What price healthcare reform
(Shanghai Daily)
Updated: 2006-01-12 09:10

Liu Guosheng, a 38-year-old migrant worker in Wuhan in Central China's Hubei Province, was diagnosed with tuberculosis in a free health examination last month. That was the first health examination he had had in the past 20 years.

Liu said that he had been feeling unwell for a long time but had decided that his slender income would be better spent on his two children's education rather than his going to hospital.

A government-initiated public health campaign started last November and has provided free health checks for 14,000 might workers in Wuhan. The results are dismal.

It was found that 20.3 percent of those examined have hepatitis B, a contagious liver disease; 8 percent, fatty liver; and, 10 percent, cardiovascular diseases.

Female migrant workers were worse off - up to 67 percent of them were suffering from one kind of genital infection or another.

Few of those diagnosed had ever gone to see a doctor before to receive proper treatment.

In most cases, they first wait for the symptoms to go away by themselves. If this wait-and-see method does not work out, they go to a pharmacy and buy medicines based on their own judgment of their illness.

Some may have no choice but to seek professional help eventually and that's where they get stripped to their shirts.

Remember, migrant workers are no more than just a fraction of the 60 percent of Chinese people who do not have any type of medical insurance.

There are farmers, laid-off workers, jobless people, to name just a few, out there on their own for fear of having to face daunting medical bills.

Making sure that these people can afford to see doctors is the biggest challenge in China's healthcare reforms. Minister of Health Gao Qiang has suggested a possible solution.

A lovely idea

Addressing a national health conference last Saturday, Gao put forward the idea of "low-price hospitals." He said that each city should select a few public hospitals and convert them into low-price hospitals for low-income groups.

According to Gao, the hospital would return all its revenue to the government and the government would be responsible for the hospital's budget auditing and financing.

A lovely idea indeed. But also a difficult one.

First of all, a clear and detailed definition of "low price" will have to be framed, otherwise it's just another high-flying concept that will never get off the ground.

Secondly, selecting the hospitals will be a major problem. Many public hospitals and their medical personnel are now thriving on charging patients soaring bills and by receiving kickbacks. Becoming a low-price hospital will mean a huge financial loss, and behind-the-scenes resistance and maneuvering can be expected.

Thirdly, retention of staff will be another problem. With "high-price" hospitals emerging, keeping qualified personnel and services available in the few "low-price" hospitals may become extremely costly for the government.

Public hospitals should never be driven by profit maximizing.

With the aim of covering the basic healthcare needs of society, they are a safety net for ordinary people - especially low-income earners - if they become ill.