Weitere Kapitel dieses Buchs durch Wischen aufrufen
Informal payments are an illegitimate practice that has been endemic in the Chinese healthcare system for decades. This chapter examines two market mechanisms that the government has used to contain it, namely, internal competition and differential pricing. It reveals that due to market failures, internal competition pushed up the demand for the services of elite practitioners and led to the concentration of informal payments in their hands. Differential pricing not only concentrated informal payments in the hands of senior surgeons, but also exacerbated health inequality and subverted the government’s ideological commitment to social justice. Both mechanisms did not achieve the purpose of controlling informal payments and have been abandoned either by hospitals or by the government.
Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten
Sie möchten Zugang zu diesem Inhalt erhalten? Dann informieren Sie sich jetzt über unsere Produkte:
Bai, J. (2015, June 20). Quxiao texu yiliao fuwu fuhe gonggong liyi (Abolishing special medical services is consistent with public interests). Renmin ribao (People’s Daily), p. 19.
Beijing Municipal Commission of Development and Reform and Beijing Municipal Health Department. (2006). Guanyu jinyibu guifan he quxiao bufen yiliao fuwu xiangmu shoufei de tongzhi (Circular about further strengthening the regulation and cancellation of the rates for some medical service categories) [online]. Available from: http://www.bjpc.gov.cn/tztg/200602/t111328.htm. Accessed 1 Dec 2015.
Beijing Price Bureau and Beijing Municipal Health Department. (2001). Guanyu guifan feiyingli yiliao jigou texu yiliao fuwu xiangmu he shoufei biaozhun de tongzhi (Circular on the standardization of the categories and rates of specially needed medical services in non-profit medical organizations) [online]. Available from: http://law.lawtime.cn/d434230439324.html. Accessed 1 Dec 2015.
Blumenthal, D., & Hsiao, W. C. (2015). Lessons from the East—China’s rapidly evolving health care system. New England Journal of Medicine, 372(14), 1281–1285. CrossRef
Bork, T., Gransow, B., Kraas, F., & Yuan, Y. (2011). Marketization and informalization of health care services in mega-urban China. In A. Kramer, M. H. Khan, & F. Kraas (Eds.), Health in megacities and urban areas. Heidelberge: Springer.
Cao, X. (2010). Submerged discontent and institutions: Doctors’ pay in Chinese hospitals. In 28th International Labour Process Conference. Rutgers University.
Cao, J. (2015, May 22). Gong yi gaige zhishi yi pian hualili de wenzhang? (Reform of public hospitals is just bravado?). Yi yao jijing bao (Pharmaceutical and Medical Economy), p. 2.
Central Committee of the Chinese Communist Party and State Council. (1997). Guanyu weisheng gaige yu fazhan de jueding (Resolution on health reform and development). Zhongguo gonggong weisheng guanli (Chinese Journal of Public Health Management), 13(2), 65–70.
Central Committee of the Chinese Communist Party and State Council. (2009). Guanyu shenhua yiyao weisheng tizhi gaige de yijian (Circular on deepening the reform to the pharmaceutical and health systems). In Z. Hu (Ed.), Shenhua yiyao weisheng tizhi gaige wenda (Q and A of deepening the reform to the pharmaceutical and health systems) (pp. 1–25). Beijing: People’s Publishing House.
Chen, X. (2006a). Fansi ‘hongbao’ xianxiang de cunzai jichu ji duice (Reflection on the foundation of ‘red packet’ phenomenon and policies dealing with it). Zhongguo yixue lunlixue (Chinese Medical Ethics), 19(1), 55–57.
Chen, X.-y. (2006b). Clinical bioethics in China: The challenge of entering a market economy. Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine, 31(1), 7–12. CrossRef
Chen, R., & Du, J. (2010, May 21). Gongli yiyuan weihe rezhong texu yiliao fuwu (Why public hospitals are enthusiastic about special medical services?). Zhongguo shuiwu bao (China Taxation), p. 8.
China Health Year Book Editorial Board. (2002). China health year book 2002. Beijing: People’s Health Publishing House.
Daniel, A. (1990). Medicine and the state: Professional autonomy and public accountability. Sydney: Allen and Unwin.
Du, J. (2010, May 12). Lai qian tai rongyi, gongli yiyuan bian xiang da gao texu yiliao fuwu (Public hospitals expand disguised special medical services for easy money). Haixia cai jing daobao (Straits Financial and Economic Guide), p. 5.
Eggleston, K., & Yip, W. (2004). Hospital competition under regulated prices: application to urban health sector reforms in China. International Journal of Health Care Finance and Economics, 4, 343–368. CrossRef
Fan, R. (2010). Reconstructionist confucianism: Rethinking morality after the West. Heidelberg: Springer Netherlands.
Gao, H., & Yang, M. (2003). Qianlun zonghexing yiyuan shishi “bingren xuan yisheng” de li yu bi (The advantages and disadvantages of implementing “patients choose doctors” in general hospitals). Zhongguo weisheng shiye guanli (Chinese Health Service Management), 8, 470–471.
Ge, Y., & Gong, S. (2007). Zhongguo yigai: wenti, genyuan, chulu (Chinese health care reform: problems, reasons and solutions). Beijing: China Development Press.
General Office of the State Council. (2015). Guanyu chengshi gongli yiyuan zonghe gaige shidian de zhidao yijian (Guiding advice on comprehensive trial reform to urban public hospitals) [online]. Available from: http://www.gov.cn/zhengce/content/2015-05/17/content_9776.htm. Accessed 22 Aug 2015.
Gu, X., Gao, M., & Yao, Y. (2006). Zhenduan yu chufang: zhi mian Zhongguo yiliao tizhi gaige (China’s health care reforms: A pathological analysis). Beijing: Social Science Academic Press (China).
Guo, Y. (2007, April 16). Weisheng bu Fu Buzhang Wang Longde: bingren xuan yisheng shi yiliao fuwu gaige de fangxiang (Vice Minister of Health Wang Longde: Patients choose doctors is the direction of medical service reform). Zhongguo qingnian bao (China Youth), p. 7.
He, D., & Jin, C. (2015, August 17). Gongli yiyuan texu fuwu hequ hecong (Speical services in public hospitals: what course to follow). Jiankang bao (Health News), p. 6.
Hong, M. (2012). Yi huan guanxi zhong hongbao xianxiang de yixue lunlixue zai tantao (Revisit medical ethics in the phenomenon of red packets in doctor-patient relationship). Zhongguo yixue lunlixue (Chinese Medical Ethics), 25(2), 207–208.
Huang, Y. (2004). Yiyuan “hongbao” xianxiang yu yiliao tizhi zhuanxing (“Red packets” in hospitals and the transition of the health care system). Shehui (Society), 10, 28–30.
Kjær, A. M. (2004). Governance. Malden: Polity Press.
Kong, G. (2004). Dujue ‘hongbao’, shi gaishan yihuan guanxi de guanjian zhiyi (Eliminating ‘red packet’ is one of the keys to improve doctor-patient relationship). Zhongguo xiandai linchuang yixue (Chinese Journal of Clinical Medicine), 3(8), 92–93.
Kong, X., Du, Z., Zhao, M., Yang, Y., & Qin, Y. (2011). Hongbao yu yi huan chengxin (Red packets and honesty in doctor-patient relationship). Yixue yu zhexue (Medicine and Philosophy), 32(5), 34–37&48.
Lewis, M. (2010). Informal payments and the financing of health care in developing and transition countries. Ann Arbor: International Policy Center, Gerald R. Ford School of Public Policy, University of Michigan [Working report]. Available from: http://ipc.umich.edu/working-papers/pdfs/ipc-98-lewis-informal-payments-financing-healt-care-developing-transition.pdf. Accessed 23 Aug 2011.
Li, B. (2001). Bingren xuan yisheng de shishi yu tantao (Implementation and discussion of patients choose doctors). Yixue yu zhexue (Medicine and Philosophy), 22(3), 8–10.
Li, L. (2005). Zhongguo ying caiqu zhengfu zhudao xing de yiliao tizhi (China should adopt government-centred health care system). Zhongguo yu shijie guancha (China and World Affairs), 1, 156–162.
Li, C. (2006, April 20). Beijing weihe jiaoting ‘diandao fei’, huanzhe fachou (Why did Beijing call an end to “scalpel nomination fees”). Renmin ribao (People’s Daily), p. 15.
Liu, D. (1994). Dui dianming shoushu wenti de shangque (A thought on operation by nomination). Zhonghua yiyuan guanli zazhi (Chinese Journal of Hospital Management), 10(9), 532–533.
Liu, W. (2000, October 11). Chongqing: Bingren xuan yisheng caozuo nan yinyou duo (Chongqing: The difficulties and concerns of patients choose doctors). Zhongguo xiaofeizhe bao (Chinese Consumers), p. A02.
Lu, Z. (2011). Qianxi ‘kanbing song hongbao’ ji zhili duice (A study of ‘giving red packet for medical treatment’ and policies dealing with it). Zhongguo yiyao zhinan (Guide of Chinese Medicine), 9(24), 360–362.
Lu, Z., Wang, X., & Zhang, J. (Eds.). (2010). Yi huan guanxi xianzhuang, yuanyin ji duice yanjiu— quanguo shi chengshi yi huan guanxi diancha yanjiu baogao (A study of the current state, reasons and solutions of doctor-patient relationship— A research report on the investigation of doctor-patient relationship in ten cities across the country). Beijing: Chinese Bookstore.
Ma, W. (2008, December 23). Jiwang kailai yong yu chuangxin anzhao Kexue Fazhan Guan yaoqiu shenru kaizhan jiufeng gongzuo—jinian dang de jilu jiancha jiguan huifu chongjian 30 zhounian (Advance and deepen the work of rectifying unhealthy tendencies innovatively in accordance with the requirements of the Scientific Outlook—On the 30th anniversary of the reinstatement and reconstruction of the Party’s discipline inspection organs). Renmin ribao (People’s Daily), p. 10.
Meng, Z., & Liu, Y. (2004). Shoushu dianming fei shi hongbao de hefahua? Huanzhe dao di gai bu gai gei? (Surgical nomination fees are legalized red packets? Should patients give or not?) [online]. Available from: http://news.xinhuanet.com/newscenter/2004-12/19/content_2353580.htm. Accessed 19 Dec 2010.
Ministry of Health. (1992). Guanyu shenhua weisheng gaige de jidian yijian (Several suggestions on deepening health reform). In Chinese Health Year Book Editorial Board (Ed.), Chinese health year book 1993. Beijing: People’s Health Publishing House.
Ministry of Health. (2004). Guanyu jiaqiang weisheng hangye zuofeng jianshe de yijian (Advice on strengthening the construction of good practice in health professions) [online]. Available from: http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohbgt/pw10405/200804/26860.htm. Accessed 17 Sept 2010.
Ministry of Health and National Planning Commission. (2000). Guanyu yiliao fuwu jiage guanli de yijian (Suggestions on the reform to the regulation of medical services pricing) [online]. Available from: http://www.moh.gov.cn/mohghcws/s3577/200804/16456.shtml. Accessed 22 Feb 2016.
Ministry of Health and State Bureau of Traditional Medicine Administration. (2000). Guanyu shixing bingren xuanze yisheng cujin yiliao jigou neibu gaige de yijian (Advice on promoting ‘patient chooses’ doctor in order to advance internal reform of medical institutions) [online]. Available from: http://www.law-lib.com/law/law_view.asp?id=15429. Accessed 17 Nov 2014.
Morris, J., & Polese, A. (Eds.). (2015). Informal economies in post-socialist spaces: Practices, institutions and networks. New York: Palgrave Macmillan.
Ni, B. (1993). “Hongbao”, ni gai tangtang zhengzheng zou qian men (“Red packets”, you should enter from the front door unshamedly). Jiaoyu yu zhiye (Education and Vocation), 9, 35.
Peng, Y. (2004). “Yiliao hongbao” xianxiang de sikao yu zhili jianyi (Consideration and suggestions on governing “medical red packets”). Jiangsu weisheng shiye guanli (Jiangsu Healthcare Administration), 15(6), 110–112.
Shi, R. (2001, February 6). Ze yi—zhe ganjue hai bucuo (Choose my doctor—I feel good). Chuncheng wanbao (Spring City Evening News), p. 4.
Shu, Z., & Wen, Z. (1993). “Dianming shoushu” gai bu gai? (“Operation by nomination” right or wrong?). Zhongguo yixue lunlixue (Chinese Medical Ethics), 3, 51–53.
State Council Economic Restructuring Office, State Economic Planning Commission, State Economic and Trade Commission, Ministry of Finance, Ministry of Labour and Welfare, Ministry of Health, State Bureau of Pharmaceutical Supervision and State Administration of Traditional Chinese Medicine. (2000). Guanyu cheng zheng yiyao weisheng tizhi gaige de zhidao yijian (Guidelines on the reforms to municipal and township pharmaceutical and health systems) [online]. Available from: http://www.cnm21.com/yyfg/yyfg_027.htm. Accessed 9 Mar 2016.
Stiglitz, J. E. (2000) Economics of the public sector (3rd ed.). New York: W.W. Norton.
Wang, Y. (1998). Dangqian yiyuan hongbao xianxiang de chengyin yu duice (The reasons and countermeasures against the current red packet phenomenon in the hospital). Jinzhou yixueyuan xuebao (Journal of Jinzhou Medical College), 19(4), 69–70.
Wang, S. (2003). Zhongguo gonggong weisheng de weiji yu zhuanji (The crisis and hope of Chinese public health). Bijiao (Comparison), p. 7.
Wang, S. (2006a, March 16). Beijing Shi ge yiyuan quxiao shoushu dianming fei: haoshi neng fou ban hao? (Beijing hospitals abolish surgical nomination fees: can a good thing be well done?). Renmin ribao (People’s Daily), p. 5.
Wang, S. (2006b). Shoushu dianming fei’ bei jiaoting: dui huanzhe shi fu shi huo? (‘Surgeon nomination fee’ is put on halt: good or bad news to the patient?) [online]. Available from: http://news.xinhuanet.com/focus/2006-03/01/content_4241894.htm. Accessed 9 Mar 2016.
Wang, J., & Kuai, S. (2008). Dui yiliao hongbao de sikao (Thoughts on medical red packets). Weisheng jingji yanjiu (Health Economics Research), 9, 12–13.
Wong, B. (2010). Wo guo zhun shichang moshi de kuibai yu zhengfu zeren queshi (The failure of quasi-market model and the absence of government accountability in our country). Dongbei daxue xuebao (Shehui kexue ban) (Journal of Northeastern University (Social Science)), 12(2), 135–140.
Wu, M. (2007). Wo guo yiliao weisheng lingyu de shichanghua chengdu fenxi (Analysis of the degree of marketization of medicine and healthcare in our country). Zhongguo weisheng jingji (Chinese Health Economics), 26(8), 5–8.
Xu, P. (2006). Hongbao’ xianxiang de zhidu jingji xue fenxi (An institutional economic analysis of the ‘red packet’ phenomenon). Zhongguo weisheng ziyuan (China Health Resources), 9(4), 147–149.
Yan, Y. (2006, April 12). Shoushu dianming fei: xiang zuo zou haishi xiang you zou (Surgical nomination fee: turning left or right). Zhongguo gaige bao (China Reform), p. 3.
Yang, J. (2009). Serve the people: Understanding ideology and professional ethics of medicine in China. Health Care Analysis, 18(3), 294–309. CrossRef
Yang, J. (2015). Governing informal payments in healthcare: Lessons from China. In J. Morris & A. Polese (Eds.), Informal economies in post-socialist spaces (pp. 245–269). New York: Palgrave Macmillan. CrossRef
Yang, C., & Ding, H. (2006, February 23). Fa gai wei jiao ting “dianming shoushu” fei (Commission of Development and Reform called an end to “operation by nomination” fees). Huaxia shibao (China Times), p. 6.
Ye, R., & Liu, X. (1993, April 6). “Hong bao” yu “shoushu dao” (“Red packets” and “scalpels”). Chuncheng wanbao (Spring City Evening News), p. 2.
Yin, D. (1993). Zai quanguo yizheng gongzuo huiyi shang de baogao (Speech at the National Conference of Medical Administration). Zhongguo yiyuan guanli (Chinese Hospital Management), 13(10), 5–12.
You, X. (2000, December 25). Xiri bingren weizhe yisheng zhuan, rujin yisheng weizhe bingren zhuan (Before patients rotated around doctors, now doctors rotate around patients). Yunnan ribao (Yunnan Daily), p. B2.
Yuan, L. (1995). Shui lai “yiliao” teshu yiliao? (Who come to “treat” special medicine?). Weisheng jingji yanjiu (Health Economics Research), 8, 29.
Yuan, G. (2014, May 6). Rang “tianjia chanfang” yuanli gongli yiyuan (Keep “exorbitantly priced delivery room” away from public hospitals). Sichuan ribao (Sichuan Daily), p. 6.
Yuan, C., Gong, G., Sun, M., & Han, Y. (2003). Bingren he yisheng dui “bingren xuan yisheng”de yixiang (Patients’ and doctors’ preference toward “patients choose doctors”). Zhongguo weisheng shiye guanli (Chinese Health Service Management), 1, 16–18.
Zhang, Y. (2000, November 4). Bingren xuan yisheng bu yao zouru wuqu (The myth of patients choose doctors). Jiancha ribao (Supervision Daily), p. 3.
Zhang, L. (2006, March 20). Quxiao dianming shoushu fei—Yisheng ruhe pingshuo (Abolishing fees for operation by nomination—doctors’ opinions). Jiankang bao (Health News), p. 3.
Zhang, Z., & Xu, B. (2007, April 29). Bingren xuan yisheng: Quanzhou liu nian shijian diaocha (Patients choose doctors: investigation after six years in practice in Quanzhou). Quanzhou wanbao (Quanzhou Evening News) [online]. Available from: http://www.qzwb.com/gb/content/2007-04/29/content_2447863.htm. Accessed 1 Jan 2008.
Zhao, Y. (2000, September 23). “Xuan” chulai de bianhua (“Chosen” changes). Renmin ribao (People’s Daily), p. 2.
Zhao, Y. (2001a, January 15). Bingren xuan yisheng (Patients choose doctors). Renmin ribao (People’s Daily), p. 2.
Zhao, Y. (2001b, January 15). Bingren xuan yisheng zhidu quanmian tuikai (“Patients choose doctors” is implemented country-wide). Renmin ribao (People’s Daily), p. 2.
Zheng, Y. (2007, May 1). “Bingren xuan yisheng” kongpa xing bu tong (“Patients choose doctors” may not work). Shengming shi bao (Life Times), p. 5.
Zhou, Q. (2008). Bing you suo yi dang wen shui? (Who should be consulted about illness?). Beijing: Beijing University Press.
Zhou, L., & Chen, Y. (2007, April 17). Nanjing: bingren xuan yisheng zhengce leisheng da yudian xiao (Nanjing: the ‘patients chooses doctors’ policy is much said but little done). Jinling wanbao (Jinling Evening Post) [online]. Available from: http://www.js.xinhua.org/xin_wen_zhong_xin/2007-04/17/content_9808586.htm. Accessed 9 Mar 2016.
Zhou, H., & Zhang, J. (2004). Analysis of the “red packet” phenomenon in China’s medical health industry. China and World Economy, 12(3), 26–37.
Zhu, H. (2002). Bingren xuan yisheng li bi fenxi ji duice sikao (Analysis of the advantages and disadvantages of patients choose doctors and solutions). Zhongguo yiyuan tongji (Chinese Journal of Hospital Statistics), 9(3), 148–149.
- Governing Informal Payments by Market in the Chinese Healthcare System
Neuer Inhalt/© Stellmach, Neuer Inhalt/© BBL, Neuer Inhalt/© Maturus, Pluta Logo/© Pluta, Neuer Inhalt/© hww, Neuer Inhalt/© julien tromeur | Fotolia