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Hiking hospital prices opens floodgates to more abuse

2014-04-14 09:13 Shanghai Daily Web Editor: Si Huan

A private Shanghai hospital recently made headlines by charging as much as 1,200 yuan (US$194) for an outpatient visit.

The hospital in question, Shanghai International Medical Center (SIMC), opened in March in Pudong New Area and began operating on a trial basis.

Its exorbitant premium services average several times the fees charged by a typical Third Grade Class-A public hospital to see a doctor, the 21st Century Business Herald reported on April 3.

A consultation with a specialist at these top-level hospitals usually costs between 100-200 yuan. For ordinary doctors, the charge is about as low as 14 yuan.

Many people were taken aback by the SIMC's predatory pricing and cried foul, calling it a rip-off that constitutes inequality for poor patients. Yet the prohibitive price tag has found vocal support from a few doctors, including Song Donglei, a director of private Deji Hospital.

Seeking a fortune

"I appreciate the step taken by SIMC, which set the proper price benchmark for Shanghai expert doctors' outpatient service," Song wrote in a personal weibo posting. He resigned from a Third Grade Class-A public hospital years ago to seek a fortune at a private facility.

No doubt this price hike will be welcomed by many doctors, who have long been condemned, indeed hated, for enriching themselves by over-prescribing medicine and treatments.

This greedy approach has created a widening gap of distrust between patients and doctors and anger occasionally boils over into fatal attacks on doctors and medical staff by disgruntled patients.

Song's words even hint at pride, since steep outpatient charges could help doctors wean themselves from dependence on prescribing unnecessary drugs and tests.

They could ideally earn their bread through medical expertise and skills, just like their Western counterparts.

It is understandable that much-maligned Chinese doctors yearn for a better reputation, since what should be a noble calling has been stigmatized over the years.

But the wisdom of hiking prices at the new hospital and other private institutions is open to question.

To begin with, what's the point of replacing one form of rip-off with another? Yet even the nation's price watchdog and medical authority seemed to be rallying behind the price hike at the new Pudong hospital.

A recent circular announced the relaxation of price caps on private hospital fees.

It was jointly published by the National Development and Reform Commission, the National Health and Family Planning Commission, and the Ministry of Human Resources and Social Security.

The move is intended to encourage the private sector to enter health care, presumably to challenge the monopoly of public hospitals and help improve overall public health care through competition.

Yet the Shanghai International Medical Center's 1,200-yuan price tag for registration appears to be an abuse of that newfound flexibility.

If doctor Song's justification of staggering health care costs is acceptable, then it might encourage a brain drain, a flight of skilled doctors from public hospitals to private clinics, enticed by the promise of better pay.

And if that happens, experienced doctors at still affordable public hospitals will be in even shorter supply, and scarcity of doctors will inevitably translate into rising prices.

Which makes one question the logic so fervently articulated by a few doctors and their supporters.

Wishful thinking

It is said the higher price will lure rich people away from public hospitals, where the queues are always long and services undesirably slow and poor for their tastes.

In this way, public hospitals will be less crowded and doctors less overworked — or so it is hoped.

It is probably wishful thinking. Even for China's newly rich, and the majority middle class citizens, being charged 1,200 yuan for a cure for a minor ailment or a cold is a rip-off anyway.

A friend of mine imprudently sent his sick daughter to a pediatrician at the enormously expensive United Family Hospital, a joint venture in Shanghai's Changning District — simply for a cold.

That visit, driven by vanity, saddled him with a bill of 2,200 yuan for emergency room treatment.

Doctor's advice? Drink more water. No drugs were prescribed.

For medical students, who must study at least five years to be eligible to practice medicine, higher medical fees may be a tantalizing reward for years of hard work.

It may no longer appeal to some doctors that the main gauge of their worth should be the satisfaction of their patients.

Hospitals are not supposed to be freewheeling institutions out to turn a profit, and doctors are not supposed to be salespersons for pharmaceuticals, either.

Overdose of stimulants

That's where the authors of the recent government circular got it seriously wrong.

For Chinese hospitals, which are already acting like unbridled free enterprises, scrapping the curbs on prices is like an overdose of stimulants that encourages the wrong trend.

While private hospitals can plead innocence by saying they are intended for the rich, not the poor — and they do have a legitimate right to inflate prices — their value should lie in widespread appreciation for quality medical services, not some sky-high price and exclusivity.

In a society where people are easily affronted by tales of exclusive clubs, schools and now hospitals catering to the wealthy, hospitals like the Shanghai International Medical Center are unbelievably insensitive to the likelihood that their price-gouging will widen the class chasm and reinforce the jaundiced perception of doctors.

In a sector where past reforms have already created a mess, if not a powder keg, the authorities should have trod with greater care and renounced the mistaken belief in the free market.

The latest episode about astronomical medical fees seems to have suggested otherwise.

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