Patients will be able to pay after they receive medical treatment rather than before, as is the current practice, China's Ministry of Health revealed yesterday.
Jiao Yahui, an official with the ministry's medical administration division, said more than 20 provincial regions are carrying out pilot programs of the new payment method.
But Jiao said the "pay after" method would not be adopted nationwide in the short term due to the country's immature social credit system and insufficient medical insurance.
Currently, Chinese citizens pay up front before being operated on or undergoing other treatment. They can then apply for a reimbursement covered by medical insurance, usually more than 70 percent of the total cost.
In August 2011, there was a national outcry after a nightshift doctor in central China's Hubei Province removed stitches from a patient, who had torn tendons in his right hand, because the patient did not have enough money to pay the fees involved.
There have also been reports of hospitals threatening to withhold medication if patients fail to pay in advance.
In Shanghai, however, some community hospitals adopted the "pay after" method two years ago. In Xuhui District, that's the practice in all community hospitals.
"By flashing the smart card with each person's medical insurance, the card can do real-time recording of all tests and prescriptions," said Guan Juanjuan of the district's health bureau. "Patients only need pay after all diagnosis and treatment is fulfilled, instead of paying fees before each test."
However, people failing to pay bills are recorded in the medical insurance system and banned from the "pay after" method the next time they seek treatment.
Larger hospitals say they would have difficulty in adopting the new method, since up to 50 percent of their patients could be from provinces which have no connection with local medical insurance.
"The government only covers 5 percent of big hospitals' costs, so the hospital must earn the other 95 percent by themselves," said Xia Lin of the Shanghai Children's Medical Center. "If promoting the method, the government should give a subsidy to cover the delayed payment of hospitalized patients."
In Shanghai, Longhua Traditional Chinese Medicine Hospital is the only large hospital using the new method, but only for outpatients covered by medical insurance.
Jiao said once the new system is implemented, patients, especially those suffering extreme conditions, receive treatment first. After the treatment, patients will only pay the part that is not included in the medical insurance. The rest will be paid to hospitals by the government.
The "pay after" method was first tested in a hospital in Beijing in 2009 and was well received by patients, Jiao said.
Pilot programs are generally going smoothly in many areas, but there were still some patients "disappearing" without paying treatment fees after leaving hospital.
If a runaway patient is covered by the country's medical insurance, hospitals can get compensation from the government, but if they did not buy any medical insurance, the hospital would not be able to get the money back, said Jiao.
The system can only be promoted step by step, Jiao added. If local governments think it is feasible, then they should do it.
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