想淘金中國民營醫療並非易事

Private equity firms engaged in an unusual bidding battle this year: slugging it out over an upmarket chain of private hospitals in China.

私人股本公司今年投入到了一場不尋常的競標戰中：它們要在中國民營醫院的高端產業鏈上一決勝負。

TPG and a consortium that included Shanghai Fosun Pharmaceutical, emerged the victor in the fight for US-listed Chindex International after sweetening its bid and shelling out $461m. Chinese media and people close to the deal named Carlyle as the rival bidder, although it declined to comment.

在對美國上市公司美中互利(Chindex International)的競購中，德克薩斯太平洋集團(TPG)和一家包括上海復星醫藥(Fosun Pharmaceutical)在內的財團提高報價並支付4.61億美元之後，成爲最終贏家。熟悉此次交易的中國媒體和知情人稱凱雷(Carlyle)也參與了競購，不過凱雷拒絕置評。

Chindex is the top of the pyramid of hundreds of potential private hospital deals, as investors chase a Chinese gold rush.

隨着衆多投資者前來淘金，中國可能會有數百家民營醫院成爲併購對象，美中互利成爲首當其衝的一家。

Guo Guangchang, chairman of Fosun Group, parent of Fosun Pharma, said recently that the group might invest in as many as 500 hospitals in China – although people close to the company say this was more an expression of enthusiasm than an exact number.

復星醫藥的母公司、復星集團(Fosun Group)的董事長郭廣昌最近表示，該集團要在中國投資500家醫院，儘管接近該公司的人士表示，這更像一種熱情洋溢的表達方式，跟確切數字無關。

Either way, investment is set to pour into the sector, continuing a trend begun when Beijing lifted restrictions on foreign investment in private hospitals in 2012.

無論是哪種情況，投資已準備涌入該領域，延續了2012年以來的趨勢。2012年，中國政府解除了外商投資民營醫院的限制。

As demand for medical care has risen in line with prosperity, demand for investment opportunities has spilled over into other appendages of a wealthier lifestyle: dentists, rehabilitation clinics and cosmetic surgery centres.

人們對醫療服務的需求隨着與經濟繁榮同步增長的同時，對投資機會的需求也有所增加，且已蔓延到高品質生活方式的其他附屬領域：牙醫、康復診所和整容手術中心。

While many investors are coveting hospitals that are already private, dozens of other local and foreign private equity investors are looking into the harder task of privatising public hospitals or building new ones.

雖然許多投資者覬覦的是已經民營化的醫院，但還有數十家中外私人股本投資機構將目光投向了更艱苦的任務：公立醫院私有化及興建新醫院。

The total value of healthcare deals in China exceeded $10bn last year, nearly five times the level of 2006, according to statistics from Dealogic.

根據Dealogic的統計數據，去年中國醫療業併購總額超過100億美元，近乎2006年水平的5倍，

Sweeping reforms of the sector are under way, including doubling the private hospital share in treating Chinese patients to 20 per cent by 2015.

該行業正進行大刀闊斧的改革，包括至2015年，實現民營醫院的牀位數佔比和服務量佔比翻一番，達到總量的20%。

Spending on healthcare is about 5 per cent of gross domestic product, compared with about 9 per cent in Japan and nearly 18 per cent in the US, according to a report from McKinsey. “Perhaps an even bigger difference is that in China, services account for only 30 per cent of spending versus 70 per cent in Japan and the US,” says Gordon Orr of McKinsey Asia.

根據麥肯錫(McKinsey)的報告，中國的醫療支出約爲國內生產總值(GDP)的5%，相比之下日本的支出約爲9%，美國的支出近於18%。麥肯錫亞洲的歐高敦(Gordon Orr)說：“或許更大的區別是，在中國，醫療服務僅佔醫療支出的30%，而在日本和美國要佔到70%。”

According to a survey by Bain & Co, healthcare was identified by private equity funds as the most attractive sector for China investment this year.

根據貝恩諮詢公司(Bain & Co)的一項調查，私人股本基金已將醫療業確定爲本年度在中國投資的最具吸引力行業。

“We are seeing a lot of interest in medtech and private hospitals but the challenge in China is that there are few large deal opportunities,” says Vinit Bhatia, head of China private equity for Bain & Co.

貝恩諮詢公司中國私人股本部門的負責人威尼•巴蒂亞(Vinit Bhatia)說：“我們看到許多機構對醫療科技和民營醫院感興趣，但中國的挑戰在於大的交易機會並不多。”

Several investors say it may prove hard to identify profitable deals in a sector where corruption is rife among doctors and administrators, and hospital finances are opaque.

一些投資者表示，在一個醫生和管理人員普遍涉嫌腐敗，且醫院財務狀況不透明的行業，想識別有利可圖的交易恐怕不容易。

Perhaps the biggest problem is that private hospitals must stick to charges held down by the government or risk losing their eligibility for public reimbursement.

或許最大的問題在於，民營醫院必須遵守政府壓低的收費標準，否則將可能被撤銷醫保定點資格。

Improving management and achieving economies of scale in drug procurement may help profitability; but attracting high-quality doctors, retraining staff in a more service-orientated culture and matching doctor salaries inflated by bribes may all prove costly, health analysts say.

健康產業分析師指出，提高管理水平、實現藥品採購的規模經濟或許有助盈利，但吸引高素質醫生、以服務型文化對員工進行再培訓，還有將醫生工資提高到被賄賂擡高的水平，這些可能都要投入大量資金。

Alexander Ng of McKinsey says the pay-off could take longer than usual for a private equity fund. “If you have an investment horizon of 20, 30, 40 years, China is the right place but if you have a seven-year timeframe then, unless you buy cheap, it may not be the place to be as the valuations are going up because of more bullish expectations.”

麥肯錫的Alexander Ng表示，私人股本基金想獲得成功要比平常花費更長時間。“如果你的投資期限爲20年、30年、40年，投資中國是選對了地方，但如果你的時間表爲7年，那麼除非你買便宜貨，否則中國不是合適的地方，因爲看漲預期較強，估值會往上走。”