News abounds about new schemes concerning public health as the new year begins.

Beijing media reports that all residents of the city will be able to enjoy a medical insurance scheme that will help them pay for operations or the treatment of serious diseases that cost more than 2,000 yuan ($267). Residents who apply for the insurance will only have to pay 50 yuan a year.

Almost at the same time, a local Guangdong bureau of labor and social security revealed that the province will introduce a new medical aid plan that will offer financial support to the poverty-stricken or lower-income people who seek medical treatment for any disease. At present, there is still a limit to the kind of illnesses for which these people can get monetary assistance.

Meanwhile, the health minister and vice-health minister jointly published an article this week elaborating on an ambitious national plan that aims to improve the health of all Chinese with the goal of reaching the level of developed countries by the year 2020.

All this is good news, but I believe it will take patience and hard work to achieve the goals. For instance, early last year, Beijing started to promote medical insurance for the young and elderly.

The young range from babies to senior middle school students. The elderly are those who have no institutional affiliation and do not have any health coverage. But when my husband and I took our daughter to the nearest neighborhood committee to register for the medical insurance in late September, we were initially told that our daughter was ineligible.

The person in charge later told us that we must produce a letter from the school ascertaining that our daughter is attending classes to prepare for college entrance examinations this summer to be able to obtain the insurance.

At first I could not understand why some strings were being attached to the medical insurance that should be universally enjoyed. But after I visited the neighborhood committee office a few times and saw the piles of certificates of medical insurance, and the crowd of elderly people waiting to get reimbursed, did I realize how troublesome the work was for staff handling the applications and approvals. They are simply short-handed to deal with the increasing services they must provide for the growing population of the retired and elderly.

In fact, according to local media reports, about 400,000 unemployed and disabled residents in Beijing are not covered by medical insurance.

But Beijing is one of the few regions in the country with arguably the widest health coverage for its residents. There are even more serious challenges to provide quality basic medical care in remote and ethnic minority populated areas.

I remember visiting three years ago a small rural clinic in a mountain village in Cangyuan, in Yunnan Province, on the border between China and Myanmar. It had just one room furnished with a wooden bed, a table, a stove and a cupboard.

The rural "doctor", about 25, only went through rudimentary medical training and did not possess a diploma. But she was the "trained doctor" who cared for the villagers and pregnant women.

I remember the then local health bureau chief lamenting the fact that those who graduate from medical colleges and universities do not want to work in the main hospitals in the remote county, let alone in the villages. The county itself was short of quality medical doctors.

Thus, however ambitious the new universal healthcare plan will be, we have a long way to go to ensure health for all, the millennium goal the United Nations set seven years ago.

(China Daily January 3, 2008)