish relatively well-equipped clinics. However, clinics built by these private organizations cannot be included in the primary healthcare system—even in remote regions—thus failing to qualify for reimbursement under the New Rural Cooperative Medical Scheme. As a result, village doctors are unable to receive either national or local subsidies, forcing the donors to bear the long-term costs of village doctor salaries and facility upgrades, which in turn undermines their enthusiasm for continuing and expanding these projects. Moreover, even if the village doctors running these clinics possess excellent medical skills and enjoy high recognition among villagers, since their clinics are not reimbursable for medication expenses, they struggle to attract more patients. This not only limits the income of village doctors but also hinders the equitable development of primary healthcare institutions.

　　To this end, Lei Jufang put forward three recommendations: First, the National Health and Family Planning Commission should explicitly include village clinics donated by civil organizations and charitable foundations in the construction of the relevant primary-level medical institutions system, and ensure that these clinics receive equitable reimbursement under the New Rural Cooperative Medical Scheme. Similarly, village doctors who meet the eligibility criteria should be treated on an equal footing and entitled to both national and regional subsidies. Second, a set of admission standards and an assessment system for village doctors should be established. Third, the National Health and Family Planning Commission should introduce policies to encourage civil organizations and charitable institutions to donate and build clinics in rural areas and ethnic minority regions; at the same time, it should set up a special award program to recognize individuals and organizations that contribute to grassroots medical care through social donations.

　　Regarding the current tense doctor-patient relationship, Lei Jufang stated that the issue stems from communication problems, trust issues, and systemic problems as well. To build a harmonious doctor-patient relationship, we must first reform the unreasonable medical insurance system.

　　Lei Jufang added that the first step is to revise the regulation limiting the length of hospital stays for serious and critical illnesses. The current 15-day limit on hospital stays has not reduced patients’ medical insurance costs; on the contrary, it has driven up costs even further. Second, we should increase the proportion of medical insurance reimbursement for rural patients with serious illnesses who are hospitalized in large hospitals. Third, in major cities, we should raise the reimbursement limits for home-based treatment of geriatric diseases. Fourth, we should streamline redundant procedures and accelerate the implementation of real-time medical insurance reimbursement across different regions.

　　Source: China Securities Journal

　　Website: http://finance.sina.com.cn/stock/t/20140307/102518437929.shtml