Opinion / You Nuo
Do not treat medical reform so casually
By You Nuo (China Daily)
Updated: 2006-01-23 05:49
Inadvertently, by reporting its suggestions on China's medical reform,
the business consulting firm McKinsey & Co might have made itself a
perfect case study of how badly an international company can adapt to the
local environment.
On January 19, the company released its study of the key dilemma of the
nation's public health development, proposing that the government should,
as reflected in most headlines in the Chinese media, "relinquish (the
management of) urban workers' medical insurance to the market."
Like in many countries, the medical insurance system is first of all a
political issue and anyone proposing a change of it will have to take
tremendous political risk; in other words the risk of causing public
denunciation.
This, unfortunately, was exactly what the company achieved not perhaps by
the words in its study, but in the way of reporting it. It is a failure
on three levels.
On the first level it was a communication failure. All the reports in the
Chinese press about the study, which one may reasonably assume to have
been based on some company handouts prepared in advance, as the practice
is everywhere in the world, were written in unclear and at times odd ways.
Little explanation was provided to back up sayings such as that the
government should withdraw from the "mature urban workers' medical
insurance system" and that nearly 85 per cent of respondents had seen
"certain marked improvement" in China's medical and public health system
over the last five years. What is the definition of a mature system? How
could so many people have spoken so highly of a system even the
government itself admitted to be problematic?
Small wonder the McKinsey & Co report immediately aroused protests from
the Chinese Internet, from bulletin boards to independent blogs. On
Saturday evening, a blog piece, which got widely reprinted, even went so
far as to call McKinsey & Co's Chinese partner a "criminal of one
thousand years."
In fact, as it seems to me, the report was not really urging the Chinese
Government to abandon the urban workers. Instead, it just said what some
reform planners might have thought about to divide the medical system
into a double-tier one one tier for the wage earners and the other for
the rich and choosy and in one way or another, let the second tier
subsidize the first tier.
If the report, or the handout of the report, is written with a headline
saying rich people should pay for the finance of the workers' medical
insurance, it would have attracted nationwide applause. But the message
simply didn't get across.
On the second level, there was a failure in the management of timing.
When the Chinese New Year, or Spring Festival, is round the corner,
people tend to be most sensitive to any sign suggesting uncertainty in
their lives, particularly their welfare and social rights. That is why
this period of time has traditionally been called "nian guan," meaning
virtually the year-end crisis.
In the middle of 2005, the central government openly admitted that the
past medical and public health reform had not been successful, with
implications that a new plan would be structured for future changes.
Since then, Chinese people, urban and those who desire to become urban,
have all been paying attention to what new ideas and changes may be
proposed in this field.
They would feel betrayed when they get the impression that the government
is being advised to abandon them by a big American company whose top
executives are all highly paid in US dollars and cannot care less about
the well-being of the 1.3 billion population of distant China, according
to descriptions offered by Chinese Internet writers.
The failure on the third level is the company's foolhardiness in advising
China on the subject, even though it claimed to have collected 1,500
questionnaires. The medical and public health reform is a political issue
and will have no smaller impact on Chinese society than a change of the
government.
Treating it as a simple economic issue is amateurish. And talking about
it in public in such careless and ill-prepared ways is certainly not
helping China. One may wonder how anyone can expect to advance his or her
career as a professional consultant by being so insensitive to potential
clients?
Of course, it is not a crime for China, as some domestic Internet critics
exaggerated (as they always do), for whether to listen to that advice or
not is still up to Beijing's decision-makers. But on the part of McKinsey
& Co, to call it a managerial blunder is not far-fetched.
Email: younuo@chinadaily.com.cn
(China Daily 01/23/2006 page4)
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