June 20, 2009. CEIBS Shanghai campus -- How will China, which unveiled its ambitious health care plan this Spring in the midst of a global economic downturn, balance the competing needs of various industry players while providing quality health care to a population of 1.3 billion? What are the challenges that will have to be faced? What role will health insurance play, what will be expected of corporations, how will R&D help change the face of medical care in China and across the globe? These were among the issues explored at today's 5th Annual China Health Care Forum, hosted by the China Europe International Business School at its campus in Pudong.
The event, held under the theme "Value Creation in Health Care" brought together a 19-member team of government officials, industry experts, and academics to probe these issues and more -- and help shape a roadmap for the road ahead.
2009 and beyond
President of Eli Lilly China Mr. David Ricks was the keynote speaker at Friday night's welcome dinner, which marked the official start of the 5th Annual Health Care Forum. Chaired by CEIBS Executive President Prof. Pedro Nueno and held at the Pudong Shangri-la Hotel, the evening affair provided an opportunity for VIP guests to network and share their thoughts on the deliberations planned for today's forum.
CEIBS President Zhu Xiaoming delivering the official welcome address.
This morning, CEIBS President Zhu Xiaoming officially welcomed participants to the conference and laid the framework for the discussions by pointing out that the Chinese government will invest 850 billion RMB in reforming the country's health care sector over the next three years. "We have gathered to discuss how to generate more value for the health care system and provide value to the public," he said.
The deliberations then began with Session One exploring "China's Health Care Reform: 2009 and Beyond". The session was an analysis of the policy parameters of the reform plan, an assessment of the potential opportunities and challenges, and an exploration of the reform's feasible policy options with the aim of creating more value for the public, and the wider society.
The first speaker was Chairman of the Chinese Hospital Association, China's former Vice Minister of Health Mr. Cao Ronggui. He gave a presentation entitled "Key relationships that need to be properly handled during the trial of public hospital reform". The speech was his personal interpretation of aspects of the plan. Mr. Cao began by addressing the significance of the reformation. "China's health care system has made significant progress, yet there are still unresolved problems; and many complaints focus on hospitals," he said, adding that "public hospital reform is the key element in deepening medical and health reform." He told the audience that there were four key relationships that need to be effectively handled -- within the context of how public hospitals function -- during the trial reform period: (1) Accelerating basic medical insurance construction; (2) Accelerating the national basic medical system; (3) Improving the grass-root health care system; and (4) Promoting equitable basic public health service.
As the trial process moves forward, the former government official recommends the use of a scientific basis for setting all guidelines; a constant thrust to understand the reality on the ground by seeking the facts; striking the right balance between the interests of various parties; and fostering an environment that will encourage public opinion. Said Mr. Cao, "Deepening medical and health reform is a long-term and complicated task -- as well as an ideological revolution. The new problems and difficulties can only be resolved and corrected during the process of reform."
In his exploration of "Historical Opportunities vs. New Challenges", Chairman of China Medical Insurance Research Association and China's Former Vice Minister of Labour and Social Security Mr. Wang Dongjin explained the rationale behind the government's health care reform plan and its main areas of focus over the next three years. He explained that the plan would offer, for the first time in China's history, universal access to "two benefits": basic healthcare services and basic medical security services. "The [documentation on the issue] also identifies, for the first time, the non-profit nature of the public healthcare services, which would be offered to all citizens as a kind of public product," added Mr. Wang. "Such an unprecedented decision, with its people-oriented nature, definitely makes a historical breakthrough both in theory and mechanism, since it benefits all citizens and reflects the confidence and determination of the Chinese Communist Party and the State Council in improving people's living [standards]."
Another key element of the plan, he said, was the reviving of the "three-in-one-initiative" which, despite widespread support from the government, industry players and the wider society, had in the past "been stagnated and frustrated, due to the lack of an effective overall planning and necessary supporting policies". Mr. Wang also told the audience that the plan had provided new opportunities for development which fell within six categories that provided a chance to:
- speed up the establishment of the basic health insurance system;
- fortify the accountability of the government, and the government-leading investment mechanism;
- build a scientific and reasonable pricing system for health care services and a price formulating system;
- explore the negotiation mechanism and fully realize the supervision function;
- perfect the urban healthcare service system, with the community-based healthcare services as the priority; and
- perfect the basic health insurance management system.
"In a word, the new ideas, new spirits and new explanations provide a new basis for the establishment of the basic medical security system. We are to take full advantage of the precious historical opportunities," he said. He acknowledged that the task ahead would not be easy, and spoke of the obstacles that would have to be overcome. The five major challenges, he noted, would be to: follow up with more detailed plans, approaches and regulations; meet the criteria of each designated task; improve the management capacity of the insurance agencies; build reasonable systems; and build the necessary supporting systems and policies.
Mr. Wang also stressed the need for all players to be actively involved in the reform process, saying, "As a great project concerning people's lives and benefits, the reform of the healthcare system is both a good thing and a difficult thing. All people involved in, or concerned with, the reform are supposed to study [the documentation] in depth and contribute their ideas for the smooth advance of the reform."
This, he added, will require sustained commitment. "It will be a long-term project to achieve the steady and sustainable development of the basic medical security system, through the synergy of all parties involved," he said.
Flu pandemic
"From SARS to Flu Pandemic: Lessons for Public Health and Health Care Industry" was the topic of the address that followed. It was delivered by World Health Organization Representative in China Dr. Hans Troedsson who told the audience that public health faced several challenges including emerging diseases such as SARS and the H1N1 virus. Others, he said, include an aging population; the double burden of both communicable and non-communicable diseases; environment and climate changes such as decreasing air quality, polluted waters, road traffic injuries, occupational disease and food safety; as well as unhealthy habits and lifestyles that run the gamut from smoking to unhealthy diets, physical inactivity and obesity.
Turning to his main topic for the day, the WHO official took a look back at the 2003 SARS epidemic and made a comparison between the fallout from that deadly virus and the impact that would result from an influenza pandemic. SARS, he said, had infected more than 8,000 people in 30 countries within a seven- to eight-month period. The economic impact of the disease had been severe, eating into 4% of Hong Kong's GDP, and 0.5% of China's.
According to Mr. Troedsson a pandemic can begin any time, anywhere; it involves a new virus and human immunity to this illness is low to nil. In addition, he said, there is sustained human-to-human transmission; it spreads globally within several weeks or months and multiple waves are seen in most communities. "Health impacts will vary widely among countries and communities, vulnerable populations are affected more severely and workplace absenteeism is higher than the clinical attack rate," he explained.
There have been three influenza pandemics in the 20th Century, he added: the 1918 Spanish Flu (H1N1) which claimed 20 million lives; the 1957 Asian Flu (H2N2) and the 1968 Hong Kong Flu (H3N2) which each killed 1 million people.
He provided data to compare the effects of an influenza pandemic with SARS, saying while the former had 8,096 cases, a flu pandemic would see 400 to 800 million people infected. In terms of the severity of the cases, all the SARS cases were classified as severe while 1 to 2.3 million of pandemic flu cases would fall into that category. In terms of lives lost, SARS accounted for 774 while a flu pandemic would leave 280,000 to 650,000 dead. Pointing out the differences between the two diseases in terms of modes of transmission, infectivity, infectious period and place of transmission, The WHO official told the audience that, "Containment is much more difficult [and] the impact is much bigger for pandemic influenza."
This June, the rapid worldwide spread of the influenza A/H1N1 virus led the WHO to issue a global pandemic alert for the first time in more than 40 years. Plans going ahead, said Mr. Troedsson, would likely be premised on expectations of more and more infections and deaths; increased demand for health services -- which may then result in a shortage of staff, medical supplies and equipment, and, as time progresses, a disruption of routine health programmes. The expected long-term impact would be a slowdown in economic and commercial activity and heightened public concern.
The negative impact would not be contained to areas directly related to health services but would spill over to affect general life, he added. In formulating plans to combat the pandemic, it is anticipated that in addition to the closure of public places such as schools and cinemas, the cancelation of conferences, meetings, and trips for vacation, there may also be closures of markets, factories, businesses and distribution systems -- which would take an additional toll on medical supplies. In the long term, a pandemic could also result in unstable food, water and electricity supplies as a result of lack of transport and sick staff. It may also see a decline in agricultural output. All these challenges, the WHO official said, would lead to increased public concern.
In explaining the public health measures that can be taken once a pandemic gets underway, the WHO official made the point that an early global response is vital. "An infectious disease in one country is a threat to others. The best chance to eradicate or contain a new or a re-emerging disease is when it surfaces; and high-level government commitment, international collaboration is needed," he said. The key response, both on a national and global level, he added should include:
- Early detection & response, reporting, information & sharing of samples with the international community and
- Treating information, samples and products (vaccines, diagnostics, drug sensitivities) as a global public good throughout the process.
"Governments need to take greater responsibilities," he stressed.
Using a pyramid to explain the different layers of preparing for a pandemic, the WHO official told the audience that there was a basic need to keep essential services running (food and water, power, transportation, telecommunications, etc). Public health measures -- broken down into medical and non-medical interventions -- are the other prongs of the approach.
Mr. Troedsson said the lessons learnt from previous influenza pandemics, which would be excellent guidelines to follow this time around, include the knowledge that:
- preparedness should also include clear division of responsibilities and simulation exercises
- surveillance must be enhanced for early detection/ treatment, and for possible signs of virus mutation
- investment is needed for hospital infection control standards, to strengthen lab capacity and overall surge capacity of health services, and
- staff must be trained in risk assessment and risk communications.
Speakers from Session One take questions from the audience.
The final speaker for Session One was CEIBS Professor of Economics and Finance Dr. Xu Xiaonian who tackled the issue of "The Economics Behind the Reform of the Medical Care System". He explained that during many debates about the reform, various economists had expressed their opinions about the economic issues involved; however he wanted to explore the supply side of the issue. Conceding that his comments were coming a bit late as the plan has already been formulated, Prof. Xu maintained that the plan has "loopholes and shortcomings and needs to be adjusted". He asked provocatively: "Economists made the diagnosis of the reform of the medical care system and wrote their prescriptions. But what if those economists were themselves ill (wrong)?" He told the audience that the economists' diagnoses had been based on faulty logic. "Their arguments don't hold water, based on my analysis," he said.
Prof. Xu then used basic economic principles to highlight the flaws in these earlier arguments. He pointed out, for example, that the idea had been posited that health care is a form of public welfare and should therefore be government-led -- however there has been no clear definition of the concept of public welfare. This, he said, was a major shortcoming of the ideological foundations of the reform plan. "Even if it is finally determined that health care is in fact public welfare, why should it be the responsibility of the government?" he asked.
He then turned to the point that efforts had been made to interpret public welfare as a public good; but dismissed this concept by pointing out the flaws in this argument: there is no need to compete for public goods, as everyone has equal (traits that medical care and the health services do not possess). "We are serious scholars, we can't lower our analysis to the level of netizens!" he chided. He also threw cold water on the popular belief that the medical care and health services industry is a natural monopoly. "That's a myth," he said. "The root cause of market malfunction is asymmetric information, and the solutions are not necessarily government-led."
Prof. Xu maintained that one major reason the reform of medical care had gone so "horribly wrong" was because there had not been enough input from neutral industry players. "Industry associations should be the ones to design the programmes," he said. "They have no vested interest."
CEIBS Vice President and Co-Dean Prof. Zhang Weijiong moderated the session which concluded with a Q&A.
Session Two: Innovation and Incentive
The day's second session looked at the role that health insurance can play in facilitating the improvement of health services, better align provider incentives and enhance service capacity. The important issue of private health insurance was also explored under the broader topic of "Health Insurance: Innovation and Incentive".
The session's first speaker was Deputy Director General of the Medical Insurance Department in China's Ministry of Human Resources and Social Security Mr. Li Zhong. His speech was entitled "The Transformation of China's Health Insurance". The government official began by outlining the typical models of health insurance systems, tracing the transformation of China's health insurance system and then explaining the major responsibilities and measures of the current health insurance system. He told the audience, "The goal of medical security is to reasonably organize fiscal resources (in a broad sense) to satisfy medical funds demands, according to specific economic development levels."
After explaining the health insurance systems in England, the U.S and Germany, Mr. Li concluded that all the models have their pros and cons, therefore China should chose the method best suited to its individual needs. He pointed out however, that the common trend is towards global coverage and there is a need for capital to be injected on both the demand and supply sides.
Bringing an academic's view to the discussions, Professor of Peking University's School of Government Prof. Gu Xin next examined the issue of "Health Insurers as Purchasers of Health Care in China". He dealt with the new trends in the reform process by probing issues such as: universal coverage of healthcare insurance; and the use of public funds to subsidize the demand side. The challenges, he said would include the purchase of healthcare services by health insurers.
Universal insurance coverage
On the issue of universal health insurance coverage, Prof. Gu explained that the priorities of health insurance programmes over the next three years would include:
• Increasing the enrolment rate to at least 90% by 2011.
• Raising the financing level. With an increase in government subsidy, individual premium contribution will increase as well.
• Enhancing the benefit level. The balance of healthcare insurance funds will be decreased to a reasonable level.
• Achieving urban and rural integration. It will be promoted step by step in the areas where conditions are permitted.
• Enrolment of rural migrant workers. Those with labour contracts will enrol in the urban employees' basic health insurance, while those without labour contracts may choose enrolment in the urban residents' health insurance or rural new cooperative medical schemes.
• Portability of health insurance entitlement. The Ministry of Manpower and Social Security and the Ministry of Health are actively trying to find ways to solve this problem.
Regarding the subsidization of the demand side, he quoted sections of the health care reform plan to highlight the thrust towards a government-dominant, multi-source health investment mechanism. This will involve increased investment -- at both the central and local government levels, based on the needs of both providers and users of the service. "Subsidizing the demand side is a new principle," Prof. Gu pointed out, adding that this aspect would account for two-thirds of the government's RMB850 billion investment in the health sector. The other third will go towards subsidizing the supply side which will see a major focus on public health, rural health care and community health care. Prof. Gu noted, "Subsidizing the supply side is not equivalent to fully funding the supply side; the operational expenses for public hospitals will not be blindly increased and personnel salary will not be totally covered."
He then turned his attention to the practical steps that will be taken to provide universal health insurance to a nation of 1.3 billion, from reform of payment modes to choices and combinations of the multiple payment methods available, to diagnosis and treatment of serious illnesses. "The payment scheme reform aims to stimulate health care providers' concern with cost-effectiveness of services, and urge hospitals to compete for referrals from primary health care providers," he said. "As a result, famous hospitals will go into communities to provide primary healthcare services, and open more branches. This will result on brand building and a move towards health care chains."
View from within the industry
Speaking from the perspective of an industry player, Global Medical Director of Bupa Dr. Andrew Vallance-Owen then addressed the topic of "Customer Centred Care: Different Nations, Same Goal". Speaking from the point of view of a 60-year-old privately-run, global company solely dedicated to health care, he began by explaining the key components of Bupa's strategy: putting customers first; using knowledge and experience to be leaders in health and care; a commitment to the company's long-term sustainability/profitability; avoidance of dependence on any single economy or sector; and the leveraging of its skills and understanding across its various geographic locations and sectors.
After touching on topics such as Bupa's China operations and the organisation's customer-centred care innovation, Mr. Vallance-Owen outlined the company's mission. "Bupa's purpose is to prevent, relieve and cure sickness and ill-health of every kind, to promote health in any way," he said. "So our mission in 2009 is to help our customers live healthier, happier, longer lives."
The session ended after a Q&A session moderated by CEIBS Assistant Professor of Management Dr. Zhang Wei.
Session Three: Corporate Wellness and Employee Health Benefit
The forum's third session consisted of a discussion, from a corporate perspective, on how to make sense of current healthcare policies, improve staff health through multi-party collaboration, and provide more satisfactory healthcare benefits so as to improve companies' overall productivity and competitiveness.
The first speaker was Principal of Health & Welfare Consulting Sector of Towers Perrin Mr. Michael Taylor, whose speech was entitled "The Value of Health Care: A Corporation's Perspective". His address covered key issues around the value of health care, the workforce well-being concept, and health care reform in the U.S today. On the topic of health care value, Mr. Taylor touched on cost, quality, productivity and competitiveness. He made the point that the ongoing increase in health care costs has outpaced CPI and wage growth in the U.S. "In the past 5 years, employers' health care costs have increased 29% and employees' by 40%," he said. "The affordability gap is growing -- with significant erosion in compensation values and consumer purchasing power." In drawing on examples from the U.S' reform of its health care system, Mr. Taylor outlined how American employers are changing, or are planning to change, active health care programmes. He also pointed out that in the area of competitiveness, the U.S. was losing ground when compared to the G5 countries but was comparable to Brazil, India and China.
He was followed by an exploration of the topic "Value in Health and Health Care Delivery: Simple Things Matter Most", by Well-being Director of Integrated Health Services of IBM Corporation Dr. Joyce Marie Young who was representing the company's Vice President of Integrated Health Services Mr. Martin J Sepulveda. Dr. Young's address covered topics such as: U.S health performance; why IBM cares; IBM's health and well-being strategy; issues of concern for the U.S; issues of concern for other countries; health and productivity at IBM; and health systems, communities and primacy of primary care.
CEIBS Executive President Prof. Pedro Nueno was the moderator for the session.
Session Four: New Medical Products
R&D in medical products was the focus of the fourth session of today's forum. Speakers explored how to combine technical and organizational innovation, and how to provide valuable new products through consistent technical innovation and business model renewal to benefit the public. The discussion also covered regulation reform.
Deputy Director General of the Policy and Regulation Department for China's State Food and Drug Administration Mr. Xu Jiaqi was the session's first speaker. He addressed the topic of "Value Creation in Policy and Regulation -- Supervision to Promote an Innovative Pharmaceutical Industry". In his speech, the government official relied on a wealth of data and statistics as he sought to answer two questions:
1) In terms of organizational structure, where is the gap between China's pharmaceutical industry and the pharmaceutical industry of developed countries?
2) What is the value created by the policies and market regulation of China's pharmaceutical industry?
For example, he told the audience that:
- There are 4,743 pharmaceutical manufacturing enterprises in China, with 1,729 chemical medicine production enterprises, 879 traditional Chinese medicine enterprises, 2,013 enterprises manufacturing traditional Chinese medicines and chemical medicines and 122 biological products enterprises.
- There are 13,292 wholesale drug enterprises and 365,578 retail drug enterprises in China, with 129,346 retail chain stores and 236,232 mono drug stores.
- The concentration of China's top 100 pharmaceutical manufacturing enterprises was 39.62% in 2007, with total sales revenues of RMB195.4 billion. In comparison, global pharmaceutical giant Pfizer Inc's totals sales revenue was 48.4 billion US dollars (RMB 364 billion). Global Top 10 pharmaceutical manufacturing enterprises racked up 384,000 US dollars (RMB 2.89 million) of per capita sales revenue in 2007, while China's top 10 pharmaceutical manufacturing enterprises had RMB 620,000 in per capita sales revenue for the same period.
- The concentration of China's top 100 pharmaceutical manufacturing enterprises was 40.59% in 2008, with total sales revenues of RMB246.937 billion.
In order for China's pharmaceutical industry to compete on a global level, Mr. Xu Jiaqi urged, "We should have financing capability of large new projects, the ability to maintain leading technological position by continuous and immense R&D investment, the ability to develop brands, the ability to invest in and employ the most up-to-date information and biological technologies, the ability to attract the best talents and the ability to integrate all links in the upstream and downstream of the value chain."
He also spoke of the need for future policies and regulations to target and promote an innovative organizational structure for the industry. He said, "Relevant government departments should focus on integration and concentration of the pharmaceutical industry within the context of globalization, study and work out a competition strategy for the industry, implement industrial reorganization and M&A, and speed up the training of its 'systems integrator' in order to deepen the medical and health care system reform."
After Chairman & Co-CEO of Shenzhen Mindray Bio-Medical Electronics Company Limited Mr. Xu Hang's presentation on "Combining Business and Science", the session wrapped up with a Q&A session moderated by CEIBS Associate Professor of Management Dr. Steven White. Mr. Xu (a CEIBS EMBA alumnus) focused on three broad areas: Health Care Investment around the World, Innovation by Chinese Enterprises, and Mindray's Leading Position in China. He told the audience of the importance of a collaborative approach to improving health care services and coverage. "The health care system and the large expenditures it requires is a bottomless pit for every government," he said. "If China wants to improve its coverage, we cannot only rely on government-led investment."
Session Five: Health Services Delivery
The penultimate session for the day turned the spotlight on the delivery of health services. It discussed the significance of -- and provided a roadmap for -- an innovative service delivery model in China. The talks also revolved around strengthening managerial capacity in provider institutions, and enhancing customer-centred medical services that are safe, effective, efficient and affordable.
The first two speakers were Director General of the Medical Service Administration Department in China's Ministry of Health Mr. Zhang Zongjiu and CEIBS Assistant Professor of Management Dr. Zhang Wei. Their respective topics were "Health Services Improvement and Health Care Reform" and "Information, Quality and Value Creation in Health Care Services".
Mr. Zhang Zongjiu outlined the major role that public hospitals play in China, and the changes that have taken place in the system over the last 30 years: greater autonomy, more responsibility for their bottom line, and increasing numbers of these facilities. He also spoke of the growth in the number of privately-run facilities, now up to about 16% of the country's total number of hospitals. The greatest challenge to China's health care system now, he said, was the disparity between the urban and rural areas.
Looking ahead at measures being explored or implemented to improve the quality of care all across China, Mr. Zhang said efforts were being made in areas such as: pay for performance; improving quality control; increased training of experts; encouraging the use of basic treatments and drugs; introducing modern accounting measures; handling medical disputes promptly; introduce an appointment system where patients can book visits by phone or internet; trying to set up a compliant system for patient use.
During his speech, Prof. Zhang Wei's main area of focus involved providing answers to the question "what is better care?" The trained medical doctor told the audience that while patients once simply wanted access to medical care, they now want access to quality care. He pointed out however that while there was a small gap between the quality of care offered to patients in China and the U.S, the attitude of some Chinese medical practitioners made the gap appear larger. It is vital, he said, to motivate medical care providers and encourage them to provide patients with all the relevant information.
The session's final speaker was Principal of Apax Partners Mr. Sandeep Naik who explored the topic "How does a Private Equity/ Hospital partnership work?" Mr. Naik delved into the discussion by examining four issues: the opportunity for investment; considerations for value creation; reasons for partnering with private equity; and issues that will arise when partnering with private equity.
Investors who are thinking about putting money into Asian companies, he explained, typically explore issues such as: how can PE create shareholder value in the asset; is there an asymmetric risk-reward payoff; is the entrepreneur and management team outstanding; is it an attractive industry; is/was ROIC consistently high. On the issue of value creation, he explained, "In an effort to increase value for its stakeholders, hospital operators have a number of strategic, operating and financial alternatives. Properly structured, a private equity partnership can assist in executing these alternatives."
In answering the question "why partner with private equity?" Mr. Naik outlined the correlation between hospital operators' expectations from a partner and what PE players have to offer. Hospitals, he said, require partners to provide access to capital and provide value added services such as: an innovative capital structure; global best practices; access to world class management talent; credibility with the public markets; and quick decision making. These are all needs that PEs can readily meet, he said.
He closed by answering his final question about issues of concern when partnering with a PE. It was important, he said, for both parties to understand each other; agree on an investment horizon, governance rights, deal structure, shareholder agreement, operational decisions, valuation criterion and measurement differences, and also have clearly defined exit options. Said Mr. Naik, "Despite differences, the partnership can be very powerful and add value. However it requires strong communication and structures to allow quick decision making."
CEIBS Professor of Marketing of Dr. Wang Gao moderated the Q&A that brought the session to a close.
Closing Speeches
"Innovation and Value Creation in Health Service Models" was the title of the day's first closing speech, delivered by President of West China Hospital Dr. Shi Yingkang who also serves as China Professor of Cardiothoracic Surgery. He was followed by Duke University's Professor of Medicine and Business Administration Dr. Kevin A. Schulman, who is also Director of the Clinical & Genetic Economics Centre at Duke University's Medical Centre. He is also Director of Fuqua School of Business' Health Sector Management Programme.
In his speech, Dr. Shi said patients are now demanding more and better treatment. Technology, he said, would be a useful tool in meeting these needs. "We're now in an IT era," he said. "The roles are changing and power has already shifted from the hands of doctors to patients who can get better and more information from the internet. The power has shifted from the doctors to the nurses, lawyers and journalists. The doctor is no longer the 'God in white'."
Dr Schulman delivered the second closing speech entitled "Creating Value in the Healthcare System". He explored the issue by focusing on 10 key points: investment, equity, competition, performance measurement, public reporting, financial incentives, management capacity, organizational innovation, clinical evidence development, and public health. He concluded, "Value is the result of a continuous process in all environments, including health care. The core concepts of business and management education are required to achieve the highest possible performance from the system. These core concepts transcend borders and cultures, but are best optimized locally based on local culture, environment, resources and needs."
Closing Address
CEIBS Executive President Prof. Pedro Nueno officially brought the conference to a close with a summary of the main points raised throughout the day and a reminder of the need for continued dialogue on the important issue of China's ever-evolving health care landscape.
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