"Common Welfare" Points to the Right Direction for China's Healthcare Reform
Chen Zhu, Minister of Health, recently noted that a health care reform plan has being formulated. The resulting plan is not any of the eight previously revealed, though tentative, plans; instead, it is one that is a synthesis of all the previous plans. It has a specific focus and will be implemented step by step.
A newspaper reported that the eighth plan submitted by China People's University might be selected. That plan proposed a reasonable degree of coordination between government leadership and market mechanisms, an equal attention to both the financial providers and the recipients, and a persistent guidance in hospital reform. It also proposed making provision for the survival of both doctors and hospitals, suggesting the need for a long-term reform policy that is combined with policies that ensure short-term results.
All citizens are concerned about the details of the health care reform plan, and wonder what the finalized plan will look like. We now have a definite answer: The health care reform plan must focus on "the common welfare" and be developed on this core issue. On October 15, the General Secretary of CPC Central Committee, Comrade Hu Jintao proposed in his report to the 17th Party Congress that "We must adhere to the common welfare of the public in regards to health care, giving priority to prevention, focusing on the rural areas, and paying equal attention to both Traditional Chinese Medicine and Western medicine. We must practice separating politics from government affairs, supervision from implementation, medical care from pharmacy, and profit making from non-profit making. We must strengthen government responsibility, increase government funding, perfect the policy for public health, and encourage participation from society. In addition, we must establish a public health service system, a medical service system, an insurance system for providing medical care as well as an insurance system for obtaining medicine. All of this must be done in a way that covers both the urban and rural sectors of society, so as to provide to our citizens a safe, effective, convenient, and inexpensive health care service.
This provides a very clear and explicit direction that the central government has given to China's future health care reform. It has solved in a practical way a very big problem that has been harassing the health care reform, that being the problem of determining our ultimate direction and goal. From this point forward, with the preconditions set, the health care reform plan will have a very clear source of reference.
Because fundamental medical service and public health service are both public services, they need to be provided by the government. This is recognized internationally. In the early 1950s, the government provided a preliminarily solution to health care for all citizens with modest funding. In the 1980s and 1990s, financial difficulties within the government led to insufficient funding for health care (government investment was only 17% of the country's total health care expenditure). This forced hospitals to take a market approach to medical care and resulted in the situation where "medicine supported medical care" to become rampant. As a result, public hospitals were losing their standing of being truly public. Yin Dakui, former vice minister of the Ministry of Health, points out that at present, government funding provides only 8% of the income for public hospitals, and this figure is only 1% to 3% for big public hospitals. This means that hospitals have to pay for medical service personnel and maintain the normal functions of the hospital through patient fees. This in turn leads to situations such as the continuous rise in price for medicine and diagnoses, heavier burdens on patients, and the insufficient supply of prevention and basic services provided by hospitals.
Health care reform is urgent. The critical issue is how to reform. The direction for reform has been set by the government. All these are decided by the amount of funding the government will provide. If the government invests sufficient funds into health care, it provides an important precondition for meeting the goal of China's health care system, that of providing common welfare; otherwise, public hospitals, the main body of China's health care system, will continue to transfer costs to the public by raising medical costs and earning high profits. It will be very difficult to restrain them.
It is of primary importance "to adhere to the ideal of common welfare for public health care", and "to strengthen government responsibility and increase government funding" as put forward by the General Secretary Hu Jintao. For this has clarified the direction and path for health care reform. Many of the challenging health care problems will be readily solved when the health care reform plan is firmly pinned on this ideal of "common welfare".
In fact, The New Rural Cooperative Medical Care System based on the ideal of "common welfare" has already achieved good results. By June 30, 2007, 2,429 counties (county towns and districts) had already started the New Rural Cooperative Medical System, representing 84.87% of the country's total. The population that participated in this system was 720 million, representing 82.83% of the country's total rural population. The system has received good remarks from all walks of life. Therefore, it is worth holding high hopes for the new health care reform plan that will be based on the ideal of "common welfare".