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Public Opinion on Shanghai’s Medical Reform

By Ellen Cao, GBI Analyst

The Shanghai Municipal Statistics Bureau has recently conducted a survey among 1,030 local residents aged 18-71 years old in a bid to understand and gather public opinion on current medical reform. Results showed that 70% of the respondents have concerns regarding the ongoing national healthcare reform (most especially the elderly) and that 69.8% are not in favor of Shanghai's proposal of a medical alliance system.
 
The proposed alliance aims to provide patients with a platform that will allow them to enjoy the convenience of medical referrals between community clinical centers and large hospitals and equally distribute medical resources. However, survey results showed that the idea of a centralized medical union caused fears of losing freedom to choose preferential hospitals (46.9%), of possible delayed treatments (22.6%) and of being unable to access reliable medical services (12.2%). In many public health systems, patients access healthcare via designated gatekeepers- but not in Shanghai (nor in China) where people are accustomed to choosing hospitals and even specific physicians. Respondents to the survey also indicated their unwillingness to receive treatments from community health centers due to the following reasons: low-level or not highly qualified physicians (47.6%), poor medical equipment (13.5%), and insufficient drug supply (11.9%).
 
In addition, it was also reported that the most commonly encountered problems during medical visits included a long waiting period and only a short-time with physicians (81.1%), expensive medical costs (76.7%), repeated queuing and payments (73.2%) and costly/high out-of-pocket costs for drugs and medical devices (64.2%). On the bright side, about 75.4% are in favor of the government plans of promoting/introducing family physicians; (vs. 10.5% of respondents who indicated a mistrust of family doctors).
 
Overall, majority of the respondents (65.9%) believe that the city’s medical reform will bring positive results to Shanghai’s healthcare system, though there are still some (less than 10%) who think the current medical reform program will not bring any significant improvement to hospital outpatient environment. As always, public opinion may vary in different aspects. But given such survey results, it would seem to matter most that the local government incorporate implementation of reduced, reasonable medical fees/drug costs as well as improvement of the “hardware” and “software” in community hospitals into its current medical reform initiatives.