Debate over the final blueprint for further medical reform
continues to rage on, an expert said Tuesday.
The major sticking points are how the country should finance the
health system to improve equity among the population and how to
better deliver more efficient medical services, Zuo Xuejin,
executive vice-president of Shanghai academy of social sciences,
told China Daily on the sidelines of the ongoing Global
Forum of Health Research in Beijing.
"That's probably why the reform plan is still kept in the
closet," Zuo said.
More than a year has passed since the government entrusted eight
institutions at home and abroad, including the World Health
Organization, McKinsey, the World Bank, the Development Research
Center of the State Council and five Chinese universities, to daft
a proposal on future reform.
Despite delays, the government is confident of the process
moving forward.
Vice-Minister of Health Gao Qiang said during the just-concluded
17th National Congress of the Communist Party of China that by the
year 2020, all Chinese citizens in urban and rural areas will have
access to basic medical care and health services.
Gao said the reform's framework, drafted on the basis of all
eight proposals, would be publicized soon.
Public health, health insurance, hospital management, and basic
health services are the major reform points.
"Waking up to the truth that commercial considerations led to
the failure of previous reforms, the government realized there
needed to be a switch in focus from individual responsibility in
medical care to more obligation from the government," Zuo said.
The government is formulating a workable health system
structure.
In 2002, the government launched the rural cooperative medical
scheme to provide subsidized basic medical care for farmers and
promised to include the entire rural population in the scheme by
2008.
However, farmers have complained about the scheme's apparent
inability to cover outpatient services, possibly because of budget
constraints.
Zuo said funding priorities for outpatient and inpatient
services might be made clearer once reform plans are finalized.
Other issues include the best mechanism for financing medical
care for individuals, either by paying the hospital providing the
service, or to the patient directly.
Some experts, including Zuo, proposed a combination of the two
funding methods, citing imbalanced economic development across the
country as a factor.
The reform will also reportedly keep the medical and
pharmaceutical sector in check, previously accused of "over and
unnecessarily" prescribing drugs and health checks to boost
profits.
Moreover, the role of public and private hospitals still need to
be further defined in the final reform plan, Zuo said.
(China Daily October 31, 2007)