China Human Rights Net > News > Focus > Health Care Reform Guidelines Unveiled in China 2009 > Analysis
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China Human Rights Net > News > Focus > Health Care Reform Guidelines Unveiled in China 2009 > Analysis
Medicare Reform is long overdue
April 7, 2009 -- Beijing has just outlined a heavyweight plan to revise its previous market-oriented health care system back to one of "public equitable entity", which, according to policy drawers, will be accessed and enjoyed by all of China's 1.3 billion nationals.

Though details to implement the plan are to be published by the government, I have enormous gratitude to the Hu-Wen administration for the vision and courage to bring free, or more accurately, inexpensive or affordable health care to 800 million rural residents, who have long been neglected, or seldom on radar screen of policy-makers.

As rural families were struggling to foot the medical bill of a seriously ailing relative, and many could do nothing but shed tears seeing beloved ones suffer from illness, the new plan, if proved successful, amounts to a hope of generations to be realized. No wonder some Chinese newspapers proclaim that the ruling Communist Party of China (CPC) has done it right, letting all citizens "enjoy the benefits of a mighty economic success", all attributable to Mr Deng Xiaoping's reform and modernization crusade launched 30 years ago.

Health Minister Chen Zhu said that thanks to a massive 850 billion yuan (US$125 billion) investment to be earmarked by the Chinese government by the end of 2011, rural folks will get at least 50 percent of their medical bills reimbursed from the plan by 2010, as compared to 20-30 percent now. That's a huge advance!

Devoted to improving the welfare of rural residents and removing a potential keg of discontent, Beijing has an apparent aim at shooting another bird with the stone. Only after the high cost and poor availability of medical services are solved, a major drag on domestic consumption will be done away with, which the government now desperately needs to boost a flagging economy. No longer concerned about the medical bill, Chinese consumers are expected to stage a substantive buying bingo.

Highlights of the medical care revamping master plan include: To phase in a basic health care system that provides safe, effective, convenient and affordable services for all residents by 2020; the system will be bolstered by a multiple arrangements of insurance programs that are to be borne by the government, the employer and the employee; pricing of medicines will be regulated by the state; and 2,000 county-level hospitals and 5,000 township clinics are to be built through out the country to cater to the needy.

Nearly all the elements of the plan are considered fair and square, but several critical questions are left answered.

First is financing this colossal project. Once the medical services are made universal, with the state coffers believed to write all the bills of 1.3 billion, how to control the cost, so that a nice public plan does not run heavily indebted, to an extent that will restrain government spending on other crucial sectors including education and infrastructure, is the magic.

Some have claimed that health care expenditure by both the private and public sector in China amounts to mere 5 percent of GDP, significantly less than the 17 percent spent in the United States, however, with a population four times that of the U.S. and a GDP one fourth of it, China can hardly fund an medical care that runs astronomically bloated. Even the U.S. model is problematic, with more than 40 million uncovered.

Second is protecting the enthusiasm and creativity of the physicians and medical students and researchers. Under the present quasi-market mechanism, top graded doctors are obtaining a bonus from hospital management, and thus throngs of talented students are lured into the trade. Once hospitals are made non-profit public institutions, which are disallowed to make a profit out of selling patients medicines, as it is the case now, and the regulator intrudes to cap compensations of medical workers, how to ensure the payment level of the physicians is another tricky issue. Yesterday, even the health minister Chen Zhu intervened to ask for more pay for top-caliber diligent physicians.

Third is a growing demand from the growing class of riches. Since these group of wealthy nationals desire for VIP hospitality and treatment, which they are also able to afford, it is wise for Beijing to approve more privately invested hospitals, where doctor-seers might get half or even less of their prescribed medication cost recouped from the plan.
  from:People Daily Online
China Society For Human Rights Studies
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