【英语中国】FT社评:中国应在医疗行业“治本” Leader_GSK and China’s war on drug prices

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所属分类:双语中国

2014-5-15 06:41

小艾摘要: China’s campaign against corruption and corporate bad behaviour is often accused of focusing on foreigners while turning a blind eye to domestic malfeasance.When Beijing handed out its biggest ever p ...
Leader_GSK and China’s war on drug prices
China’s campaign against corruption and corporate bad behaviour is often accused of focusing on foreigners while turning a blind eye to domestic malfeasance.

When Beijing handed out its biggest ever pollution fine this week, it targeted a US company for the crime of open-air spray-painting. That a foreign venture should be shamed in this manner, rather than one of the many smoke-belching coal-fired utilities that ring China’s capital, seems to speak of a skewed sense of priorities.

At first sight, the accusations brought by the Chinese authorities against GlaxoSmithKline seem to fit a similar pattern. The police investigation is part of a wider crackdown by the state on unfair pricing practices. The government believes that Chinese consumers often pay far more for goods and services than they should and the pharmaceuticals industry is an important focus of this inquiry. True, some domestic businesses have been roped into this probe. But most of the high-profile targets to date have been foreign.

Still, the severity of the charges levelled at GSK is striking. Mark Reilly, the company’s former head in China, and many others, are accused of orchestrating a scheme by which GSK staff offered illegal incentives to purchase the company’s medicines. GSK staff allegedly concocted expense claims to hide the payment of cash bribes to doctors who prescribed the drugs.

This, the police claim, had the effect of artificially raising drug prices and distorting competition. At a briefing this week, they alleged that GSK drugs cost up to seven times more than they did in other countries because of such practices. The case has now been handed to the Chinese prosecutor who must decide whether to pursue it in the courts.

GSK must clearly answer any charges that are brought by the Chinese authorities. But the matter should not rest there: it resonates far beyond China. The company may also face prosecution under British and US bribery legislation.

In July GSK admitted that some of its Chinese executives had broken the law, and sacked several it claimed had gone rogue. What is not clear is to what extent the company was aware of the activities in China. Claims that executives attempted to suborn government officials are especially worrying. GSK needs to investigate exactly what happened to establish who knew what and whether people higher up in the organisation may have encouraged or turned a blind eye to any wrongdoing.

The Chinese authorities are right to crack down if companies have been abusing the healthcare system. But if they wish to eradicate malfeasance they should lift their eyes beyond large corporations and address some of the shortcomings in the healthcare sector.

The Chinese government does not pay hospitals enough to cover the cost of treating patients, leaving a shortfall that must be made up elsewhere. Patients who cannot afford to pay often struggle to get treatment. Even the luckier ones sometimes endure unnecessary procedures, peddled by hospitals seeking extra fees. Drugs, to which healthcare providers add a 15 per cent mark-up as a source of income, are liberally prescribed.

Doctors, too, are disgruntled. They struggle to make ends meet on wages that are low even by Chinese standards. In a country in which bribery remains a problem, hardship among doctors makes it almost inevitable that some will look for kickbacks to supplement their meagre incomes.

None of this excuses improper conduct by drugs companies or the medical profession. Still, enforcing the law is only part of the solution. The powerful incentives for misbehaviour must be removed. Corporate prosecutions are necessary where rules have been broken. They should not, however, be the end of the story.

中国打击腐败和企业不良行为的运动经常被指责专门针对外国人,而对国内违规行为视若不见。

当北京市本周开出史上最高金额的污染罚单时,被罚的是一家犯有“露天喷漆罪”的美国公司。一家外国企业(而不是环绕中国首都的众多大量排放烟气的燃煤电厂之一)以这种方式蒙羞,似乎说明了一种优先顺序上的把握不当。

乍看之下,中国当局对葛兰素史克(GSK)的指控似乎有相似的模式。警方调查是中国政府打击不公平定价做法的整体行动的一部分。政府认为,中国消费者为产品和服务支付的价格往往远高于合理水平,而制药行业是这次调查的一个重点。没错,国内一些企业也被卷入这一调查。但迄今大多数令人瞩目的目标都是外资企业。

尽管如此,针对GSK的指控的严重性是触目惊心的。GSK中国区前主管马克锐(Mark Reilly)等多人被指控策划一个计划,由GSK员工提供非法激励,鼓励购买该公司的药品。GSK员工涉嫌编造费用,以隐藏向在处方中开出该公司药品的医生支付的现金贿赂。

警方称,这些行为产生了人为抬高药品价格和扭曲竞争的效果。在本周的一个简报会上,他们声称这种做法使GSK在中国市场的药品价格最高达到其它市场的7倍。本案已经移送中国检察机关,由其审查并决定是否起诉。

GSK必须清楚回答中国当局提出的任何指控。但事情不应止于此:这件事产生的冲击波远远超出了中国。该公司还可能在英国和美国面临根据贿赂法律的公诉。

去年7月,GSK承认该公司的某些中国高管触犯了法律,还解雇了几名公司称犯有违规行为的高管。尚不清楚的是,公司在多大程度上意识到中国业务部门的活动。有关高管试图收买政府官员的指控尤其令人担忧。GSK需要调查究竟发生了什么,以确定谁知道什么,确定企业高层的人员是否鼓励了任何不当行为,或对其不闻不问。

如果企业损害了医疗体系,中国当局进行打击是正确的。但是,如果他们希望根除违规行为,他们的眼光不能只停留在大企业身上,而要去解决医疗行业的一些缺陷。

中国政府对医院的拨款不足以覆盖治疗病人的成本,留下一个只能通过其它途径填补的缺口。无力付费的病人往往难以获得治疗。就连更为幸运的病人,有时也得忍受寻求额外费用的医院兜售的不必要的小手术。中国的医疗服务提供机构对药品加价15%作为一种收入来源;医生倾向于多开药。

医生们也不满。即使按照中国的标准,他们的工资也偏低,难以维持生计。在一个贿赂仍是问题的国家,医生的生活困难意味着,其中有些人难免会寻求回扣以补充自己的微薄收入。

这些都不是制药公司或医务人员从事不当行为的借口。可话说回来,执法只是解决方案的一部分。必须消除不当行为的强大激励。在违反规则的情况下,对企业提起公诉是必要的。但公诉不应该是整个故事的结尾。

译者/和风

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