Quenching Thirst with Poison: A Socio-Economic Audit of China's DRG/DIP Reforms and the Mirror of Japan's Historical Spiral
This report examines the deep-seated tensions within China’s transition from fee-for-service (FFS) to prospective payment systems—specifically Diagnosis-Related Groups (DRG) and Diagnosis-Intervention Packets (DIP). Driven by a macro-economic imbalance where health expenditure growth (11.05%) consistently outpaces GDP growth (8.03%), these reforms aim for fiscal sustainability. However, empirical evidence suggests a profound transfer of systemic risk from the state to medical providers, resulting in significant salary reductions for physicians and the "sicker and quicker" discharge phenomenon for patients. By drawing a historical parallel with Japan’s 1990s introduction of the DPC/PDPS system, this audit argues that the current reform path mirrors a "cyclical error" where a generation of medical professionals and vulnerable patients absorbs the costs of structural adjustments, only for the system to later critique the very path it enforced.