China's healthcare system searching for remedy
In 2003, the average annual income for China's 800 million rural population was 2,622 yuan (328 U.S. dollars) while the average medical expenses were 2,236 yuan (280 U.S.dollars), according to the Ministry of Health in 2004.
The latest national health survey in 2003 revealed that about 73 percent of people in rural areas who should have sought medical treatment chose not to do so because of the cost.
In urban areas, the figure was 64 percent. As China's socioeconomic system moves increasingly market-oriented and the role of the government as a provider of public services diminishes, the country's health care system, traditionally one of the core elements of Chinese socialism, is suffering.
The health care system is dominated by pay-per-service care, notes Ge Yanfeng, deputy director of the Department of Social Development with the Development and Research Center (DRC) of the State Council. "Patients have to pay for treatment out of their own pockets with large differences in quality and access among income groups and between rural and urban populations," he said.
But the government has failed to establish a viable substitute. Almost 90 percent of the rural population has no health insurance. The urban population isn't much better off. Nearly 60 percent of city dwellers are not covered by health insurance, according to the Ministry of Health.
Eighty percent of government funding in urban areas is only used by 8.5 million people, mainly officials at various levels, revealed a report by the China Academy of Sciences. Possessing the fourth largest economy in the world, China ranks 188th of the 191 member countries of the World Health Organization in the fairness of its medical resources distribution.
"China's health care reforms have turned hospitals into clubs for the rich," said a 2005 report released by the Development Research Center (DRC) of the State Council, which concluded the reform "unsuccessful". "It's a market failure," said Li Ling, professor at Beijing University's China Center for Economic Research.
"It is not right. The economy is growing, people have more disposable income, but medicine costs are rising even faster." "Indeed, since doctors and hospitals rely more on profits, they have come to rely on medicine sales for the bulk of their revenues." Ge Yanfeng of DRC noted that 5 to 20 percent of medical staff salaries are provided by the government, while 80 to 95 percent has to be gained from patients.
"This leads to a tendency to overprescribe medicines, which can carry public health risks," He said. The business of peddling medicines to hospitals has also bred corruption, with many hospitals accepting kickbacks from drug companies.
To quell rising medicine prices, China's National Development and Reform Commission (NDRC) has issued its 19th medicine price cap at the end of this August, which involves 99 antimicrobial drugs. It is estimated that the annual saving from the price cut for patients can reach 4.3 billion yuan (about 538 million dollars).
However, critics also argued that the cuts may not provide a cure. Prof. Li Ling observed. "They are far from a quick-fix solution, and could even exasperate the tendency to overprescribe, " she said.
She said the previous price cuts only resulted in some drug manufacturers ratcheting up prices after altering product names and packaging. Some hospitals and clinics raise the costs of medical services, turned a blind eye to government standards or even turned down low-priced drugs. |