Mon, Apr 20, 2009 - Page 4 News List

FEATURE : China’s poor hope reforms will fix healthcare


Wang Jun’s eyesight is slowly deteriorating from suspected glaucoma, but there is nothing hazy about his view of China’s much-maligned health system.

“It’s really lacking, really inadequate,” said the retired 56-year-old former dairy farm worker, reflecting a view widely held in this country as he awaits treatment in a grubby clinic in northern China.

China this month announced plans to dramatically reform an unpopular healthcare system seen as costly, underfunded and providing shoddy treatment, especially in poor rural regions.

That will come as good news to countless Chinese like Wang, who have watched the deterioration of a system once widely praised for improving the health of millions as social welfare has been scaled back in China’s capitalist rush.

Complaints about inadequate funding and indifferent care seem borne out at the facility Wang visits in this hardscrabble town on the dry grasslands of Inner Mongolia.

Brusque nurses alternately ignore and bark orders at patients, several of whom must stand, due to a lack of chairs, as they wait to see one of the few doctors.

A plastic wash-basin placed on the floor to catch drippings from a water-stained spot in the ceiling has been kicked aside. The resulting small puddle is an accident waiting to happen.

But the rising cost of drugs is the biggest woe, says Wang, who also has problems with rheumatism.

Though the care was often rudimentary, Wang fondly remembers how costs used to be covered by the state-run dairy cooperative a few hours’ drive away where he worked for 22 years before he was laid off.

Since the 1990s Wang’s family, like millions of others, has been forced to squirrel away modest savings for medical emergencies no longer adequately covered under today’s profit-driven, hybrid public-private system.

Wang says his out-of-pocket drug costs have grown five-fold over the past decade.

Not surprisingly, he welcomed the reform plan.

“It is very good. It shows the government cares for the people,” he beamed.

Beijing says the reform will bring “safe, effective, convenient and affordable” health services to each of China’s 1.3 billion people by 2020.

An initial three-year implementation period will see 850 billion yuan (US$124.4 billion) invested in building more than 30,000 new hospitals and clinics, and training nearly 2 million new healthcare workers.

The establishment of a national healthcare system after Communist China’s 1949 founding was widely credited with curbing many endemic diseases and giving vast backward regions their first taste of basic medical care.

But the steady withdrawal of government support left a “perverse system” with hospitals relying on prescribing drugs to raise money, putting economics ahead of quality care, said Hans Troedsson, the WHO’s China representative.

“So you have situations where drugs cause side effects and another drug is prescribed for the side effects and so on,” he said.

China will face a challenge luring sufficient health professionals to vast rural regions, and it remains unclear how poorer areas will come up with their share of funding for the reforms, he said. Only 40 percent of the money will come from the central government.

But for a patient at the Siziwangqi clinic who gave only his surname, Qi, the thought of cheaper and better care someday has already had a therapeutic affect.

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