Richard L. Clarke, DHA, FHFMAPresident and CEO, HFMA
It’s Friday and I’m on my way back to the United States from China. The flight leaves at 4:00 p.m. and arrives at 3:50 p.m. on the same day--arriving before I leave. International flights are fascinating.
What is more fascinating is the People’s Republic of China. The people (all 1.4 billion of them), culture, and unprecedented economic growth create a country full of contrasts, opportunities, and challenges--especially for its healthcare system.
The trip to China was part of HFMA Abroad, a program of international travel that includes both professional and cultural elements. Sixty-one HFMA delegates joined Joe Abel (HFMA’s Director of Professional Development) and myself on this inaugural trip to Beijing, Guilin, and Shanghai.
The facilities, services, and frankly cleanliness of the health facilities we toured were a study in contrast. We visited two private hospitals, a small rural hospital and clinic, and a public hospital that integrated traditional Chinese medicine (TCM) and western medicine. The new private hospitals were as impressive as any in the West. The public hospital was a study in contrast within itself because of the use of TCM along side of Western medicine. We were especially fascinated by the TCM hospital pharmacy, which dispensed prescribed herbs and potions that have been used for centuries. Physicians trained in TCM use a combination of this approach and Western techniques depending on the patient’s wishes and condition.
But the rural hospital is burned into my memory. The hospital was located in a small village outside of Guilin. The staff were very sharp and attentive to our questions about rural health care. They asked probing questions about healthcare delivery and financing in the United States. The tour of the hospital, however, revealed an old facility in desperate need of repair and a massive cleaning. Dirt, mold, and antique equipment were the lasting image. We were amazed that the educated, well-spoken staff had to work in such primitive surroundings. They did what they could with the resources they had available to serve a population that would otherwise go without health services. An amazing place.
Opportunities for U.S. healthcare companies appear obvious based on the somewhat limited services offered in the public sector. And government representatives indicated a willingness to embrace more private facilities to augment the public ones. The challenge for China is to update and modernize its healthcare delivery system without bankrupting the country. Currently more than 70 percent of the population have very limited or no health insurance. As China attempts to increase coverage and modernize its delivery system, demand for services may outstrip its capabilities to finance these services. It’s a delicate balance that the Chinese government must achieve to continue economic growth. The visit puts the U.S. efforts to achieve such a balance in perspective.
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