Hospitals are shedding their long waits.
Imagine paying for care with just a glance, or having one insurance wallet that shields your entire family, no matter where they live.
What sounds like sci-fi is becoming reality in China's clinics.
Today we explore the new digital keys and how they're turning a potentially stressful visit into a queue-free, connected experience.
We're live from our studios in Beijing.
This is Roundtable.
I'm Steve.
Thank you for sharing your time with us today.
And for the show, I'm with Feifei and Yushan.
Up first.
For decades, the hospital experience has been synonymous with endless wait, a frustrating loop of multiple queues at different windows just to see a doctor or pay for a prescription.
But imagine a future where you can walk into a clinic without a wallet, a card or even a smartphone and finish your visit with just a glance at a screen.
Picture an insurance wallet that doesn't just belong to you but acts as a shared health fund for your parents, children and even grandparents, regardless of where they live.
This isn't just about updating software.
It's about redefining warmth, if we can call it, that of medical care through face scans, credit-based payments and a family safety net that crosses borders.
How will these changes make a difference?
How will the hospital experience And the insurance experience change for us all.
You know, I think I was being a little critical in the opening when I said you know, the hospital experience has been synonymous with the endless wait.
Because in my experience, it's been pretty quick.
It's been pretty efficient.
And I've had a great experience each time I visited the hospital.
I was talking about it a couple of days on the show, ago on the show.
But I guess an endless wait is a relative term, because I'm used to Canadian hospitals where you can spend hours in there waiting to see a doctor.
Well you know Steve, if you visit a very top hospital here in Beijing that's crowded with patients coming from across the country to see a top doctor for their sickness, you will encounter these cues in hospitals.
And a lot of times is that there are people, there are big crowds in the halls, in the waiting room and even in the doctor's offices.
So now that's why that we're seeing that the National Healthcare Security Administration, one of the top authorities overseeing the medical care sector, has announced a plan to make not only the visits to hospital more convenient and faster and also make the payment through the healthcare insurance system faster, more convenient, over the next three years, basically.
So that is also one of the methods that is trying to tackle this frustration of long waits and complicated procedures that patients often face when paying at hospital, especially for those who travel to a different city or even different province for that.
Yeah, because each time you go to a hospital, a hospital will have its own setup.
They're not all the same.
So when you're visiting a hospital for the first time, knowing what to do and where to go and how to do it can indeed be a confusing experience, and this time there are many new upgrades and the whole idea is to roll out a more streamlined payment system that includes options like facial recognition, one code scanning so you have one qr code for everything, and also mobile payments, which will save at least me, because sometimes, after you see the doctor and she or he gives you a prescription, or rather a list of things you need to pay for before you continue on with the treatment, you have to leave the office and go to another department, on a different floor sometimes, and pay and then come back and wait in that line again to be checked by the doctor.
So if we can just do that mobile payment thing like pay it instantly on the phone, that will be such a game changer.
And then there are even credit-based payment that's covering everything from outpatient visits to emergencies and inpatient care.
And also for local areas, they can roll out these changes based on their specific needs.
And hospitals and pharmacies and financial institutions.
They will also be encouraged to get involved as part of this whole system in the future.
And, of course, the Medical Insurance Bureau will be closely monitoring how well these systems are working by including them in their hospital assessments, ensuring that they actually are improving the patient's experiences in these institutions.
Which is the whole point.
Right.
All right.
So let's get into the specific details then.
The payment methods, maybe we can start with those.
What kind of difference will this make?
Well, first of all is with the use of facial recognition that let patients pay without needing a card or even a smartphone.
Because I remembered, you know back, I don't know three, five years ago.
We need to carry our own card, health care insurance card, to go to the hospitals.
And then, you know, different hospitals have their own different systems.
Some of them would ask you to register at hospital, they will give you a different card.
And you need to present two cars at this hospital.
And if you go to another hospital, that means you need to apply for a new car.
And then this is one of the hurdles that you can reimagine.
You have a stack of cars in your drawer.
Yeah, and you have to know which one to take at which particular time.
Not long ago on Roundtable, we talked about the apps at universities and how students were complaining that there are too many apps online.
Yeah, it's basically a very similar idea.
It's kind of a similar concept here.
Yeah, and especially considering the older patients that they are already struggling with a lot of this registration.
You know different floors, you know different maps in different big hospitals and different card systems.
If... they can use this technology of facial recognition.
It's very easy for them to just scan their face and just go.
Yeah, because forgetting your card is an easy thing for someone to do no matter how old you are.
It's funny you mentioned forgetting the card, because this just reminds me of an anecdote that once, when I was going to was visiting one of the major hospitals here in beijing and it was full of people and you kind of need to need your insurance card to they call it guahao, like announce sort of register, register your entrance and get you into the system to wait to be called.
And i just left my card inside the the registration machine and i went upstairs and then i realized oh my gosh my, My card is left downstairs and I rushed down.
It was only five minutes and it was already gone.
And I panicked and then asked around and asked the volunteer.
My card was right here like five minutes ago.
And the girl told me, oh, you just go to the security room.
They have it.
We know they have it.
And when I got there and the security guy said, oh, do you have your ID card?
Yes, I do.
And I showed my ID card and they put my ID card into one box.
And that box just spit out my security card because it registered, well, it recognized my ID.
And that's when the reporter side of me got kicked in and I asked him how many cars do you collect every day?
Oh, must be hundreds.
And he's like, since my shift this morning, 31.
Yeah.
You're the 31st.
Yeah.
I left my credit card in a gas station payment thing one time and I went back to pick it up and the guy opened the box and there were probably 500 credit cards in there.
I said, OK, good.
I'm not the only one who does this.
Anyway, we're not talking gas stations today.
So I guess before the point here is that what previously at a hospital in China.
When you wanted to pay for something at the hospital, you'd have to go to one queue wait, go to another queue, wait and go to another queue and wait.
Yeah, yeah.
And that time just adds up.
So this will save this one code payment will save people a lot of time.
Yes, with a single scan.
The code basically can handle everything from the reimbursement of your medical insurance to some people have their personal medical insurance account and have some money inside and you can also use the money inside of that account or out-of-pocket costs.
So you don't have to go through different accounts, but with one single code.
That basically eliminates the hassle of jumping between these different systems.
What about the credit system?
This is also a big step.
Yeah, the credit system is something that allows insured patients to pay for medical expenses later, which means that you can get treated first and then pay afterwards.
So that's because your bank kind of covers the cost up front based on an agreement credit limit that's already made prior to this.
And this really offers a lot more flexibility for the patients.
And for example, some elderly people, they may find it difficult to pay at the hospital.
With the introduction of credit payments.
Of course, they can receive treatment first and have their family settle the bill later on, when they get home.
Much more convenient.
Yeah, that's something very smart, I'll say.
Maybe the biggest change or the most significant change in this policy, you could argue that is the Cross-Province Mutual Medical Aid.
That's what it's called.
And this reduces the burden of medical costs.
It comes from the National Health Care Security Administration working together with the Ministry of Finance.
They announced this plan very recently, on the 9th of January, to speed up the use of workers' personal accounts of the basic medical insurance across different provinces.
So what will this difference make for families?
Well, first of all, that means, for example, in my family, my husband, who is working in a company and he has this health care insurance account and he has some money input every month based on his salaries.
And that money can be used to pay the health insurance, for example, for our children or for his parents.
And now I think not only that is trying to cover more members of the family.
For example, Right now the policymakers want that account to be able to also cover my parents.
My husband's account can also cover my parents and even his grandparents and grandchildren, if he has any.
And also that hope to cover parents or close family members outside of the city.
So that's why it's called cross-provincial mutual medical aid.
I mean, this is going to make a big difference for a ton of people, I would think, because the simple fact is is that people grow up and then they move and take work in another city.
And that means they live there and then they still have family members there, where they're from, who would rely on their medical insurance.
And the best part, I guess, is that the binding of the accounts and also the stopping of this alignment is all voluntarily.
As long as you're willing to share your account with your family member, it can be done in the future regardless of geographical distance between you guys.
And we now see millions of younger, relatively healthier workers in big cities such as Beijing and Shanghai and Shenzhen.
They us.
We have money just sitting right in the health accounts that we rarely use.
I just checked mine but right before the show I have over 5000 in my account, and if that 5000 can help out with my grandparents, who is constantly in need of purchasing medicine and going to the clinics to check out, then that's That's a better choice than just letting it sitting there.
So that's sort of like helping this trapped money to flow a bit into the system.
And the reason it was sitting there, as you put it, is because that money is kind of geographically locked.
Because you are in Beijing and your grandparents are in a different part of the country, in a different province previously.
That health insurance money could not cross borders.
Yes, because, you know, when it comes to health insurance system, it's very complicated.
Even though we have this national system ready.
But when it comes to, you know, actual payments they have like different pools.
And most of the time this poll is well before.
This is sort of restricted into a county, a city and sometimes in provinces.
And even though we have pilot programs before trying to make you know people go into different places so that they can also, their medical treatment can also be covered by the system.
But that often happens within the same, within a similar some, some sort of a region, for example, in a lot of provinces and cities in China, that you can go to different hospitals and pay with your medical health insurance.
That's only within the province.
But when it comes to cross provincial visits and I have a figure here that more than 120 million people are traveling across provinces in China
And that means a lot of them are unable to tap into that money in their medical health insurance account.
And so with this cross, provincial and especially, I think, for those that their parents are living in rural areas, that they are paying their own health care insurance.
I think it's about 400 yuan a year themselves.
And it's not a lot of money, but it can still mean some sort of a burden for some families.
And now, for example, if their children are working in Beijing, their children can pay for that 400 yuan for their parents.
Yeah, right.
So this just cuts a lot of red tape and a lot.
It saves a lot of time as well.
It's a digital upgrade to the, to the safety net and it.
It recognizes too, that families are often spread out across the country, and then it allows them to use their collective health funds efficiently.
It reduces out-of-pocket stress And it makes the system more flexible and, you could argue, it makes it more humane as well.
And it's not just about the policy, it's about practical family support in these modern times where people are oftentimes so spread out.
Yeah, and I remember seeing the data right before the show that, as of the end of last year I believe, there are about 30 provinces we can call them pilot provinces that has been exploring cross-provincial support with 337 coordinated areas in Xinjiang Uyghur autonomous region, now offering the personal medical insurance wallet and enabling cross-provincial mutual aid.
And that's not saying that these 30 provinces are all, or rather the entire area within this provincial governance is all applying this to their own local medical system.
It's that there are only few cities inside the provinces, sometimes only one or two, that's doing this and it doesn't mean that it works on a very much full scale now, but that's where we're heading.
We're trying to expand the implementation nationwide at this point.
So we mentioned grant.
We keep saying grandparents, grandparents or parents parents, but it's not just, it's not just those groups.
Yeah, And also you can apply.
Children can also try to use that money.
I think for us in Beijing.
Actually we've started similar pilot schemes a couple of years ago actually.
So, for example, my children's health insurance, which is also about 300 400 yen a year, is paid by my husband's health insurance account.
And also when it comes to those accounts.
The money in that account can also be used to buy medicine at home, certain pharmacies, not only just hospitals.
And also right now, I think his parents, who are not living in Beijing, can also start tapping into his account.
And also covers grandparents, that's very important.
Of course, yeah.
The pharmacies, do they need to be part of the program?
It wouldn't just mean every pharmacy everywhere?
No, they also need to be sort of registered inside the system so that you can pay using that account as well.
So, in terms of using the money you set up a personal insurance wallet through and this is necessary right.
Through the National Unified Medical Insurance Information Platform.
And then the person who has the insurance.
They can set a limit for their family member or members through that wallet.
And then that wallet gets managed virtually online.
And there's no transfer of funds to the wallet that occur.
And this helps out with the safety of the medical insurance funds, too.
It's a big move because it's not like the son in Beijing couldn't send money to his father in Yunnan, for example, before.
It's just communication is required.
So if the father was at the hospital and needed money, then he has to text his son, who's probably working at the time, may not be able to see that message immediately, and then it just.
It just gets rid of all of that in between stuff yeah, and also makes the flow make sense.
For example, if you have, for example, 5 000 us sitting in your health insurance account and you are not using it very frequently, you can't use it elsewhere as well?
You can't just thinking about, I need to spend this 5,000 yuan.
Maybe I need to buy something from the pharmacies.
But while your father, for example, in Beijing is, you know, need to go to the hospital because of some of the medical conditions and need really regular prescriptions from pharmacies.
And now they can use that money in more of a financial sense.
But we kind of need to make sure also that in order to qualify our family members for that, father in Yunnan must himself be enrolled in basic medical insurance as well.
So that there's a count on your side.
There's also accounts on the family member's side too for this to work.
You mentioned rural communities and health care services in those rural communities.
One of the issues oftentimes with rural communities is access to providers and facilities.
Does this policy impact that at all?
Yes, many of those living in rural areas face this shortage of health care providers and facilities.
And with this kind of policy ready, that means family members in the cities can use their insurance funds to help with their close family members in the rural areas, access better medical care in nearby urban centers or even in one of the top med hospitals in Beijing or Shanghai or Chengdu.
Yeah, and it's totally understandable sometimes that as the city grows and expands, the better medical resources sort of gather at where the population kind of has the most density.
So regarding rural areas, it's less people comparing to a lot of the major cities.
So they sometimes have this underserved case where the healthcare is, even though it's available, it's probably have a higher cost for them.
So this is there to help and also to try to enhance the quality of the they can receive by just sharing that account and getting better, higher quality treatment from major hospitals nowadays.
I think it sort of removes the barriers for these residents because when it comes to having money out of their pockets, even though you can get it reimbursed later for a lot of these residents in these rural areas, they'll try to avoid going to the hospitals, not only because of the travel time but also because of the money.
So I think by removing these barriers, they can be feeling more confident going to the hospital.
It's one less thing they have to worry about.
Now, putting this type of thing, this type of schemed, together on a national level has got to be hard, because I asked a moment ago about the pharmacies and you said yeah, the pharmacies have to be a part of the program.
So that means everyone involved needs to be a part of the program.
That has to be a serious challenge to put together a system like this when you're talking about multiple provinces all around the country.
Yeah, because different provinces, they can sometimes have different health care regulations and local systems of their own which, of course, could complicate the seamless fund sharing and integration we're trying to build at this point.
Yeah, and also technology would also be a big hurdle.
Just imagine having billions of people's data on some sort of system across provinces and they need to work together efficiently and also securely.
It will be a very difficult technological challenge as well.
Well, let alone the one code for all.
It's hard enough to teach my grandparents to trust the QR code they have on their phone.
Oh, really?
Yeah.
That's where we are now.
Right, yeah.
I suppose there would be a risk as well of people using the funds incorrectly or in ways that they shouldn't be using them.
Yeah, there comes to the risk of fraud.
Because of this greater flexibility, as we discussed, there will be potential for misuse and even fraudulent claims.
That also means, I think... strict monitoring, regulation, and also, you know, technological wise.
Yeah, and that's going to.
Yeah auditing, regular auditing that's going to mean a lot more work too, but hopefully that's not needed so often.
Getting people to be aware you just mentioned it, yushan your grandparents still don't trust a qr code.
Yeah, they like something that they can hold in their hands, such as a car.
Yeah yeah, exactly.
Well no, i mean, that sounds to us.
Maybe that might sound like that's cute, but that's the reality for, for a lot of people, something tangible that they can hold in their hand.
They know this is my hospital card.
This is what i need when i go to the hospital.
Trying to change those habits and trust in something that they're not familiar with would be a big step.
Yeah, so I think for that, that probably means more of this publicity of the system.
Maybe volunteers, for example, in hospital telling them that you can trust this.
We accept this code.
Don't worry about that.
And even when you forget to bring it to the hospital.
There's also a plan B, a digital plan B, that you can rely on, like seriously.
Yeah, yeah.
What will the healthcare system do?
We mentioned auditing as one of the things to make sure that everything does run as it is supposed to run.
Also, there is the data security and verification process we kind of need to look up to too, because the use of a unified national platform should require secure verification processes so that people can trust it better, like facial recognition or mobile-based checks or payment methods, like we mentioned earlier.
That's all to ensure that only authorized individuals can access and use these funds.
And also means for those that offend or violates these rules and regulations.
There need to be penalties or consequences that for anyone caught attempting to misuse the system or getting illegal access to different data on that system as well.
Is this something people are talking about?
Have you noticed your family group chat, anybody talking about this?
Because this seems to me like this would be a really significant change in how the health care system works.
So have you heard your grandparents or your parents or anybody discussing this with people living in different parts of the country?
Well, I think my husband is already sort of applying for that, because you also need to register and applying first of all on that system.
And then they are able to share that account or money.
But I'm not sure.
I haven't really checked on him on this.
Yeah.
And my grandparents, they have not yet tapped into this system.
They're not ready yet.
Yeah, they are aware.
Well, they're sort of aware of it, but there's Still waiting to see how it's going to really push through as a national policy.
Let other people try it out first, maybe, and see how it goes.
Yeah, it is big news.
It's a big step here for the healthcare industry in the country.
That much is for sure.
