A well-to-do society can only be built on the foundation of a
healthy population. As an important part of its social development,
China's health care system will face challenges as well as
opportunities in the coming two decades, when the country strives
to reach the goal of common prosperity.
A New Health Care System in Line with Social Development
International health economic experts generally agree that China's
macro economic development can be divided into two periods,
1949-1980 and 1980-2002, during which China successfully
established its unique economic system and obtained unprecedented
experience. The development of China's health care system has also
passed through two periods. In the former period, the government
made good use of its social resources and built up an efficient
medicare system, which played a vital role in improving people's
health. But since the country adopted the policies of reform and
opening to the outside world, its old health care system can no
longer function well. China's health index obviously lags behind
the growth rate of people's average income.
The medicare system gradually built following the founding of New
China in 1949 includes multiple forms such as public health
services, labor health care insurance, rural collective-economy
health care and self-supported health care. It provided basic
medical guarantee for the massive public. However, this system
cannot meet the requirement of a socialist market economy. That is
why the state has decided to reform the old medicare system. So
far, 86.91 million people have been covered by the new system, the
Basic Medical Insurance System for Urban Employees.
Concern for the Medicare of People in Underdeveloped
Areas
The rural people benefited a lot from the cooperative health care
system in the past decades. However, along with the spectacular
change in the rural economic system, the cooperative health care
system faded away. In the middle 1980s and 1990s, governments at
various levels made great efforts in restoring this once efficient
system, but achieved little because of all kinds of difficulties
and problems.
At
a recent national conference on rural health care, the central
authorities worked out a series of regulations for further
strengthening medicare in rural areas. According to the "Decisions
on Improving Rural Health Care Undertaking," local governments
shall gradually establish a new rural cooperative medicare system
focusing on comprehensive arrangement for serious diseases, with
funds raised from individuals, collectives and governmental
subsidies, and pilot projects should be established first. A
medical assistance system for poverty-stricken peasant families
shall also be set up with funds pooled through various
channels.
The central government in particular stresses the increase of
health care input for the middle and west regions of China and
poverty-stricken areas. Finance departments at various levels
should increase their budgets for rural health care every year.
Beginning from 2003, the central government will allocate a subsidy
fund of 10 yuan (US$1.2) per year for each rural resident listed in
the new cooperative health care system in those areas. Local
governments must annually provide at least 10 yuan (US$1.2) per
person for these rural people.
While increasing investment, governments at various levels should
give priority to improving management and raising efficiency of
rural medical institutes, the document states.
Double Disease-Burden' Widens the Gap Between Urban and Rural
People
The health care revolution happened in the 20th century and the
migration trend contributed to the progression of China's disease
model, which varies greatly in urban and rural areas. Urban
citizens have developed a new disease model. Besides the new
epidemics like HIV/AIDS, they are now suffering more chronic
diseases like cancer, cardiovascular diseases and diabetes in
addition to psychological problems. But in the rural areas,
especially in poverty-stricken areas, some epidemics and endemics
have not yet been eradicated and some gynaopathies and children's
diseases are still rioting, due to poor hygienic sanitation and
unfavorable ecological environment. The imbalanced developments of
urban and rural areas render a wide gap in public health services.
Urban citizens and the majority of rural citizens are actually in
different disease model progression stages. This double burden of
epidemic disease adds further strains to China's underdeveloped
health care system for its 1.3 billion population.
Threat from New Diseases Like HIV/AIDS
In
health economics research, whether a disease attacks the young and
middle-aged labor force is an important index for assessing its
threat. In China, 93.9 percent of the 1 million HIV/AIDS infected
people are reportedly people from 15 to 49. The attack of HIV/AIDS
on the young and middle-aged not only decreases the work force and
lays more burdens on society but also brings lots of other social
problems. It is estimated that various epidemic diseases, including
AIDS, will exert negative influences on China's economic growth
rate.
Medicare Sector Contributes to National Economic Growth
China is ready to march towards its goal of common prosperity. The
health of its 1.3 billion people is part of this program. There is
no doubt that the medicare sector will make its own contribution to
the country's GDP growth.
Overseas health economic experts hold that health care is an
important momentum of a country's economic development. Along with
longer lives, the numbers of chronic patients and geriatrics
patients will increase and more and more people will demand for
quality health care. This will promote the development of medical
industry, increasing production and creating employment
opportunities. When China continues to enjoy high economic growth
rate, people's income will increase and their consumption on health
products will increase too. For most of them, the rate of their
expenditure increase for health care will surpass that of their
income. This will serve as a stimulus to increase employment and
output of the medical care sector. The health care sector is a
labor-intensive sector. In Germany, one out of every 10 jobs is for
or related to health care.
During the first period of China's medical care development, most
common epidemics were put under control and people's health and
physical conditions improved remarkably. This made it possible for
China's economy to develop rapidly in the 1980s. Good health is a
foundation for people to receive education and increase work
efficiency. According to the studies of World Bank experts, 8-10
percent of the world's economic growth in the last four decades
should be credited to the health of the population. A research of
Harvard University also indicates that about 30-40 percent of the
Asian economic wonders should be credited to the fact of having a
healthy population.
(china.org.cn by Alex Xu, January 21, 2003)