Remedy you can't afford not to take
A second University of Hong Kong teaching hospital to open in Shenzhen soon expects to have no trouble filling its 2,000 beds - 1,200 of them for public patients at 500 yuan (HK$602) a day. This will cover everything from a bed to major surgery. It means these patients will be willing to pay six times what people pay in Hong Kong, and not just because mainlanders perceive Hong Kong has higher standards of treatment and care. They will also avoid the illicit practices adopted by many mainland hospitals and doctors to support their incomes, such as overprescription of expensive drugs and unnecessary tests, not to mention fees payable up front for treatment.
Mainland public hospital doctors earn from 3,000 yuan in their first few years to 40,000 yuan in their forties; hospitals have been left largely to stand on their own feet with limited government financial support following market reforms. Now the doctors face a new standardised training scheme for hospital residents that will leave them better trained and qualified, but even worse off financially, by delaying the start of their medical careers. As a result, the Chinese Medical Doctor Association is calling on the central government to grant a major increase in doctors' salaries or face the prospect of fewer students applying for medical schools.
The new training scheme is part of reforms intended to improve the efficiency and affordability of the mainland's health system. The HKU teaching hospital, funded by Shenzhen and supported by the Ministry of Health, is at its forefront. The reforms cannot come a moment too soon, going by a World Bank report that chronic illness in people over 40, such as heart and respiratory disease, cancer and diabetes will at least double in the next two decades without effective prevention strategies, including the promotion of healthier lifestyles, and better access to quality care. If this is so, it is not a question of whether the government can afford to pay more to retain doctors and attract new medical students. It cannot afford not to.