Globalization and Public Sector Reform in China by Kjeld Erik Brødsgaard

Author:Kjeld Erik Brødsgaard [Brødsgaard, Kjeld Erik]
Language: eng
Format: epub
ISBN: 9780415788069
Barnesnoble:
Publisher: Taylor & Francis
Published: 2016-12-09T00:00:00+00:00

As for associational groups, key actors in the Chinese health industry are grouped in various organizations, such as the Chinese Hospital Association, the Research and Development-based Pharmaceutical Association, the China Insurance Association, the China Pharmaceutical Commerce Association and the China Hospital Information Management Association. In general terms, these groupings seem to fit into the framework of state-corporatist organizations, working as a consultative arm of the government (Unger and Chan 1995: 37–51; Thompson 2009: 64). One example is the Chinese Hospital Information Management Association (CHIMA) which, over the past few years, has been working closely with the MoH to define hospital information systems (HIS) standards. Associations, however, can at times also be utilized as channels to convey demands and opinions upwards, formulated either by their own constituencies or by actors affected by the decisions being taken at higher levels. While introducing the characteristics of the new HIS national standards to a group of hospital managers in 2009, a CHIMA senior advisor was repeatedly questioned about the inclusion among the mandatory HIS modules of a new software, generating a DRG (Diagnosis Related Groups) code for each hospitalized patient.14 The issue at stake was not the software itself, but rather the fact that its introduction would probably have led to closer controls over clinical and accounting practices. The scepticism expressed by hospital managers was subsequently the object of thorough discussion between the parties involved in a project promoting the adoption of efficient HIS systems, of which the gathering of hospital managers had been intended to be a start-up activity. To add more complexity to the analysis of these groupings is the fact that, although associations often appear to be ‘monolithic’ entities, the interests of individual members might not be. A glance at the board of advisors of Pharma China, an influential business media tied to the US consulting firm WiCON International, which advocates giving freer rein to the Chinese health care market, can help in giving a clearer picture of the links between government advisors, private consultancy firms and membership in key industry associations. Among the 12 people composing the board, five have a simultaneous involvement in government agencies and associations, as well as—in four cases—in the private sector.15 This kind of multiple memberships reinforces the idea that the dynamics within associations might not be strictly controlled by government diktats and rather permeable to private interests.

Other than into institutional and associational groups, economically driven interests can coalesce into corporate interest groups. Corporate pressures, through either legal or illegal avenues—lobbying, kickbacks, bribes—have been widely documented in the pharmaceutical industry. In 2007, a scandal involved the Chinese SFDA, the government agency in charge of registering new drugs which can be sold on the Chinese market. The director of the agency, Zheng Xiaoyu, was executed after having been found guilty of receiving bribes to smooth the path for approving drugs that did not comply with mandatory quality and safety standards (Xinhua News Agency 2007; BBC News 2007). The dynamics of interest articulation in other key regulatory

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