Health services cost the earth and fail poorest people
Public funds have shrunk in reforms implemented over the past 20 years, forcing hospitals to charge for treatment to the detriment of the poorest people. There are fears that, failing decisive intervention, infectious diseases once eradicated will reappear.
Beijing (AsiaNews/SCMP) China's health services charge exorbitant bills and do not assist the poorest of the poor, according to an annual report about the national health system. The "Green Book of Health" published by the Chinese Academy of Social Sciences, said government reforms over the last 10 years had created an inefficient and inequitable system, with a "lack of government financial support, inadequate official supervision and improper government intervention in some areas".
The report said sick people did not dare to go to hospitals, which were characterized by high costs, doctors who acted like businessmen, and a lack of cheaper medicines.
Already in 2005, a study by the State Council's Development Research Centre had concluded that health reforms had failed, especially because of a lack of public funds. But the Green Book looked at the problem more closely.
Du Lexun, the report's editor and commissioner of the Ministry of Health, said poor financial support had forced public hospitals to charge patients, in order to finance themselves. In 2003, the government only covered 16.96% of general health costs compared to 38.69% in 1986. "The problem of high costs is the result of government action," said Professor Du.
The problem is more severe in rural areas, where 90% of the population has access to only the most basic services; they must pay for the rest, which usually cost more than they can possibly afford. Before the reforms, everyone had access to medical care at a minimal cost, especially through "barefoot doctors", people who were usually middle school graduates, given training in first aid: to set broken limbs, administer basic drugs and give pre-natal examinations. This system led to the eradication of many infectious diseases from 1949 to the mid-70s, and increased life expectancy from 35 to 65 years.
Since the 80s, however, subsidies for public hospitals have dwindled, with a corresponding increase in costs paid by patients.
Experts said this system meant that those who could pay more got treated first.
Another pressing problem is the lack of proper monitoring: Shi Guang, head of the National Health Economics Institute's Policy Study Department, said ironically: "The government has a triple status of athlete, coach and referee."
What is needed instead is the setting up an independent regulatory body covering all related departments, similar to the US Department of Health and Human Services.
To tackle the most urgent problem - high medical costs often prescribed to increase profits rather than because they are really needed - the report suggested "completely separating pharmacy charges from the hospitals".
Experts said that in their eagerness to enhance the nation's economic development, government leaders have forgotten one of the main dogmas of developed countries: health and wellbeing should develop at an equal pace. If radical reforms are not implemented, the country risks the return of infectious diseases and deterioration of the population's health, which would damage economic development.
Among the proposals for reform are calls for more public intervention for those with less income, as already takes place in Hong Kong's public hospitals. (PB)
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10/02/2020 15:47
