Beijing began implementing its program on public hospital reform on July 1. The Beijing Friendship Hospital is the one that will eliminate the 15 percent drug mark-up, and introduce a medical care service fee. This reform aims to separate hospital's income from medical treatment and prescription medicine.

The medical care service fees depend on the qualifications of the doctor. It varies from 42 yuan ($6.6), to 100 yuan ($15.7). The fee replaces the current 5 yuan ($0.8) registration fee and 14 yuan ($2.2) consultation fee. Patients will be reimbursed 40 yuan ($6.3) under medicare policies.

Liu Jian, director of Beijing Friendship Hospital, said, "In the past, the fee to see a senior specialist was very low, so everyone wanted to see a specialist. As a result, it was harder for those who had a real need to see them, as their availability was limited. This new pricing system can help better utilize our human capital."

Meanwhile, the hospital has cut the 15-percent markup of drugs, which used to be a major source of income in China's public hospitals. The potential economic losses can be compensated for by the medical care service fee. This not only increases the initiatives of doctors, but benefits the patients.

Fang Laiying, director of Beijing Hospital Management Bureau, said, "Patients are reimbursed 70 percent of prescription medicine fees, under the medicare system. 40 yuan ($6.3) of the medical service fee is also reimbursed. People only spend 2 yuan ($0.3) to see a general practitioner. This has reduced the medical costs for most patients."

However, there are some concerns about the trial program. After introducing the medical service fees, the number of patients seeing general practitioners has increased, because of the rising cost of seeing a senior physician or specialist. This makes it difficult for patients to register to see general practitioners, while it's easier to see senior physicians and specialists. The opinions of patients are mixed.

A patient in Beijing Friendship Hospital, said, "I went to see a top specialist. In the past, there was very little chance to see this doctor. I think the reform is great."

A patient in Beijing Friendship Hospital, said, "Most of patients prefer to see general practitioners with less medical care service fee. Me too. But this time I have to pay 60 yuan to see a top specialist which I really don't need, because I failed to get the registration number for seeing a general practitioner."

The hospital is now doing research on patients' demand for general practitioners and senior doctors after launching the pilot program, Liu said. They will review the reactions and opinions of patients while assessing the reform measures.

Besides the Beijing Friendship Hospital, four other Beijing hospitals are testing different reform programs, including the new management and medicare mechanism. These reforms will promote better service to the public from state-owned medical facilities, Fang said .

(CNTV.cn July 3, 2012)