英国向中国推销医保模式

The NHS has long been a global symbol of gigantism. Its 1.3m workforce vies with Indian Railways and the Chinese People’s Liberation Army for the title of world’s biggest employer.

放眼全球，“庞然大物的代名词长期以来非英国国民健康服务(NHS)体系莫属。这个拥有130万员工的机构可与印度铁路(Indian Railways)和中国人民解放军(PLA)竞争全球最大雇主称号。

Now this lumbering public service – “the closest thing the English have to a religion, as Nigel Lawson, former chancellor, once wrote – is seeking to transform itself from a consumer of national resources to a wealth creator as the UK struggles to find a path back to growth.

英国前财政大臣尼格尔·劳森(Nigel Lawson)曾写到，NHS是“英国人拥有的最接近宗教的东西。如今，随着英国奋力寻找一条重新实现增长的道路，这一庞大的公共服务机构正试图从国家资源的消费者转变成财富的创造者。

In a drive spearheaded by Ken Clarke, the former health secretary and now minister without portfolio, the NHS is hoping to sell its expertise to the Chinese as they seek to establish a health service fit for the world’s leading emerging economy.

英国前卫生大臣、现任不管部部长(minister without portfolio)肯·克拉克(Ken Clarke)正在领导一项计划，希望向中国（全球一个主要的新兴经济体）输出NHS的专业技能。中国此刻正寻求建立一种适合本国的卫生服务体系。

The initiative is part of a broader government push to reap commercial rewards from its huge investment in healthcare. Opportunities could range from consultancy and training to hospital design and IT. An official report published last year, with a foreword by Sir David Nicholson, NHS chief executive, argued that the service should do more to exploit the value of its “knowledge, information, ideas and people.

英国政府正试图从自己的巨额医疗投入中获取一些商业回报，以上倡议是这种努力的一部分。机会可能存在于各个领域，从咨询、培训到医院设计和IT。去年发表的一份官方报告辩称，NHS应努力从其“知识、信息、理念和人才中挖掘更多价值。该报告的序言由NHS首席执行官戴维·尼科尔森爵士(Sir David Nicholson)撰写。

Innovation, Health and Wealth said that, if the opportunities were grasped, “they would not only return revenue, expertise and new ideas to the NHS?.?.?.?but will also help drive growth in UK plc.

这份报告的题目是《创新、卫生事业和财富》(Innovation, Health and Wealth)。报告称，如果NHS能抓住这些机会，那么“这些机会不仅会为NHS带来更多收入、更高超的专业技能和新的理念……还有助于推动英国经济更快增长。

To the many critics of the NHS, the idea of others looking to it for inspiration might raise eyebrows. However, the Commonwealth Fund, which surveys international health systems, consistently rates it among the world’s strongest performers.

其他人希望从NHS那里获得灵感，这个想法可能会让NHS的很多批评者感到吃惊。然而，对世界各国卫生体制进行调查的英联邦基金会(Commonwealth Fund)，一直将NHS评为全球一流的卫生体制。

“If you are interested in universality as a concept, the NHS is probably as good as it gets, said Mike Farrar, chief executive of the NHS Confederation. “It is cost effective compared to the levels of outcome and we get them for everybody, not just a few.

“如果你对普适性这个概念感兴趣，你会发现NHS可能在这方面或许已经做到了极致。NHS联合会(NHS Confederation)会长迈克·法勒(Mike Farrar)表示，“就其提供服务的水平而言，NHS的成本并不高，而且我们提供的服务面向全体国民，而非由少数人独享。

Many believe the government has underestimated the productive potential of healthcare. Stephen Dorrell, chairman of the health select committee and a former Conservative health secretary, pointed out that health and care services together represent 10 per cent of the UK economy.

很多人认为，英国政府低估了卫生服务的生产潜力。英国卫生特别委员会(health select committee)主席、曾任英国卫生大臣的保守党人斯蒂芬·多雷尔(Stephen Dorrell)指出，卫生和保健服务总计占英国经济的10%。

“Not merely the production of pharmaceuticals and health technology, but the delivery of health services themselves, is a form of wealth-generating activity both in the home economy and with huge export potential, he said.

他表示：“不仅是制药业和医疗科技业，卫生服务的提供本身也是一种创造财富的活动，不仅为本国经济创造财富，还具有巨大出口潜力。

Question marks remain over whether China will offer the revenue-raising potential the government dreams of. Chinese officials have conducted studies into the British system and have shown interest in replicating some aspects such as elderly care, but analysts say they are unlikely to pay the NHS to help put these ideas into practice.

至于中国是否会提供这一英国政府梦寐以求的创收可能性，我们还要打个问号。中国官员对英国NHS体系进行了研究，并对复制其中的一些部分（如老年人医保）表示了兴趣，但分析师表示，他们不太可能付钱给NHS，让其帮助自己将这些想法投入实践。

Beijing has announced plans to allow more private and international healthcare companies to invest in the country, particularly in the high-end private segment of the market.

中国政府已宣布计划，将允许更多民营和外资医疗企业来中国投资，特别是在高端私人医疗领域。

The NHS may find some scope to bid for business in this area but it will be competing with the world’s biggest private healthcare providers, in particular those from the US.

NHS可能会在这个领域找到一些争取业务的空间，但与其一决高下的将是全球最大型的那些私营医疗服务供应商，特别是来自美国的企业。

Global private healthcare companies already operating in China say it is an extremely difficult market to enter and succeed in because of problems of protectionism, corruption and intellectual property theft.

已在中国开展业务的一些外资私营医疗企业表示，由于保护主义和腐败活动盛行、知识产权盗窃活动猖獗等问题，进入中国市场并取得成功极其困难。

It is also very politically sensitive for the ruling Communist party, which sees problems in the health system as having potential to foment social unrest in the one-party state.

对于执政的中国共产党而言，向民企和外资企业开放医疗行业也是个非常敏感的政治问题。中国共产党认为，卫生体系的问题有可能会在这个一党制国家引发社会动荡。

China’s health ministry declined to comment when asked whether the Chinese government would consider seeking advice from the UK or paying for NHS services.

在被问及中国政府是否会考虑向英国咨询或购买NHS的服务时，中国卫生部拒绝置评。

“The Communist party knows it needs to create a modern healthcare system and to be seen as leading that process, so looking to another government for help is unlikely to meet their political goals, said Jason Mann, head of China healthcare and pharmaceuticals research at Barclays. “As far as a partnership with the NHS, I think that is a bit far fetched, based on China’s political realities.

“共产党知道，它必须创建一个现代医疗体系，也必需让别人认为自己在主导这一创建过程，因此，向别国政府求助可能不符合他们的政治目标。巴克莱(Barclays)中国医疗和制药研究主管贾森·曼(Jason Mann)表示，“至于与NHS合作，基于中国的政治现实，我认为，这种说法有些不切实际。

UK ministers hope Mr Clarke’s famous élan and broad political hinterland – at 72 he has held many of the most significant portfolios, including chancellor and home secretary – will win over the sceptics when the UK goes to negotiate with foreign clients.

现年72岁的克拉克政治履历丰富，曾担任多个重要职位，包括财政大臣和内政大臣。他为人热情，这一点众所周知。英国的大臣们希望，克拉克在英国与外国客户的谈判中能够凭借自己的政治经验和热情，打消怀疑者的疑虑。