Wednesday, 9 April 2014

Are China's health reforms stalling? Health ministry denies rumours

by Michael Woodhead
In an unusual move, a spokesman for the National Health and Family Planning Commission (NHFPC) this week spent much of a press conference trying to refute rumours that the health reforms were proving "too difficult" for the NHFPC to implement.
The spokesman for  health minister Li Bin specifically rejected media speculation that the State Council had decided  that implementation of health reforms should be transferred back the the National Reform and Development Commission.
The move comes after media reports noted that plans to merge China's urban and rural  health insurance schemes had stalled. A financial article re-published widely on social media site WeChat had also questioned whether the health ministry had the clout to push through necessary reforms of hospital finances to remove the dependence on income from pharmaceuticals. This was a tough task as the reforms face strong opposition from the medical profession, whose income is based on sales on drugs. Some have also questioned the ability of the health ministry to be a reformer "reforming itself"
and say it has shown weakness in co-ordinating reforms.
Spokesman Mao Qunan said the article was just a rumour and there were no plans to return the reforms to the National Reform and development Commission. He said health reforms were progressing steadily and it was expected hat there would be difficulties along the way. He noted that Premier Li Keqiang had put special emphasis on deepening the health reforms and implementing them in public hospitals, and this was now being extended to more than 1000 country level hospitals.
Health economists such as Professor Hu Suanlian of Fudan University, Shanghai have commented that health reforms are difficult to implement and co-ordinate because they involve many departments with different aims and responsibilities - such as finance, social security and health. There is also the problem of different provinces and cities having different health insurance arrangements and different priorities.
[Editor's note: This unusual admission of a rumour - and the concerted effort to quash it suggests  there is real opposition within the health system - and perhaps the political establishment - to China's health reforms. The health ministry spokesman made specific reference to doctors' income and the pharmaceutical procurement system as sensitive areas of the reforms. This suggests that those with financial vested interests in the status quo - the medical profession, hospitals and the pharma industry - may be trying to stall the reforms or turn them to their advantage.]

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