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Sunday 23rd October 2016

China's troubled health system

8th May 2007

The health care system in China faces such enormous problems that many see a “pressing need for reform,� writes Francis Markus for the BBC.


A recent survey by China’s Health Ministry found that 36% of patients in urban areas and 39% in the countryside did not go to the doctor when they were unwell because they were unable to afford medical treatment. Nearly 30% of those admitted to hospital left because they could not afford to stay. According to Mr Markus, wealthy Chinese are unhappy with the medical care on offer and the poor can’t afford to access it meaning the system is facing crisis.

Chinese state media say the study of nearly 200,000 urban and rural residents found that the cost of medical treatment has risen much faster than salaries, which is why so many face illness without treatment. Health professionals also blame a culture of corruption whereby doctors unnecessarily prescribe expensive medicines to increase hospital revenues. One doctor is quoted as saying, "I think it's true that doctors take 'red envelopes' [bribes] or they prescribe expensive medicines because their incomes are so low." The basic salary for a doctor in China is $360 a month and pharmaceutical companies also come under fire from the medic who accuses them of corrupting doctors on low incomes who can’t resist the temptation.

The Chinese government is now looking at ways to reform its health system before a real crisis is reached. Foreign investment is one solution being carefully considered but economists are also calling for the government to spend more money on fewer hospitals in a non-for-profit, decentralised manner in order for Chinese healthcare to become viable as a public service. Another area of deep concern is the health of residents in poorer rural areas of the country where most Chinese have no access to medical facilities and health insurance. The country is now experimenting with a pilot rural health insurance scheme under which farmers pay in an annual $1.20, which is then matched by local and central governments. If successful, the government hopes to roll out the scheme across its entire rural remit where currently illness can mean extreme poverty for many families.

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