Eyeworld

EW NEWS & OPINION 14 February 2015 by David F. Chang, MD the central healthcare reform policy with regard to developing a parallel private system to complement the public system. There is something called CEPA (Closer Economic Partnership Arrangement), which addresses and promotes economic partnerships between Hong Kong and China. This facilitates a venture such as ours through certain incen- tives and other favorable measures such as physician licensure. This has also allowed our Hong Kong group to fully own the new eye hospi- tal, which in turn gives us greater control over important matters of operations, management style, and Dr. Chang: Tell us what the cen- tral Chinese government is doing to stimulate the growth of private healthcare in China. Why are they promoting private care in a social- ized healthcare system? Dr. Lam: I think with the latest healthcare reform in China, one of the main directions is to develop not just the public but also the private healthcare sector. If you look at this globally, there are 3 major types of healthcare systems. One is a nation- al healthcare system, such as in the United Kingdom. Another one is made up of smaller, private oriented entities, such as the U.S. Then in Hong Kong and Singapore, we have both parallel private and public systems. The Chinese government has been clearly stating that it wants a more balanced system. In the past, it's basically only had public services. So if we are able to devel- op high quality private services in China, then there will be more of a choice for patients. And because these private patients' care will not be subsidized by the government, the country's economic healthcare burden would be lessened. Having a system of quality private service would introduce competition, which in turn would stimulate and im- prove quality. So in these terms, I think the direction toward building a private healthcare arm is really wonderful. I come from Hong Kong, where historically both the public and private healthcare sectors have their own separate but complimentary roles. I am also a Chinese National People's Congress deputy, and I have been hearing about this new policy direction for about 5 or 6 years. I think it has been very clear from the government's annual report that they want to encourage private sector development. However, the investment funding would not be coming from the government, but rather from entrepreneurs and over- seas investors, such as from Hong Kong and Taiwan. I'm in agreement with these big picture policies. In one of the very recent reports, it's estimated that in 5 to 10 years' time the government wants the private sector to account for at least 20% of all healthcare delivery in China. Because of the size of China's popu- lation, this will mean a lot in terms of the size and scale of the private sector. Dr. Chang: How did you decide to develop the first private eye hospital under this new model that is encouraged by the Chinese government? Dr. Lam: This would not have been possible without certain healthcare reform policies. I certainly support Why a communist government wants to expand private healthcare A s the blueprint for healthcare reform in the U.S., many predict that the ACA will further weaken the independent private practice model. How ironic it is then that China, the world's largest communist country, wants to cultivate and expand private healthcare. Their reasoning actually makes a lot of sense. The government system is badly overburdened and the lack of competition reduces incentives for excellence in customer service and clinical innovation. China sees a strong private health- care sector as a way to provide greater choice to its citizens and to raise local standards to the highest international levels. Reducing the number of citizens dependent on government hospitals would also expand access to those patients most in need. Next month marks the 2-year anniversary of the opening of Dennis Lam's C-MER Eye Hospital in Shenzhen, China—the very first to be developed under a unique economic policy encouraging Hong Kong investors to build and own private hospitals in China. I toured the hospital during its first year of operation and was impressed that it is as well equipped and staffed as any modern American counterpart. As one of Asia's top academic ophthal- mologists, Dennis Lam, MD, has directed two of the region's most prestigious ophthalmology departments—Chinese University in Hong Kong and the State Key Laboratory of Zhongshan Ophthalmic Center, Sun Yat-sen University in Guangzhou. On the international level, he is the president elect (and past sec- retary general) of the Asia-Pacific Academy of Ophthalmology, and 2 years ago launched the Asia-Pacific Journal of Ophthalmology as the founding editor-in-chief. On top of all of these responsibilities, Dennis founded and directs Project Vision— an ambitious initiative to alleviate preventable blindness in underserved areas of China. Since its inception in 2004, Project Vision has already helped more than 100,000 patients, and now offers a sustainable blueprint for reversing the large backlog of cataract blindness in rural Chinese communities. I have always been im- pressed by the tremendous energy, talent, and innovative leadership that Dennis brings to any project he undertakes, whether it is in clinical research, teaching, or humanitarian outreach. Establishing the very first foreign-owned, private eye hospital in China is the latest way that Dennis is advancing and changing the face of ophthalmology in this region. David F. Chang, MD, chief medical editor Located in the Shenzhen Central Business District, the 38,000-square-foot hospital has a main reception (upper right photo), 5 fully equipped operating theaters (bottom right photo), and 30 in-patient beds (middle right photo). The hospital is looking to operate in a paperless environment by establishing a number of e-platforms. Using the PACS (picture archiving and communication system), Dr. Lam is discussing results, received from another room, with a patient. Chief medical editor's corner of the world

• Cover