Chang-Hong Whitney11.11.08
According to Chinese officials, the roadmap outlined above is just the first part of a wider restructuring related to health management, health facility operations, healthcare investment and funding, medical and drug pricing, healthcare supervision, technology and personnel development, medical information systems, and the healthcare legal system.
The health management structure would be featured with centralized guidelines and regulations to be implemented across the country.
The country’s health facility operation will establish public health facilities as the core of health management by providing funding from the central government. Investment into the healthcare arena by commercial investments would be encouraged. Government funding would focus on non-profit healthcare centers, while commercial money would be used to fund private practices.
Medical pricing would be set by the government, which would subsidize basic medical care items, but allow for pricing variability among different levels of health facilities. This structure would dictate pricing for medical consumable and implantable products in distribution and to end-users. Healthcare supervision would be strengthened for closer control of pricing, manufacturing and distribution.
A medical technology initiative would push for increased research and development activities in medical device and pharmaceuticals as one of the broader economic technology focuses for China. Officials hope for breakthroughs in new medical technology through a combination of Western and Eastern medicines.
A planned medical information initiative would standardize the medical information format used across the country, establishing a personal heath information card for the insured. A new healthcare legal framework would establish protections for patients and identify provider responsibilities.
In addition to long-term goals, the plan also outlined five short-term objectives: expedite basic health insurance programs; begin drafting guidelines for a basic national drug regulation and a basic drug list; broaden the fundamental health service system; expand the public health service program and shrink the quality gap between rural and urban healthcare; and begin an experimental program to reform public hospitals.
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Thirty years ago, China had an effective basic healthcare infrastructure. An army of “barefoot doctors” fulfilled healthcare and disease prevention needs at a very basic level. With the growth of a market economy and an increasing desire for capitalism, China’s healthcare safety net is close to extinction due to lack of funding and resources. Government funding of healthcare decreased through the years. According to data from Ministry of Health, contributions by government, society and individuals to healthcare costs have shifted from 25.1%, 39.2% and 35.7%, respectively, in 1990 to 18.1%, 32.6% and 49.3% today. Most economists believe personal contribution to healthcare has risen to more than 60%. Healthcare expense allocations in the government's financial budget decreased from 2.53% in 1970s to 1.59% in 2002. Disease prevention also has been neglected.
The lack of basic healthcare, limited access to good medicine and skyrocketing medical costs have created major social and economic problems, prompting such major step by the government to rebuild a deteriorating medical system and reinvent the system’s failed infrastructure. More policies and regulations are expected to be released in the years to come.