healthcare law Review second Edition Editor Sarah Ellson lawreviews the healthcare law Review second Edition © 2018 Law Business Research Ltdhealthcare law Review second Edition Editor Sarah Ellson lawreviews Reproduced with permission from Law Business Research Ltd This article was first published in September 2018 For further information please contact Nick.Barettethelawreviews.co.uk © 2018 Law Business Research LtdPUBLISHER Tom Barnes SENIOR BUSINESS DEVELOPMENT MANAGER Nick Barette BUSINESS DEVELOPMENT MANAGERS Thomas Lee, Joel Woods SENIOR ACCOUNT MANAGER Pere Aspinall ACCOUNT MANAGERS Jack Bagnall, Sophie Emberson, Katie Hodgetts PRODUCT MARKETING EXECUTIVE Rebecca Mogridge RESEARCHER Keavy Hunnigal-Gaw EDITORIAL ASSISTANT Tommy Lawson HEAD OF PRODUCTION Adam Myers PRODUCTION EDITOR Louise Robb SUBEDITOR Charlotte Stretch CHIEF EXECUTIVE OFFICER Paul Howarth Published in the United Kingdom by Law Business Research Ltd, London 87 Lancaster Road, London, W11 1QQ, UK © 2018 Law Business Research Ltd TheLawReviews.co.uk No photocopying: copyright licences do not apply. 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Enquiries concerning editorial content should be directed to the Publisher tom.barneslbresearch ISBN 978-1-92228-52-2 Printed in Great Britain by Encompass Print Solutions, Derbyshire Tel: 0844 2480 112 © 2018 Law Business Research Ltdi ACKNOWLEDGEMENTS AL TAMIMI models of commissioning; the interplay (or lack of it) between primary, secondary and social care; and the regulatory and licensing arrangements for healthcare providers and professionals. These continue to be exciting times for the delivery of healthcare, with digital technologies, genomic personalised medicine and the eradication of certain diseases through vaccination. Patients, data and providers are moving globally and the pace of development is relentless. This year has seen a recognition of the real value of data in the provision of care and the development of healthcare technology; this has been coupled with new legislation including the European General Data Protection Regulation, which has impacted not just on data controllers in Europe but on many of the international providers caring for EU citizens. Younger healthcare economies are offering exciting new opportunities in a market where healthcare professionals can be a scarce resource; more mature markets are having to address ageing infrastructure and a pressing need to reform to meet todays challenges. © 2018 Law Business Research LtdEditors Preface vi Each chapter has been written by leading experts who describe succinctly their own countrys healthcare ecosystems. I would like to thank them for the time and attention they have given to this project and also the wider team at Law Business Research for their support and organisation. Sarah Ellson Fieldfisher Manchester July 2018 © 2018 Law Business Research Ltd39 Chapter 4 CHINA Min Zhu 1 I OVERVIEW Chinas healthcare system is mainly composed of the healthcare services sector, the healthcare insurance sector, and the drugs and medical equipment sector, which are supervised by three separate government departments. Specifically, the PRC National Health Commission (NHC) 2is responsible for supervising the medical institutions and medical services industry, the Ministry of Human Resources and Social Security is responsible for formulating the basic healthcare insurance system and policy and for managing healthcare insurance funds, and the State Drug Administration (SDA) 3is responsible for drug and medical equipment registration and supervision. II THE HEALTHCARE ECONOMY i General Healthcare services can be divided into basic healthcare services and special healthcare services, depending on coverage scope and extent of the specific services. Basic healthcare services Basic healthcare services are composed of public healthcare services and basic medical services. The scope of basic public healthcare services in China has been revised and expanded since the launch of Chinas healthcare reform in 2009. The National Basic Public Healthcare Service Standards (Third Edition), promulgated in 2017, stipulate that basic public healthcare services consist of 13 types of services, including residents health file management, vaccinations, health administration for special groups (children aged under six, pregnant women, the elderly, and patients with hypertension, type 2 diabetes, severe mental disorders and tuberculosis), infectious diseases and public healthcare emergency reporting and treatment, and so on. 1 Min Zhu is a partner at Han Kun Law Offices. The firm also wishes to acknowledge the contributions to this publication by Serina Wei, an associate at the firm. 2 The duties of the former PRC National Health and Family Planning Commission were merged into the newly established PRC NHC following the implementation of the Programme for the Reform of State Council Organs on 18 March 2018. 3 The SDA was newly established under the supervision of the State Administration for Market Regulation following the implementation of the Programme for the Reform of State Council Organs. © 2018 Law Business Research LtdChina 40 Special healthcare services In addition to basic healthcare services, the Chinese healthcare system also includes special healthcare services, which refer to medical services provided by medical institutions to satisfy special medical needs, such as specified surgical operations, full nursing care, special wards, specialist outpatient services and medical cosmetic surgery. ii The role of health insurance Chinas basic healthcare insurance system currently includes a basic urban employee healthcare insurance system, a healthcare system for urban residents and a new rural cooperative healthcare insurance system. Among these, the basic urban employee healthcare system is compulsory, and requires all urban employers and employees to contribute to the system. Urban residents who are not covered by the basic urban employee healthcare insurance system, including students, children and other non-employed urban residents, may voluntarily choose to purchase the urban resident healthcare insurance. A new rural cooperative healthcare insurance system, the rural medical mutual aid system, has been designated for rural residents and is mainly funded by government financial appropriations and supplemented by individual and collective contributions. Rural residents may choose to participate in the system at their discretion. 4According to the Opinions on the Integration of the Basic Healthcare Insurance System for Urban and Rural Residents promulgated by the State Council in 2016, the above three basic healthcare insurance systems will be integrated into a unified basic healthcare insurance system applicable to both urban and rural residents. At present, the healthcare insurance system for urban residents and the new rural cooperative medical insurance system have been successfully integrated. iii Funding and payment for specific services In addition to basic healthcare services, medical institutions also provide special healthcare services to satisfy non-basic medical needs. Special healthcare services may be provided by both public and non-public medical institutions. However, the amount of special medical services provided by public medical institutions is limited, and cannot exceed 10 per cent of all healthcare services that such institutions provide. According to the relevant provisions of the current basic healthcare insurance system in China, the cost of special healthcare services will not be covered by the national healthcare insurance system. Such costs are to be directly undertaken by the individual incurring such costs or reimbursed by commercial health insurance. 5 III PRIMARY / FAMILY MEDICINE, HOSPITALS AND SOCIAL CARE i Chinas healthcare services system Chinas healthcare service system is developed under a dual structure for urban and rural areas. The rural healthcare system is composed of three grades of medical institutions, which 4 China Health Industry Bluebook (2017), pages 13 and 14 (China Medical Indus Info Ctr, 2017) (Bluebook 2017). 5 Opinions of the CPC Central Committee and the State Council on Deepening Reform of the Medical and Healthcare Systems, Article 10 (CPC Central Comm, St Council, promulgated 17 March 2009). © 2018 Law Business Research Ltd