Deep interpretation: the dilemma of China's telemedicine
There are currently two pricing methods for telemedicine services in China. One is a remote consultation. This is not a new thing. It has been around for many years, mainly for intractable diseases, emergencies and major diseases in remote areas. The cost of consultation is very high. For example, the consultation fee for telemedicine outpatient clinic of Zhejiang University is 280 yuan/time, the emergency consultation fee is 1,000 yuan/time, and the appointment consultation fee is 600 yuan/time. Anhui synchronous remote pathology consultation 300 yuan / time, non-synchronous remote pathology consultation 280 yuan / time, clinical experts consultation 600 yuan / hour. The other is also the B-B-C end that the government is pushing strongly. The charging system is still unclear. For example, Guangdong Network Hospital does not charge at the beginning, and the registration fee currently charged is 10 yuan/time. The cost of these two types of telemedicine services is very different. For the former, because of the difference in medical resources, patients have an urgent need for remote services, but there are two contradictions. First of all, this service is very expensive, comparable to the cost of VIP clinics in the top three public hospitals in the city, the more difficult it is for patients in remote areas to accept. At the same time, the current consultation is not included in the medical insurance system, and the number of patients who can afford it at their own expense is a minority. Paradoxically, because the cost of public hospital services in China is already seriously underestimated, any additional visits may be positioned as a way to earn income faster, so the price is high, but the B-B demand is powerless. This pays the bill. From the analysis of the US case, this type of B-B consultation for the major illness must be reimbursed by the payer to develop rapidly. The contradiction of pricing at the B-B-C end is that there is little difference between price and offline outpatient services. The difference in the registration fee between different hospitals in China can be neglected, and the network hospital has no advantage in terms of cost. And the reason why users choose a network hospital is that they hope to get another way when they can't hang on the top three. This approach may increase the number of outpatients in the top three, but the contradiction is that because the user can take medicines nearby (such as pharmacies), the hospital can not make money through prescriptions, and the service income is negligible, so the power of the top three is very small. Compared with China, the pricing of telemedicine in the United States has a clear price advantage compared to offline. The core advantage of the development of telemedicine in the United States is the low price. The cost of a single visit to a telemedicine GP is between $30 and $45 (single times, or maybe 15-20 minutes), but if you have a monthly or annual subscription, the price will be very cheap, such as HealthTap $99. In the year, MDLive's monthly fee ranges from $15 to $25 (individual or family). In contrast, offline services are much more expensive, even if there is insurance, users must first pay a part of the self-funded service fee, usually ranging from 30-80 dollars, the general department is cheap, if the emergency room may be more expensive, I have to pay about $100 first. The pricing of China's two telemedicine services in B-B and B-B-C is very different. The core reason is that the overall medical service price is seriously underestimated. The offline service pricing is too low, and the telemedicine for the B-B-C end of the conventional disease has no advantage in the service price. On the contrary, it also diverts the drug income of the large hospital. Therefore, only the hospital with low outpatient volume may have the motivation to do it. The stronger the hospital, the weaker the power. Also because offline service charges are too low, teleconsultation has become another high-priced income channel similar to VIP, and the lack of medical insurance support makes these services too small, and it is impossible to cover a large number of people who really need it.
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