December Updates from China
Five-Year Progress Report from Traditional Chinese Medicine AIDS Treatment Program
Encouraging results from a pilot program initiated in 2004 showed that 5,972 HIV/AIDS patients in 17 provinces are currently receiving free traditional Chinese medicine (TCM) treatment. The nationwide program is managed by the State Administration of Traditional Chinese Medicine (SATCM) with 160 million RMB in funding, to date, from the central government. About 25 percent of close to 6,000 patients have received uninterrupted treatment for 48 months. The results showed that TCM is efficacious for treating fever, coughing, weakness, diarrhea, shortness of breath, skin diseases, digestive diseases and other clinical symptoms, in improving and stabilizing immune function, elevating the patient’s quality of life and reducing adverse reactions to medications. The SATCM has established the AIDS Prevention and Treatment Center at the Academy of Traditional Chinese Medicine and is building regional and local infrastructure to evaluate treatment and management models. The report states that clinical trials in Tanzania initiated in 1987 have demonstrated the efficacy of dozens of TCM treatments for AIDS and identified an additional 20 TCM entities for additional research.
Heated Debates About Healthcare Cost Shifting Continue
When the opinion paper “Reform of drug and healthcare service pricing model and system” from the Ministry of Health and related government bureaus was released on November 23, one of the key premises—reducing drug costs while elevating service costs—garnered immediate, heated comments. Some typical questions raised were: Is it possible to fix the old system of subsidizing services with high drug costs? Can the doctor’s value be fully recognized? Will this reduce overall healthcare costs? Will this improve the quality of service? Here is a snapshot of the opinions voiced.
- Service fee increases do not compensate for lowered drug costs. One hospital that reduced the cost of 1,054 drugs (Western) and 562 TCM items and reduced the cost burden on patients experienced a huge increase in outpatient volume (at the expense of nearby hospitals that have not reduced prices). But the corresponding 4 percent increase in service fees is inadequate for covering the lost drug revenue, and the hospital administrator does not believe current price levels are sustainable.
- Higher service fees elevate expectations of better quality care. The hospital administrator of a major tertiary care center believes that the shift could break the vicious cycle of physicians seeking compensation by prescribing more expensive drugs. Another hospital administrator commented that improving physician compensation may encourage more young people to become doctors. But the bottom line is that higher service fees must be reflected in improved care.
- Government subsidy may be the way. The recurring theme seems to be that the rise in service fees cannot happen fast enough or substantially enough to cover the lost drug revenue. And the government needs to step in to fill the gap.