Liu Minxia

    mllmx@msn.com

    STARTING Sunday, hospital goers will not need to pay a one-yuan (US$0.14) registration fee before seeing a doctor in Shenzhen among a number of price changes the city’s health commission unveiled yesterday to deepen a years-long health-care reform that has entered a difficult stage.

    Tasked by the Central Government to pilot the country’s medical reform in 2010, Shenzhen has been exploring ways to overhaul the health-care system, including advocating family medicine, changing the doctor employment mechanism, and pushing for reservation services, to target major patient complaints like difficulties in accessing high-quality medical services and the high prices of such services.

    Through a three-step price-adjusting plan that will start Sunday and be completed before the end of next year, Shenzhen’s health commission hopes to reduce the expense of health care for patients, Liu Kun, a deputy director of the health commission, told reporters yesterday.

    The initial step, unveiled yesterday, included changes to the pricing of 833 medical service items, which represents 9.2 percent of the total. The changes are expected to save a total of 30 million yuan for patients annually, said Bu Qiwen, deputy director of the commission’s finance department.

    The 833 price changes fall into four major areas: a 20-percent reduction on 252 types of medical examinations using large equipment such as CT, MRI and PET-CT; cancellation of seven types of fees, including the one-yuan registration fee that is usually charged together with the consultation fees and air-conditioning fees for hospital beds; an average 50-percent increase on prices for 357 types of difficult surgeries; and an average 25-percent rise on 217 treatment services that are mostly neonatal care, pediatric services, rehabilitation services, traditional Chinese medicine services and psychiatric treatment.

    The cancellation of the registration fee will enable patients with a reservation to go directly to see a doctor and make all the payments with their mobile phones.

    “Shenzhen’s current medical service pricing measures were installed 10 years ago, which need to be updated and re-adjusted,” said Bu.

    The 20-percent reduction on medical checkups using large equipment is expected to save patients 165 million yuan annually, while the cancellation of seven types of fees are expected to save patients 72 million yuan annually, he said.

    The two types of price increases will cost roughly 270 million yuan more annually, he said.

    “The changes in total are minor at the initial step, and big changes are expected during the second step when we target the price of medicines,” said Bu.

    The commission is considering a collective medicine purchasing system for its second step in the first half of next year which is expected to reduce medical costs by 30 percent, said Li Chuang, another director of the commission.

    Doctors say they understand the changes are trying to bring esteem to their work. “Some difficult surgeries are priced too low. For example, a hip replacement surgery is priced between 1,800 yuan and 2,300 yuan, but it usually involves four doctors and two nurses and lasts for one to two hours,” said Wang Hua, a doctor at Shenzhen People’s Hospital’s arthropathy department.

    Shenzhen has invested more than 70 billion yuan to support public health care since 2010, and government subsidies account for 30 percent of the revenue of public hospitals, up from 19.2 percent six years ago, said Li.

    The average expense for a Shenzhen outpatient is 214.9 yuan, while that for an inpatient is 9,592.2 yuan, which is much lower than in other cities, Li said. Shenzhen patients pay 19.29 percent of their total medical care expenses, while medical insurance covers the rest, Li said. The proportion has dropped from 23.82 percent since 2012.