Over-prescription of drugs, the scourge of the medical system – Opinion

Editor’s Note: From “barefoot doctors” to the largest and most efficient medical insurance system, China has made remarkable achievements in the health sector. In the third in a series of commentaries, a veteran China Daily reporter traces the eventful course of China’s health care achievements.

Although 1.35 billion Chinese citizens are covered by various types of medical insurance, complaints about the shortcomings of the health system have not ceased. China has nearly a million medical facilities that most people, no matter what part of the country they are in, can access within 15 minutes of their homes. But the majority of them are basic clinics that can only treat mild illnesses. And with just over 30,000 hospitals providing inpatient services, patients, in some cases, have to travel long distances, mostly to cities, to seek treatment for serious illnesses.

The number of hospitals may be low due to insufficient investment in the medical sector. China is home to around 20% of the world’s population, but its investment in health is only 2% of the global total. The good news is that China’s investment in healthcare has grown by double digits in recent decades, mainly to build more hospitals, buy more medical supplies, and raise salaries for healthcare workers. Investment in health care is expected to increase further.

Another challenge facing the medical sector is the imbalanced distribution of medical resources. The best hospitals are mainly located in metropolises such as Beijing, Shanghai and other top-tier cities, while many county and township hospitals in the western region are facing problems due to outdated facilities and ” unqualified and / or inexperienced medical personnel.

But central and local governments are taking steps to improve the situation. For example, new investments are mainly aimed at modernizing basic medical institutions, encouraging good hospitals to open branches in the western region, and ensuring that more qualified doctors work in rural areas on a rotational basis. While providing appropriate treatment to patients, these doctors also give on-site training to local health workers so that they can work more efficiently.

Although around 800 million people in rural areas have joined the new rural cooperative medical insurance program, only a small percentage of their medical costs can be reimbursed due to lack of funds. People who take out rural insurance pay around 200 yuan ($ 30.72) each year as a bonus, while the government pays around 500 yuan. But even the combined total of 700 yuan is far less than the amount paid by employers and employees – 8% of an employee’s income – as a bonus in urban areas.

Therefore, when a rural resident is diagnosed with a serious illness, the percentage of medical bills he has to pay is high, so high that it could force a family into extreme poverty. Calls have been made to unify rural and urban health insurance systems to alleviate the medical burden on rural residents. But for this, the government will have to invest billions of additional yuan in the health sector, as it is unrealistic to ask people in rural areas to pay higher premiums, as millions of them come from. get out of poverty.

Although improving the health system as a whole may take some time, strict measures must be taken immediately to stop the wastage of precious and limited medical resources. In China, doctors’ income is to some extent tied to the income of their hospitals, both public and private, leading many to over-prescribe drugs and / or medical tests to patients.

Probably, many families throw away a certain amount of Western or traditional Chinese medicine every year because they were over-prescribed by doctors. This gave birth to a new kind of illegal activity: collecting drugs from patients in cities and selling them to rural clinics at a lower price.

No one knows exactly how much money and how much of the drugs are involved, but the widespread advertisements of these drugs on streetlights and walls suggest that it could be a multi-billion dollar business, one run. by “money leaks” from government funds and insurance companies. and patient pockets.
Therefore, health authorities, hospitals and insurance companies should take strict measures to stop the over-prescribing of drugs. And doctors’ incomes should not be tied to the amount of drugs and medical tests they order.

If over-prescribing of drugs is stopped, some experts say, a third of medical resources can be saved. And it can help cure one of the ailments of the healthcare system.

The author is the former deputy editor of China Daily.
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The opinions expressed here are those of the writer and do not necessarily represent the views of China Daily and the China Daily website.

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