Healthcare in China today

by on Saturday, 29 December 2007 Comments
China faces several emerging healthcare challenges, among them are:
- Diseases linked to air pollution and cigarettes: respiratory illnesses are now the first cause of mortality.
- HIV-epidemic: in January 2006, according to a joint estimation by the Chinese government, WHO and UNAIDS, there were 650 000 HIV-infected people in China.
- The pressing necessity to build a healthcare system that better caters for the needs of rural areas and the urban poor.
In 2006, 80% of medical resources were concentrated in cities.

From the eighties on, costs of medical treatment have increased, while rural health coverage has decreased as economic reforms have yielded priority to market mechanisms.

In 2003, 80% of the rural population was not covered by any insurance. Furthermore, 120 million workers going from the countryside to the cities were excluded from the public health care insurance system. Several studies show that at least 30% of Chinese people refuse to be hospitalized because of financial costs.

The Public Health Insurance

Chinese Public Health Insurance reforms started in 1998. It mainly covers big enterprises’ employees in the cities and is financed out of "welfare funds".

The public health insurance is slowly covering more and more of the urban population. Over the past years, the government has decided to extend it to the self-employed and the migrant workers. Between 1998 and 2006, the number of urbanites covered by the public health insurance system increased sevenfold. However by the end of 2006, only 160 million of the 500 million urban residents were covered.

The public health insurance system is supposed to cover all urban residents by 2012.

The New Rural Cooperative Medical Care System (NRCMCS)

Since 2003, cooperatives has subsidised health insurance for rural households who now voluntarily pay a contribution of 10 RMB (1.28 $US) per person and per year. The enrollees can have between 20% and 60% of their healthcare costs reimbursed but they have to pay first their costs.

By the end of 2006, the government was allocating 4.23 billion RMB to the NRCMCS. In March 2007, 410 million of rural residents were covered (i.e. 50.7% of the rural population). The government expects the NRCMS to cover 100% of the rural population by 2010.

A balance between the market (private insurance) and the State has not been found yet. In a time of environmental diseases and risks of pandemics, the Chinese healthcare system remains fragile.

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