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China / Society

New surgery insurance finds few takers

By Wang Qingyun (China Daily) Updated: 2014-04-14 07:11

Few people are choosing to take part in a new surgical insurance program that is designed to reduce medical disputes.

Beijing's You'an Hospital and Anzhen Hospital said they have seen fewer patients than expected get the insurance and more time is necessary for the plan to work.

The two hospitals are among several in the city that have introduced the surgical accident insurance programs.

This insurance is different from the medical liability insurance program that all State-owned nonprofit hospitals in Beijing were asked to join. The medical liability insurance pays only in the event of unsatisfactory results caused by medical malpractice.

But hospitals found they are involved in an increasing number of medical disputes in which hospitals and doctors didn't do anything wrong during the treatment, yet patients still died due to surgical complications.

In such disputes, patients won't get compensation from the medical liability insurance. The surgical accident insurance program was introduced to serve as a "comfort" to these patients and their families by paying them a certain amount of money, said Yang Yu, director of the patient-doctor relationship office of You'an Hospital.

Since You'an Hospital launched the insurance program in January, about 90 patients - 10 percent of those who qualify - have bought the insurance, Yang said.

The 90 patients paid insurance premiums of more than 50,000 yuan ($8,000), and two patients' families have been paid 13,000 yuan, Yang said.

But the insurance program has not been widely accepted by patients, Yang said.

"Some patients underestimate the risks of surgery. Some don't want to pay extra. And some don't find the compensation attractive," Yang said.

"It will take time before the number of purchasers increases, thus lowering the price of the insurance and enhancing the amount of compensation."

Xu Xuemin, director of Anzhen Hospital's department of social work, an office that oversees the hospital's medical disputes, said only a small percentage of patients have purchased the insurance since it was introduced at the heart surgery department in November.

Of those, many were challenging cases, increasing the likelihood of compensation payouts and lessening the profits for the insurance companies.

Xu said he is trying to make the insurance available to patients in "less risky" departments to keep the program going.

Li Zhiyuan, assistant director of Fuwai Hospital, the first hospital in the city to design an insurance plan that covers surgical risks other than medical malpractice, said it is "totally understandable" that the number of buyers would be low at first.

Fuwai Hospital, which specializes in treating cardiovascular disease, designed an insurance plan to cover risks in its heart surgery cases as early as in 2003.

"When we first launched the insurance, the purchase rate stayed at 10 to 20 percent. It was pretty tough. It took six months before it reached about 80 percent and stayed there," Li said.

"First, the insurance plans should be designed properly to both solve patients' problems and suit the condition of the hospital. Second, an insurance company needs to prepare for possible losses when people are not aware of the importance of warding off surgical risks. Third, the hospital should let patients know how they can benefit from the insurance through active communication," he said.

"The death rate of heart surgery cases conducted by Fuwai Hospital has been under 1 percent for seven consecutive years, which ranks among the best, even in the world. But the risk that someone will die in a heart surgery case does exist."

wangqingyun@chinadaily.com.cn

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