On March 15, a widely circulated online letter of assistance in research (hereinafter referred to as the “Letter”) signed from the “Department of Reform of the Health and Health Commission” aroused industry attention.
This Letter proposes three “soul tortures”, referring to the issue of listing and financing of for-profit medical institutions.
Affected by this, the stock prices of many private listed medical institutions fell to varying degrees.
In this regard, industry experts believe that the market is suspected of over-interpreting the “Letter”, and assisting in providing research materials is an annual routine behavior, that’s all.
Three “Soul Tortures”
The above-mentioned “Letter” mentioned that in order to promote the sustainable, standardized and healthy development of social medical services, relevant departments are now required to provide relevant research materials in three aspects.
These three aspects all point to the listing and financing of for-profit medical institutions:
Does it conform to the policy guidance for the development of the health industry?
Will there be a bad example in the medical industry?
Will it lead to the risk of disorderly expansion of social capital?
Affected by this, the stock prices of many private listed medical institutions fell to varying degrees. According to statistics from the health industry, at the close of trading on March 15, Aier Ophthalmology fell by 11.41%; Tongce Medical, Samsung Medical, etc. fell by the limit; Shapu Aisi, Yingkang Life, etc. fell by more than 7%.
In this regard, some industry insiders revealed to the health community that there is no need to over-interpret the “Letter”. Every year, the Department of Economic Reform of the Health and Health Commission will organize the association to conduct regular research data collection activities. Basic understanding of the industry.
Large scale and small role, private hospitals only care about expansion?
In fact, as early as the 2009 medical reform plan, private hospitals have been placed in an important position.
The new medical reform plan proposes to actively promote the development of non-public medical and health institutions, form a medical system with diversified investment subjects and diversified investment methods, moderately reduce the proportion of public medical institutions, and form public hospitals. A pattern of mutual promotion and common development with non-public hospitals.
Since then, by 2015, private hospitals outnumbered public hospitals for the first time.
It can be seen from the report “Number of National Medical and Health Institutions at the End of November 2021” released by the National Health Commission that as of the end of November 2021, there were 36,000 hospitals in the country, of which private hospitals reached 36,000. 25,000, accounting for nearly 70%. And compared with the same period in 2020, the number of public hospitals decreased by 38, while the number of private hospitals increased by 1,377.
However, contrary to its trend of expansion, the number of visits undertaken by private hospitals has not met “expected”.
From January to November 2021, the total number of visits to medical and health institutions nationwide was 6.05 billion, a year-on-year increase of 22.4%. Among them, 3.22 billion people in public hospitals, an increase of 28.3% year-on-year; 580 million people in private hospitals, a year-on-year increase of 24.8%.
Although the number of medical visits undertaken by private hospitals is also increasing, the increase is lower than that of public hospitals. And the absolute number of people is only 18% of public hospitals.
More than twice the size of a public hospital, but less than 20% of the patient volume. The pressure of patient visits in China is still on the public hospital side.
A sober capital is needed: The average loss of private hospitals is 5.2 million yuan
The mismatch between the scale and the volume of admissions reveals the contradiction in the development of private hospitals, which was once referred to as “barbaric expansion.” Many analysts have pointed out that the involvement of capital is one of the main drivers of the “barbaric expansion” of private hospitals.
However, after the news that private hospitals went bankrupt and IPO failed in the past two years, the enthusiasm of capital is also cooling down year by year.
In 2019, the total financing amount in China’s medical service sector was 14.43 billion yuan, but in 2020, this figure has plummeted to 5.8 billion yuan, an increase of nearly 60%.
Funding is the lifeblood of private hospital expansion and survival. Losing the attractiveness of capital means losing “Half-Life”.
For example, in a recent case, on February 21 this year, the People’s Court of Xuzhou District, Yibin City, Sichuan Province issued two announcements in succession. It has ruled to accept the bankruptcy liquidation cases of Yibin Shunan Hospital Co., Ltd. and Yibin Aidi Eye Hospital Co., Ltd.
Behind these failures, without exception, are inextricably linked to “blind scaling.”
The person in charge of a private hospital told the health community that only those private hospitals with consumption attributes have greater financing needs, and truly comprehensive private hospitals do not need financing, and do not The “capitalization” route cannot be taken.
“It is easy for private hospitals such as stomatology and medical aesthetics to form standardized processes, and rapid expansion can be achieved with the help of capital,” said the person in charge, “but general private hospitals pay more attention to treatment, and their core It’s a doctor’s level, so the pattern can’t be replicated at all.”
The consequences of disorderly expansion lead to supply and demandseek imbalance.
According to the data released by the National Health Commission, in 2020, the total revenue of private hospitals in my country is 670 billion yuan, but the expenditure is as high as 800 billion yuan. This means that the overall loss of private hospitals in the year reached more than 130 billion yuan.
If the average number reaches 25,000, each private hospital will lose an average of 5.2 million yuan in 2020.
Therefore, closure, cancellation and reshuffle have become the most severe situation that private hospitals will face.
According to statistics, in 2019 and 2020, the number of private hospitals cancelled in my country reached 347 and 685 respectively.
Don’t read too much
As soon as the “Letter” mentioned at the beginning was circulated, Aier Eye’s stock price was the “most injured” party.
Health community officials contacted the company’s executive for “no comment.”
However, from the “Third Round Inquiry Letter” issued by Shenzhen Stock Exchange to Aier Ophthalmology, it can be found that the refinancing of private hospitals has indeed attracted the attention of the regulators.
However, looking at the public information of the National Health Commission, it can be found that “the state supports the society to run medical care, and it has never changed.”
In June 2019, 10 departments including the National Health Commission jointly issued the “Opinions on Promoting the Sustainable, Healthy and Standardized Development of Social Medical Services”.
In June 2020, the Basic Medical Health and Health Promotion Law was promulgated, which clearly stipulates that the state takes various measures to encourage and guide social forces to establish medical and health institutions in accordance with the law, support Cooperate with medical and health institutions organized by standardized social forces and medical and health institutions organized by the government to carry out various types of medical services, discipline construction, and personnel training.
In terms of tax policy, in 2019, the VAT exemption for small and micro enterprises will be increased from 30,000 yuan to 100,000 yuan in monthly sales, and 50% of small-scale VAT taxpayers will be exempted. Some local taxes and surcharges are reduced and levied within the country. Eligible for-profit medical institutions can enjoy the above preferential tax policies according to regulations.
In terms of medical insurance, the designated medical institutions for social security such as basic medical insurance, work-related injury insurance, maternity insurance, medical assistance, etc. implement dynamic management, and more qualified social medical institutions are included in the designated medical institutions. , to further expand the coverage of designated social medical insurance.
The National Health Commission also encourages commercial insurance institutions and social medical institutions to jointly develop diversified and personalized health insurance products to complement basic medical insurance. According to preliminary statistics, in 2019, there were 20,228 socially-run hospitals designated by medical insurance, accounting for 96.4% of the national socially-run hospitals.
In January 2021, the Health and Health Commission’s letter on the reply to the proposal of the third meeting of the 13th National Committee of the Chinese People’s Political Consultative Conference No. 3451 (No. 517 for medical and sports) mentioned that it will continue to encourage And guide banking financial institutions to increase credit support and product innovation, and actively meet the diversified financing needs of medical market players, including for-profit medical institutions.
“No one can achieve a monopoly, medical institutions have a consumption radius, and even the best private hospitals are limited to the scope they can cover. There is no need to over-interpret the “Letter”.” The aforementioned industry insiders said.
Source｜WeChat Public Account of Health Industry
Writing｜Lao Zhao next door
Editor｜Boss Crab