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Panacea for a pressing healthcare predicament

By Qin Xiaoying (China Daily)
Updated: 2009-04-14 07:41

"Do you know who are those qualified to be labeled 'rich' in today's China? Those who can afford to see the doctor."

This was a statement I happened to hear at a large hospital in Beijing where I was a few months ago.

It was part of a casual conversation between two patients and one that spoke of the predicament of many ordinary folk in the country.

Due to a variety of factors, common Chinese people, especially those in the middle- and lower-income groups, suffer from a longstanding problem of being unable to pay for medical bills or not having adequate access to medical care and health services.

It is not rare for an ordinary Chinese family to be reduced to poverty overnight only because one of its members was hospitalized.

Such incidents not only worry and dishearten a number of local officials, they also deeply affect many foreigners who hold good impressions of the great achievements made by China since it adopted its reform and opening-up policy in 1978.

As a matter of fact, the country's long-controversial medical and healthcare system, as well as the endless number of hospital-patient disputes and medical corruption cases, has always been a heated topic and focal point for domestic media in their coverage of social issues.

At this year's sessions of the National People's Congress and the Chinese People's Political Consultative Conference held last month, the motions involving the country's medical care and healthcare system outnumbered other motions submitted by participants, ranging from unemployment of migrant workers to employment of graduates and environmental protection, all having drawn attention nationwide.

The root cause of why ordinary Chinese people cannot afford to go to hospital or have no convenient access to medical institutions, either in cities or in the countryside, has been attributed to the fact that the public healthcare system has long been under-funded and the ideas dominating the reform of the country's medical system derailed.

Undoubtedly, China's large population and the inadequacies of its medical facilities and staff have also contributed to this problem. At the same time, there have existed thorny obstacles in the country's efforts to improve the current healthcare and social security systems.

All these outstanding problems have contributed to the change of the country's medical and healthcare cause, which should have been largely public welfare-oriented, into one that is market-dependent.

The insufficient government input in the country's healthcare system, a public welfare cause, has been a main factor accounting for why a lot of ordinary Chinese are kept away from hospitals.

According to statistics, 96 percent of China's hospitals are State-run. However, financial input from the government only accounts for 7 to 8 percent of their revenues. About 90 percent of their incomes come from their medical care services and medicine sales.

An overwhelming majority of these hospitals' expenses including salaries and the upgrading and maintenance of medical equipment, as well as normal operations, are subsidized by their own profits. Under these circumstances, the role of public welfare provider that State-run hospitals should have played has given way to their profit-pursuing impulse.

In the newly unveiled medical reform package, the country vows to offer all of its 1.3 billion people basic medical and healthcare coverage as a public item, a move that has been welcomed by many.

The new system aims to build a basic medical and healthcare system covering all urban and rural residents by 2020. With an increased government subsidy, the establishment of such a system will help reduce the number of patients paying for their own medical bills and cover more residents.

It will greatly ease ordinary people's difficulties in seeing the doctor and reducing their medical costs. The developments in the new medical and healthcare system have fully displayed the image of the Chinese government as a responsible one that ensures all people get access to basic medical services.

The success of the country's new healthcare package, which is mainly aimed at covering low-income residents, grassroots communities and rural areas, will be largely decided by how it can provide all Chinese with equal medical services.

Along with efforts to retrieve the long-lost role of the country's healthcare system as a provider of public welfare, the latest package also embodies moves to explore and frame a medical system with Chinese characteristics.

The move to allow doctors to work in more than one medical facility is also expected to dramatically improve the quality of the country's current basic health services.

The planned healthcare reform is by no means the country's step back to the era of a previous planned economy. It serves as a concrete move toward correcting the shortfalls brought about by a market-oriented healthcare system.

There are good reasons to believe the success of the country's latest healthcare reform will help push for the establishment of other social security and public welfare systems, all indicators of social progress and harmony.

The author is a researcher with the China Foundation for International and Strategic Studies

(China Daily 04/14/2009 page6)