Healthcare in China

Rural-urban inequities, over prescription of drugs by public hospitals, underpaid healthcare professionals and unequal distribution of healthcare resources remained some of the challenges faced by the Chinese Government today. In 2006, President Hu Jintao publicly acknowledged health care as one of the top priorities for a rapidly modernizing China and recently opened the door to foreign investors into Chinese hospitals.  The present state of the Chinese health care industry creates unique challenges for companies and market researchers intent on discovering insights to assist with product and brand development in China.

The health care reforms of the 80’s were successful in raising health standards and in turn, life expectancy for millions of rural dwelling Chinese. However, a lack of primary care facilities such as general practitioner clinics has led to chaotic over-crowding and confusion at hospitals. Seriously ill patients are forced to stand in line with patients who have minor ailments. While there are some specialized clinics to cater for women’s health or cancer, many of them are still located on the same premises as the general hospitals and are generally priced beyond the average income of the majority of Chinese citizens.  Thus patients in China’s 18,000 plus hospitals are left jostling in queues to consult their doctors.

In Shanghai, where the average salary of doctors is among the highest in the country, doctors are only paid a declared income of RMB 5,000 (US$795) per month. To supplement their incomes, many of them work on commission schemes that pay cash for each test administered and medication prescribed. This has resulted in many unnecessary prescriptions. 

While the rich are predominantly well-insured and only need to pay a small percentage of their medical expenses, many of the poor are left with no alternative but to deal with their illnesses outside of hospitals. Currently, urban economic centers such as Shanghai, Beijing and Guangzhou have hospitals which are able to provide excellent doctors and quality equipment. However, this same level of services is understandably not possible across smaller cities and rural areas due to the huge costs involved.

Given the state of the health care industry in China market researchers need to suggest workable methods to meet clients’ research objectives. With doctors working long and intensive hours, interviews with researchers are understandably not highly ranked on their list of priorities. As a result, it is generally only feasible to pre-recruit doctors in person at the hospital and determine a time outside of normal working hours to conduct an interview. Again, face to face is the more feasible method of interviewing, for the primary reason that a cash gratuity can be delivered upon completion.  From our experience, cash is by far the most effective incentive as doctors look to supplement their incomes.

On a macro level, health care research projects should be structured to take into account the differing strata of amenities across urban and rural areas. Multi-country study planners who want to include China need to focus on first tier level cities to ensure consistency. Qualitative projects using skilled medical moderators are more efficient and cost effective than larger quantitative studies in which the same face to face recruitment and interviewing limitations are involved. Analysts for quantitative projects with large sample sizes must also take into account that the sample involved in the project may be vastly different from first to third development tiers, as well are urban and rural regions.

Although the state of the industry has again reached a point where new reforms are introduced, brand and market strategists can still elicit useful information through careful planning and understanding of the market environment in China.  In the coming years more progress is expected as health care remains one of the top priorities of the Chinese Government and the door to foreign investors into Chinese hospitals is now opened.