Infamous hospital surcharge to be axed by 2015
Beijing has pledged to scrap the notorious surcharges charged by hospitals - the main reason for extortionate prices of drugs and excessive prescriptions- by 2015.
Twenty years ago, hospitals were left on their own to generate income and pay for equipment. In turn, they were allowed to charge a 15 per cent surcharge for prescribed medicine. Some hospitals received as little as 10 per cent of their income from the government funding, getting most from surcharges and tests.
This is the first time the Health Ministry has set a timetable for abolishing the surcharge. Beijing promised to gradually eliminate them three years ago when it released a blueprint to revamp health care but no deadline was set because of strong resistance from hospital operators.
At a conference on Thursday to lay out the ministry's agenda, Health Minister Chen Zhu (pictured) said 300 county-level hospitals would start eliminating the surcharge, to be followed by all such hospitals next year. By 2015, all public hospitals would be free of the surcharge.
But a leading economics professor who is also a government adviser said eliminating the surcharge was only feasible if hospitals and doctors could cover their costs and wages by other means.
'The target cannot be met if such orders are carried out thoroughly,' said Li Ling, an expert on public hospital reform at Peking University. 'There won't necessarily be strong opposition from hospitals if they are still guaranteed the income.
'For example, if a hospital gets 15 yuan for prescribing 100 yuan of unnecessary medicine the old way, we could give the 15 yuan directly to the hospital and save the 85 yuan spent on unnecessary drugs.'
It is proposed that the surcharge be replaced by raising fees for services, which are considered unreasonably low. The consultation fee for a doctor is five yuan (HK$6.10), rising to seven yuan if the doctor is an assistant professor and 14 yuan if they are a full professor. It is common for a doctor to be paid less than 100 yuan for performing surgery.
Li said the higher fees should be covered by contributions from the government, insurance and patients- but the part shouldered by patients should be lower than now, otherwise the reform would fail.