China outlines plans to reform health care

BEIJING - China yesterday announced the outlines of a thorough reform of the health-care system that pledges to provide improved services to all citizens by 2020, tackling a critical issue that has become a major source of public dissatisfaction.

While many details remain unclear, the announcement underscored the communist government's need to at least appear to be making progress on the issue. Public health care has been underfunded for years, and the high cost and poor availability of services are among the biggest complaints of the Chinese public.

A serious illness can wipe out a family's life savings, and the need to set aside earnings for potential medical costs is considered a major drag on the domestic consumption that the government so badly needs to boost the flagging economy.

Credited with making huge inroads against infectious diseases and providing basic free care to most citizens, China's Soviet-style public-health system was largely dismantled in the 1980s amid economic reforms and a growing taste for privatization. Seeing a doctor became far more expensive, and the gap between rural and urban health care began to grow, undercutting efforts to boost rural incomes.

Health-care spending by both the private and public sector in China amounts to just 5 percent of GDP, significantly less than the 17 percent in the United States.

According to a text of the roadmap for reform released yesterday by the official Xinhua News Agency, the first stage of the plan calls for extending some form of basic health insurance to 90 percent of the population by the end of 2011. Now, only 30 percent of China's population of 1.3 billion is covered.

Further improvements in funding and oversight will then provide "safe, effective, convenient and affordable" health services for all citizens by the end of the next decade, according to the plan.

Hospitals and clinics in the poor countryside and less developed cities would be improved, and the price of essential medicines would be capped. Disease prevention and control, maternal health, mental health and first-aid services would also receive greater attention, it said.

Xinhua said the reforms envisioned "diversified medical insurance systems" to cover employees in the private sector, nonworking urbanites, and residents of the poor countryside.