USA Today Examines $124B 3-Year Chinese Health Care System Overhaul
USA Today examines the Chinese government's new $124 billion three-year health care system overhaul. The government asserts that the new package will provide "safe, effective, convenient and affordable health services" to all of China's 1.3 billion people by 2020. More than 200 million Chinese have no health insurance, according to government statistics, and rural residents often struggle to find and pay for health care. The overhaul could cover 90% of the population with basic health insurance in two years.
According to USA Today, "The insurance coverage will reimburse a significant percentage of patient costs, but not all." The overhaul aims to build new clinics in the country's 700,000 villages and cost caps for hundreds of prescription drugs. USA Today writes that its impact is expected to extend beyond China's borders as a way to "stimulate the economy" and allow the "Chinese to spend more on goods instead of saving for future medical care." They system is expected to enable the country to better handle health crises, such as SARS, bird influenza and H1N1 outbreaks.
Economist and Peking University professor Gordon Liu, who served as an advisor on the plan said China opted for a social insurance system with government, society and individual contribution, rather than a welfare health system. "The system offers the choice of the USA, but the financing of France or Germany to try to persuade everyone to join," he says. "China is on the right track now, but on the delivery side, we face a major challenge." Sarah Barber, a health policy expert at the WHO in Beijing, agrees that placing qualified staff in rural clinics and paying them is still a significant challenge.
"Shanghai and Beijing are moving ahead very quickly" with the announced changes, said Barber, adding, "[T]he poorer regions will struggle to come up with the funds" for their share. According to USA Today, the central government will pay 40% of the $124 billion, but local governments must come up with the rest.
The new plan "is the most progressive, intense reform effort I've seen," David Wood a former senior manager at hospitals in California and Colorado, who runs the ChinaCare Group health consultant in Beijing said. "Directing money to community health clinics is by far the most effective way of providing better care," he said.
Liu Qun a pharmaceutical tycoon who launched free check-up and low-cost drug program for 1 million farmers in Chongqing province said, "Some of the new policies are the same as I offered three years ago, but they don't go far enough." He added, "Medical resources remain very poor in the villages, and there is great waste of resources from doctors overprescribing. To solve China's health problems, we should be more like Western countries and allow market models, companies and non-governmental groups such as charities to make their contribution" (MacLeod, USA Today, 5/7).
The Journal of the American Medical Association published a commentary about China's "long-awaited health reform plan." In addition to examining the structure of the plan, the authors also include some information about its history (Ho/Gostin, JAMA, 5/6).