China unveiled a three-year plan on health care reform Tuesday, which it said would lay a solid foundation for equitable and universal access to essential health care for all in China by 2020.
Under the 850 billion yuan (124 billion U.S. dollars) plan for 2009 to 2011, the government promised universal access to basic health insurance, introduction of an essential drug system, improved primary health care facilities, equitable access to basic public health services and pilot reform of state-run hospitals.
The document from the State Council, or Cabinet, detailed tasks and goals for the 2009-2011 period as the government explained how it would implement its long-term health care reform plan, which it announced Monday.
The plan did not elaborate how the 850 billion yuan, including 331.8 billion yuan from the central budget, would be used.
But it is widely expected to be spent on subsidizing basic medical insurance programs, supporting grassroots-level health facilities and in underdeveloped western and rural regions.
TARGETING SCARCE, COSTLY CARE
After more than 20 years of transition from a socialist planned to a market economy, China's cradle-to-grave social security network was gradually dismantled, leaving many vulnerable.
Efforts in the past decade to reform the health sector were also regarded as unsuccessful.
Between 1980 and 2005, annual disposable income per capita increased by almost 20 times in China, while annual health expenditure per capita increased by 133 times, according to figures from the Ministry of Health.
According to the 2007 World Health Statistics, available on the ministry website, government and private expenditures on the health sector in China were respectively 38 percent and 62 percent in 2004, compared with 54.1 percent and 45.9 percent in Brazil, 17.3 percent and 82.7 percent in India, 86.3 percent and 13.7 percent in Britain, and 44.7 percent and 55.3 percent in the United States.
In the same year, China's total health expenditure accounted for 4.7 percent of its GDP, against 15.4 percent in the United States, 8.8 percent in Brazil, 8.1 percent in Britain, and 5 percent in India.
"The three-year reform mainly targets the pressing problem that medical care is too expensive and hard to get, which has drawn many complaints from the people," said the document.
The current system had many problems, the government admitted.
"Some people are not covered by medical insurance, the public health sector has been weak for a long period, and state-run hospitals are too profit-obsessed," said the document.
"These problems must be solved to lay a solid foundation for the long term and for overall health care reform," it said.
China wants to have more than 90 percent of its population covered by some sort of basic medical insurance by 2011.
Three different insurance programs already exist for urban employees, unemployed urban residents and rural residents, into which governments, employers, and individuals contribute.
More than 200 million urban workers, 100 million urban residents and some 800 million rural residents have already joined the three programs respectively, according to the Development Research Center under the State Council.
The health insurance subsidy offered by the government for unemployed urban residents and farmers will rise from 80 yuan per person to 120 yuan per person as of next year, according to the action plan.
The level of reimbursement an inpatient or an outpatient can get from one of the three programs will be gradually raised.
The reformers also intend to have more vulnerable people covered by insurance, such as retirees from bankrupt or financially troubled companies that can no longer pay for insurance, migrant workers and the self-employed.
In some places where pilot work was carried out, progresses have been made in bringing more people under the shelter of medical insurance.
Li Liang, a farmer in Ejin Horo County, north China's Inner Mongolia Autonomous Region, said he only paid 10 yuan (1.46 dollars) a year to join the New Rural Cooperative Medical Care system, into which the central and local governments contribute 130 yuan.
Meanwhile, Li is entitled to have as much as 50,000 yuan reimbursed every year to pay his medical bill, if there is any.
"Now I feel quite relieved because 50,000 yuan can be a huge burden for me and my family," said Li.
Fu Wei, an official with the health ministry, said the reimbursement level would be further raised to ease rural residents' financial burden.
