China to overhaul health care system
Updated
China has unveiled a plan to overhaul its health care system earmarking 120 billion dollars to make improvements, over the next three years. Premier Wen Jiabao made the announcement at a meeting of the cabinet-level State Council.
Presenter: Sen Lam
Speaker: Professor Bruce Neal, senior director of the George Institute in Sydney
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NEAL: Look, China's got massive problems with its health care until it undertook its market reforms, it had reasonable sort of safety net system which covered most of the people, but with the market reforms this is one of the things that went by the wayside.
LAM: As you say, China used to have cheap health care before the economic reforms were put in place in the 1980s. But what was health care like then before the reforms?
NEAL: Well, health care was actually very different to what's required now. I mean one of the things that China, like many other developing countries in the region are facing is a very rapid and massive transition in what people are suffering from and what people die from. So in rural China, for example, the leading cause of death now is stroke, followed by other chronic conditions, such as heart disease, cancers and the like. And the health system prior to this was not set up to look after these conditions and so we're actually looking for a pretty massive transition in what the health system can do.
LAM: And Professor Neal, which sectors to your mind are in most dire need of reform?
NEAL: Well, I mean I think it's really rural China, where the majority of the population still lives, but only a fraction of the health care resources are expended, that really needs to see urgent change.
LAM: And what about the urban centres, is health care any better in the bigger Chinese city?
NEAL: Well, in the more developed sort of cities along the east coast. I mean you can get absolutely top notch health care, but you will have to pay for it and again this is one of the key problems, is that if you're wealthy and you're able to pay for it, then you can buy health care, but if you are not sufficiently wealthy, then a serious event, a serious illness in the family can be an economically as well as physically devastating problem.
LAM: Well, the state council also heard of what Premier Wen Jiabao called "basic medical protection". Does that mean some form of national health insurance?
NEAL: Yeah, I think that's exactly what China's trying to get back to is some form of basic safety net, which covers essential health care for the entire population. At the moment, that is seriously lacking and I think the goal that the Chinese government has set is an admirable one and is absolutely essential if China is to maintain the health of its population.
LAM: Well, China's health sector is not new to scandals. You may remember a few years ago, there was the scandal of tainted blood, of people selling blood that was tainted with HIV. Do you think the situation of monitoring and indeed accountability, has that improved?
NEAL: Look, I mean it's very hard to know exactly what is going on in the Chinese health system as an outsider. What is clear is that there are some sort of perverse incentives in parts of the system which are not helping things. So for example, hospitals are encouraged very much to operate as businesses to sell drug therapies and to make money out of delivering services. And the problem here is that when the financial incentive drives the service provision, what you get is inappropriate.
