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July 23, 2012

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Home » Metro » Health and Science

International medicine a growing presence

MOTHER-TO-BE Echo Zhang inspected several hospitals before deciding to have her baby at Shanghai United Family Hospitals and Clinics, a US-China joint venture hospital that costs up to 10 times more than maternity care in state-owned health facilities.

"I know it costs more," Zhang said. "But having a baby is a happy event for the whole family, so Chinese couples are willing to pay a big sum for a comfortable environment, less waiting time and nicer medical staff for the mother and baby."

Zhang's husband is a senior business executive who can pay for premium maternity care that costs between 70,000 yuan (US$11,111) and 120,000 yuan. Many expatriates have health insurance to defray the additional cost.

"The price at United Family is really high, and it is a big expense for a middle-class family on China's mainland," said Milan Koev, a Bulgarian waiting for a prenatal check-up. "Even for many foreigners living in Shanghai, it is expensive. I come here because it's a hospital recognized by my insurance company."

Improved services

International hospitals and clinics have a growing presence in the local health-care market. The government is trying to encourage the establishment of more high-end health facilities to meet demand from people who can afford that level of care and to help improve the quality of local services by introducing the latest in global medical care.

The Shanghai Health Bureau said the city is especially interested in promoting improved services in the fields of elderly care, mental health and rehabilitation.

Joint venture hospitals in Shanghai performed 370,000 outpatient and emergency services and nearly 10,000 inpatient hospital procedures in 2010, earning 1 billion yuan, according to the Shanghai Health Bureau.

Offshore investment on China's mainland hospitals used to be allowed only in joint ventures with Chinese partners. In recent years, investment from Hong Kong, Macau and Taiwan is being allowed on a wholly owned basis.

Shanghai has 19 joint venture facilities: seven full-service hospitals, two specialty hospitals, six comprehensive clinics and four specialized clinics. Eight hospitals have wards with 521 beds.

The main users are expatriates, who comprise as much as 95 percent of the patient load. United Family, perhaps because of its popular maternity services, attracts more Chinese than other international hospitals. About a quarter of its patients are Chinese.

"International hospitals and clinics have no access to local government-run medical insurance, and most Chinese don't buy the kind of insurance that would cover expenses at international health facilities," said Xu Wenxiang, the executive vice president of the SinoUnited Health, a US-invested clinic offering rehabilitation and treatment for pain and sports injuries.

International healthcare providers said they would like to see more favorable policies from the government.

"It is very difficult to hire good people, especially in some professional fields, from local big hospitals under strict personnel rules," Xu said.

"I hope the government will introduce more flexible policies to help us hire experts from state-owned hospitals and expedite visas and employment for foreign medical staff," Xu said.

Foreign-invested healthcare providers typically recruit much of their staff from overseas, especially in fields such as pediatrics, dentistry and internal medicine. That obviously creates language problems because many overseas medical practitioners don't speak Chinese and often staff from state-owned hospitals are brought in to act as intermediaries.

Hiring without proper approval

Some worry about lax controls.

"The government should strengthen its inspection of international hospitals," said Cindy Wang, CEO of Shanghai East International Medical Center, the first joint venture hospital founded in Shanghai in 2003. "It is common for international hospitals to hire medical staff from state-owned hospitals without proper approval, and some medical centers are operating special services without licenses."

In Shanghai, doctors in state-owned hospitals must be OK'd by the health bureau before working in a second facility.

Sino-US WorldPath Clinic International was recently fined by the Shanghai Health Bureau for carrying out in-vitro fertilization services without a license and for hiring staff without proper maternity care accreditation.

To stanch the drain of higher-income patients to international hospitals and clinics, some state-owned hospitals have expanded their VIP sections to attract expatriates and wealthy Chinese.

Xia Lin, an official from Shanghai Children's Medical Center, said such premium services in state-owned hospitals can't compete with foreign joint venture hospitals in either environment or services, but government medical facilities can boast among the highest-qualified medical staff, in many cases because of links to medical schools.

"The VIP department is popular among Chinese with higher incomes and among people mostly from Hong Kong, Taiwan and Macau," she said. "But it is true that many high-end people won't come here because the entire environment is poorer than its foreign joint venture counterparts."

For major surgeries, most expatriates prefer to return to their home countries, while Chinese patients still prefer to trust doctors at big state-owned hospitals.

For ordinary medical care, like prenatal examinations, foreign-funded clinics offer people a relaxing respite from the hurly-burly of government facilities.

"I am satisfied with the service so far and am looking forward to a nice experience having my baby delivered at United Family," Zhang said.

"If it's as good as I hope, I will come back if I have a second child."


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