Business / healthcare

Health insurance policy seen as essential to medical alliance

By Wang Qingyun (China Daily) Updated: 2012-11-08 09:31

As Beijing's Chaoyang Hospital prepares to establish an alliance with other medical institutions, insiders involved in the project said the hospital will find itself under less pressure only if changes are made to public health insurance policies.

The alliance, which involves four hospitals and seven community healthcare centers in Chaoyang district, is meant to encourage more people to seek treatment at small institutions. That will enable those small institutions to concentrate on chronic ailments and large hospitals to mostly treat more complicated conditions.

Chen Yong, executive director of the hospital, said the alliance will be a way to share the burden of providing healthcare services.

"Our resources are scarce and are being wasted," he said. "Many people with chronic conditions choose to consult our doctors instead of going to smaller institutions."

To get smaller clinics more involved in treating less-severe diseases, Chaoyang Hospital began collaborating with community health centers in 2007.

Chen said the cooperation has not gone well, mostly because there is no clear division of labor among the institutions. Chaoyang Hospital is trying to improve the situation by supporting the other members of the alliance as they work to develop their own strengths, which will enable them to oversee the recovery and long-term treatment of different kinds of patients.

For example, a healthcare center in Beijing's Gaobeidian community has been chosen to aid in the recovery of patients treated with hyperbaric therapy, which involves using oxygen at a pressure that is greater than atmospheric pressure.

Wei Xiaodong, whose son has brain damage and had been undergoing hyperbaric therapy in Chaoyang Hospital, said her son has undergone rehabilitation in the Gaobeidian healthcare center for about a year.

"I took my son to the center because Chaoyang Hospital doesn't have a rehabilitation department," said the 50-year-old mother. "Here, we've been provided with professional therapists and rehabilitation."

The differences that exist among healthcare policies are perhaps the biggest difficulties the alliance must contend with, said Ji Heping, director of the Gaobeidian healthcare center.

"Although people enjoy 90 percent reimbursements for seeking medical help in the grassroots healthcare centers, we have fewer kinds of medicine that you can secure reimbursements for than large hospitals do," he said. "This means a patient transferred here from a large hospital may need to pay for medication that he could have received a reimbursement for before. This may prevent more people from coming to us."

"Large hospitals may find it desirable to channel patients to small healthcare centers in an attempt to control their expenses," Ji said. "But their smaller counterparts usually face stricter control on using the insurance.

"We will never push patients away, but right now the center has almost used up its grant money this year," Ji said.

"If we need to carry through with the alliance program, it will be necessary to change current healthcare insurance policies," Chen added.

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