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A long and winding road to recovery

By Lan Tian, Song Jing and Liang Qiwen (China Daily)
Updated: 2009-04-28 11:00

With the new medical reform plan, which was announced on April 6 and is aimed at providing fair and affordable services for all 1.3 billion residents by 2020, these kinds of stories could be a thing of the past.

A long and winding road to recovery
Hu Ailing, 54, queues up in the Songchuang Village Clinic for a routine medical checkup. After the Tongzhou health bureau confiscated the illegal dialysis machines from Baimiao village, the 10 uremia sufferers were offered temporary, free treatment in four hospitals. [Wang Lei/China Daily]

Statistics released by the Ministry of Health (MOH) showed 200 million people were not covered by China's medical insurance network. The plan aims to include them within three years.

However, to make treatment affordable the government must first tackle the profit-seeking public hospital system, a task many analysts have dubbed "mission impossible".

Chi Fulin, a political advisor and president of Hainan-based China Institute for Reform and Development (CIRD), said it would be "one of the most difficult parts", while Li Ling, professor with the national school of development of the Peking University, was quoted by the China Economic Herald as saying: "If the public hospital reform does not succeed, it would be hard to fulfill the other parts of the medical reform."

Even Chen Zhu, the health minister, admitted: "Public hospital problems are where the shoe pinches. It's a key issue for the medical reform."

Since the founding of the People's Republic of China in 1949, the nation has offered free healthcare to its citizens, with the central government financing the construction of hospitals and running costs. But when the country began its economic reforms in the early 1980s, funding dried up and hospitals were urged to seek other avenues for revenue.

This they did through expensive medicine and consultations, with statistics showing that 70 percent of poor rural families in western China were in poverty because of illness.

The State Council set up a medical reform steering group, led by Vice-premier Li Keqiang, in 2006 and, this month, the plan was finally released, promising to restore the welfare nature of public hospitals and tackle four key areas: universal access to basic health insurance, the introduction of an essential medicine system, improved primary health care facilities and equal access to basic public health services.

The reform of public hospitals will focus on management, operation and supervision of systems and government funding, as well as encourage more private medical institutions, especially non-profit clinics.

However, many claim public hospitals have become money-driven due to poor government support. A senior official at one of the country's top public hospitals in Beijing, who asked to remain anonymous, said: "The biggest problem at our hospital is the lack of funding. Public hospitals should be non-profit and patient-oriented, which our hospital has followed all along."

She said a bed in her hospital costs just 25 yuan a day, which is cheaper than the daily parking rate in downtown Beijing, while a patient pays only 10 yuan to register with a medical expert, less than the price of a haircut.

The government's financial aid accounted for only 5-9 percent of the hospital's total income, she said, adding: "I hope the government will improve funding. It's the foundation to maintaining the public welfare nature."

Almost half of the income for China's public hospitals comes from profits on drug sales, according to official statistics. But the medical reform road map states public health facilities will receive more subsidies and be supplied essential medicines with prices regulated by the government. They will be banned from profiting through subscribing expensive medicines.

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