EVERYONE IN China has a story about a friend who went to visit a healthcare professional and had to pay exorbitant prices for treatment, as the medic cranked up the prices for treatment and medicine to help pay for shortfalls in funding at their hospital.
Underfunding of the public health system is one of the chief causes of social unrest in China.
One story doing the rounds at the moment is about a doctor at a state hospital in central China who took a brief look up a boy’s nose and said he would need three surgeries costing €3,500 and a 10-day stay in the hospital. A subsequent check showed he needed €22 worth of treatment.
The health reform plan unveiled in April this year, which will spend 850 billion yuan (€88 billion) on health over three years, envisages a clinic in every village, 2,000 new hospitals across the country and health coverage for 200 million uninsured Chinese. The plan foresees universal healthcare services available to all of its citizens by 2020, as it seeks to address a system that is threatening to buckle under the demands of 1.3 billion people.
Beijing will pay 40 per cent of the reform costs, while local governments will provide the rest.
However, the World Bank has said China’s overhaul of its healthcare system must address the prescription of unnecessary drugs and treatments.
“Clearly, new ways must be found to finance healthcare provision,” the World Bank said in a report on reforming China’s rural health system, launched this week. It added that reforms should encourage health providers to watch their costs and prescribe treatments appropriately.
There are provisions in the plan to limit the mark-up that hospitals and drug distributors can charge, and efforts to regulate the price difference between patent and generic drugs.
The overwhelming majority of hospitals in China are state-owned. By some estimates, drug sales in the countryside contribute almost 50 per cent of the revenue of health facilities.
Adam Wagstaff, lead author of the report, said a system that does not encourage “unnecessary care, or care that is unnecessarily expensive” was needed. “I think this is going to be the biggest challenge,” he said.
After the revolution that brought the Communist Party to power in 1949, China introduced a Soviet-style healthcare system which made major advances in fighting infectious diseases and providing a good basic level of healthcare for most of the country.
State healthcare suffered badly during the economic reform of the 1980s, when many companies were privatised and it became expensive to see a doctor. The focus then shifted heavily to cities.
Most healthcare is paid for out of a family’s savings. Chinese people are famous savers, putting aside up to 45 per cent of their income, and a big whack of that goes on providing for healthcare.