Prescribing Competition: Open Market Competition Is the Cure for China's Healthcare Challenges

How to Address the Challenge of Difficult Access to Medical Care? Stakeholders Across the Healthcare Industry Offer Their Own Prescriptions.

Proponents of Western medicine argue that the difficulty in accessing medical care is undoubtedly due to a shortage of physicians and an irrational allocation of medical resources; therefore, the solution lies in optimizing the distribution of doctors. How, then, can doctors be allocated more rationally? Through appointment registration systems. Consequently, companies specializing in appointment scheduling emerged, displacing the scalpers who previously operated outside hospital entrances. Under the banner of “Internet Healthcare,” these platforms integrated hospital appointment systems. This category of companies began gaining momentum in 2012 and has since largely saturated the appointment scheduling market. Not content to rest on their laurels, they also tackled hospital queue management, significantly enhancing the user experience.Observing this trend, the two prominent entrepreneurs known as the “Mas” realized they could not afford to lag behind while others were already carving up the market share. Thus, in 2014 and 2015, they made aggressive entries into the sector, integrating services such as payment processing and patient laboratory test information.The current situation is that securing an appointment is no longer particularly difficult; in principle, one can book an appointment with a specialist at nearly any hospital. The challenge now lies in the waiting time, which typically exceeds one week and often extends beyond half a month. After waiting two weeks for an appointment, the consultation itself still lasts only five minutes. Before patients have even finished describing their symptoms, the renowned specialist interrupts, advising them to undergo further tests first.

“TCM” takes one look, and Western medicine is left speechless, thoroughly amused. “I have a plan,” I said. “Hurry up and present it! Don’t dawdle.” “TCM” replied that we should not merely treat the head when it hurts or the foot when it aches. The difficulty in accessing medical care appears, on the surface, to be an inability to secure appointments. In reality, it stems from the uneven distribution of medical resources, with everyone flocking to large hospitals, making appointments naturally scarce. Hospitals like the First Affiliated Hospital of Zhengzhou University, with nearly 10,000 beds, are not something every province can afford to operate. Therefore, solving the problem of difficult access to care requires addressing the allocation of medical resources. Large Grade-A tertiary hospitals should support the development of small and medium-sized hospitals. National policies should also bolster these smaller institutions. We should advocate for foreign models such as “tiered diagnosis and treatment” and implement policies that provide support to hospitals based on the population they serve. Currently, this understanding has become a consensus among most industry professionals: learn from overseas tiered diagnosis and treatment systems, pilot them in select provinces, and then roll them out nationwide. This editor cannot outargue “TCM” and will refrain from further commentary. However, one point remains: after working in the healthcare industry for so many years, I have observed that whenever someone falls ill, people rush to leverage their connections to get patients into major hospitals. If even healthcare professionals behave this way, ordinary citizens are no exception. What I wish to convey is that while the tiered system is sound and well-designed, changing industry perceptions is not something likely to be achieved within just two or three years. In other industries, two or three years might see tremendous progress—like a light boat passing ten thousand mountains—but in the healthcare sector, it amounts to merely crossing a small stream. By the time Mr. “TCM” finishes taking the pulse and prescribes his all-encompassing tonic, our daylilies will have grown cold.

So, is there a more suitable approach? The charlatans have arrived. The “Department of Integrated Traditional Chinese and Western Medicine” claims, “We Putian natives have been dedicated to integrating traditional Chinese and Western medicine for many years. We focus on only one thing: whether there is sufficient market competition. In any industry with robust competition, we are invariably successful.” Examples range from andrology and gynecology to the increasingly high-end fields of immune cell and stem cell therapies. The common denominator is that these markets allow for full competition.

Returning to the issue of healthcare, the difficulty in accessing medical care is not about the challenge of registering appointments, nor is it due to a lack of hospitals. So what is it? The editor still agrees with the statement made by the "Department of Integrated Traditional Chinese and Western Medicine,"Open Market Competition Is the Real CurePutian-based private hospitals, unable to access medical insurance reimbursements, naturally cannot compete with public hospitals. The state has now opened up the private hospital sector, and the medical insurance system is gradually exploring mechanisms for liberalization. Once reimbursement restrictions are lifted at the source, both small and medium-sized hospitals and private institutions will be able to find their appropriate market positioning without government subsidies, attracting suitable patients and thereby naturally alleviating the difficulty of accessing medical care. Furthermore, the current medical insurance system resembles a terminally ill elderly person, struggling to meet the public’s growing health needs. By liberalizing commercial insurance and introducing large-scale market-oriented commercial insurance into healthcare, competition will be introduced not only at the hospital level but also within the medical insurance framework, ultimately better serving the public. When a tripartite game-theoretic system involving medical professionals, hospitals, and medical insurance is established, healthcare will cease to be a problem and instead become a service. At that point, we might hear: “Dear patient, if your treatment was successful, please leave us a positive review.”

In essence, while the internet appears to be a competition of business models, it is fundamentally a process in which new productive forces replace old ones.Internet healthcare can make an impact on all three of the aforementioned levels. For instance, companies that have tackled the difficulty of appointment registration—such as Alibaba Health, Tencent Weiyi, and Jiuyi 160—have already aggressively captured a significant share of the market. Meanwhile, companies addressing the challenge of finding doctors and positioning themselves within tiered diagnosis and treatment systems serve as entry points to physician resources; examples include Ping An Good Doctor, Haodf, and DXY.

Yunjingxuan’s entry point is competition. It first builds a hospital-level competitive platform, introduces competition within the industry to optimize the healthcare ecosystem, and ultimately expands into the social insurance sector, introducing “clean water” at the source to irrigate and cultivate fertile ground.

(Author: Jingyunsu; Contact: QQ 377076933. Established in 2012, Jingyunsu currently has an R&D team of nearly 50 members, with its products serving approximately 300 hospitals across all provinces in China. Jingyunsu positions its offerings as internet-based healthcare solutions built on a medical technology platform, integrating industry patient and physician resources to achieve the goal of a platform-oriented internet healthcare product.)