A Milestone Event of Chinese Medical Reform – Same Insurance, Different Treatments

There are five types of insurance in America that have the closest relation with international students : U.S. dental insurance (aka 美国牙医保险), U.S. vision insurance (aka 美国眼科保险), U.S. travel insurance (aka 美国旅游保险), basic international student health insurance (aka 留学生保险), and OPT insurance (aka opt 保险). These insurances protect international students from unnecessary financial debt just in case. The U.S. government has a clear, serious attitude of the international student health insurance in terms of the Affordable Care Act as well as the requirement of waiving health insurance (aka 替换保险). However, this is not the case in China.

Different from the ambiguous attitudes of the clinics, the national medical insurance authority in some cities is slightly unconcerned about clinics. According to Ding Xiangyang, the former Deputy Mayor of Beijing, the authority treats the clinics based on their ownership, public or private.

Since the day of its birth, a public hospital has been designated as a health facility covered by medical insurance because it is one of the responsibilities of public hospitals to provide basic medical services, the medical insurance that guarantees basic medical services naturally covers all public hospitals.

In contrast, as a complement to basic medical services, clinics just provide more choices for patients who have more needs. In this context, it is not difficult to understand why the government refused to include clinics to the national medical insurance system.

Yet, this “mindset” is no longer applicable to the current situation. On May 13, the National Health Commission, together with other four departments, issued the Opinions on Promoting the Clinic Development Pilot (hereinafter referred to as Opinions), and emphasized that clinics should provide common diseases treatment, frequently-occurring disease therapy and contractual service of family doctors.

According to the Opinions, primary medical care is also one of the starting points for clinics. Therefore, the Opinions requires the medical insurance authority to make no exception for clinics and to include qualified ones as designated health facilities accordingly.

Although the government has been supportive, clinics which are regarded as market participants are also required to not always take the policy “shortcut”. Zhu Minglai believes that whether to lift the restrictions on medical insurance in clinics will ultimately depend on the patients’ needs, and the government should relinquish control.

Shortly after the release of the Opinions, the person in charge of Beijing Fengtai District Medical Insurance Management Center said that they had not received the notice and had not heard of it yet when CN-Healthcare interviewed on the application of clinic for the inclusion of the national medical insurance system.