Such horror stories prompted the government to launch a three-year, $124-billion effort this year to rebuild the crumbling healthcare system. China once provided rudimentary but universal care to everyone. As the country shifted from socialism to a market economy over the past 30 years, health care frayed. Medical costs soared faster than incomes, and treatment today depends on the patient's ability to pay. Nearly a third of the poor say that health is the most important cause of their poverty, according to the World Health Organization.
"People are paying too much out of pocket for their services for their health care. Many are becoming impoverished in the process," said John Langenbrunner, a World Bank health economist in Beijing. "The level of dissatisfaction, at the local level, is very high and the government is responding to this."
Affordable medical services also could help reduce China's dependence on exports by encouraging people to stop saving so much for potential medical costs and spend their earnings on consumer goods. The government's goals include: Improving health services, in part by building 2,000 county hospitals and 29,000 township hospitals and ensuring that each of the country's almost 700,000 villages has a clinic; expanding state health insurance from 70% to 90% of the population, or an additional 200 million people. That is equivalent to two-thirds of the U.S. population; and reducing drug costs by controlling prices for medications deemed essential.
Longer term, the government is seeking ways to cut back on unnecessary treatment and drug prescriptions that are blamed for skyrocketing fees at public hospitals.
Eight months into the three-year plan, reform remains a work in progress. Sixty percent of the funding is supposed to come from regional governments, and it is unclear how poorer ones will come up with the money. The central government has laid out a broad strategy but left specifics to local officials. The result is a series of experiments. While learning by doing is fine, there appears to be little formal evaluation of these trials, which may make it difficult to pinpoint what works, said Langenbrunner of the World Bank.
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