Health care in China - Ups and downs

China is the second largest economy in the world. However, not only the outbreak of the Corona virus in the Chinese city of Wuhan has raised questions about the quality of China's healthcare system. The Sars pandemic also had its origins in China, so there seems to be a clear discrepancy between economic and medical and humanitarian development processes. Reason enough to take a closer look at the healthcare system in China and at the same time take a look at the development of new medical products in medical technology design.

The Chinese government had undoubtedly learned from the experience of the Sars pandemic and improved general disease prevention and health care. The central government launched a large-scale reform intended to fundamentally upgrade the healthcare system in China. The goal was to be able to detect and contain new viral diseases more quickly in the future. Due to these reforms, almost everyone in China now has health insurance. On top of that, the general quality of health care has noticeably improved overall. This can be proven, among other things, by life expectancy at birth, which has increased by more than 30 years in recent years.

Despite these great advances, China's healthcare system is far from being comparable to the quality of European countries. In this regard, particularly the Healthcare Access and Quality Index (HAQ Index) should be mentioned, which measures the healthcare performance of countries globally. Here it becomes clear that China's healthcare system has improved massively and has risen from 38 to 54 points within the last 30 years. At the same time, this value is still far from the European standard. For comparison: Germany has an HQA index of over 90 points out of a total of 100. But why is it that China's healthcare system is lagging so far behind despite its massive economic power?

Health care in China is perpetually being subsidized, and increasingly more money is poured into these systems every year. However, if you compare China's spending percentages with other countries, it becomes clear that there is a big difference here. In 2016, around five percent of the gross domestic product (GDP) flowed into China's healthcare system. In contrast, Germany has invested around eleven percent, i.e. more than twice as much, in healthcare. The US even spent 17 percent of GDP on the medical sector. In comparison, it becomes clear that China tends to invest less money in the healthcare system, despite its economic strength.

Another factor that explains why the healthcare system in China is not comparable to that of Western nations is regional differences in care. Unlike in Germany, for example, the principle of general practitioners is not common. The first point of contact here is the hospital. This is problematic insofar as there are striking quality differences between individual hospitals. According to the unanimous statement of many experts, health care in rural hospitals is significantly worse than in the large Chinese metropolises. Hospital staff are also generally less well trained in rural areas.

It can therefore be said that China's healthcare system suffers primarily from underfunding, which in turn manifests itself in regional differences in quality. What's more, there is a major corruption problem in China's health care system.

In China's health care system, the salary of doctors consists of a basic salary, bonus payments and any perks that may apply. According to representative surveys, the basic salary only accounts for around 13% of the total salary of medical professionals. The rest of the salary is made up of additional payments and bonuses. This situation in China's health care system is concerning as there are no set standards for these co-payments. The hospitals determine these autonomously. A system in which doctors are underpaid invites corruption and bribery. Patients spend a lot of money on treatment and then have correspondingly high expectations of the treatment results. If these are not met, more and more violent conflicts between doctors and patients in China's healthcare system have ensued, some even ending fatally.

Despite the obvious problems in China's healthcare system, the People's Republic is a major driver of innovation in the field of medical technology design. Because of its size, the Chinese market is also an attractive distribution channel for German distributors. At the same time, the approval costs for medical technology in China are extremely high. Not only each product family, but also each specific system combination need to be approved separately before they can be sold. The documents required for this must also be submitted in Chineseas well as the original language. Packaging and labeling that is understandable beyond the language barrier also poses major challenges for many companies. However, since 2019, the submission of documents has been made considerably easier by the introduction of the electronic registration system eRPS, short for "Electronic Regulated Product Submission". The system also enables direct interaction with the health authorities in China via current status reports. Although an initial registration takes up to four years, the market remains very attractive for sellers even after that. In the future, robotics in particular will represent a market area with enormous potential. In this regard, the specialist areas of UX in medical technology and graphical user interface design are particularly interesting for manufacturers in the field of medical design.

If you have any further questions about healthcare in China, please feel free to contact us at any time. We look forward to your inquiry.