From November 9 to 16, a training course for health bureau directors was held in Beijing. Minister of Health Gao Qiang gave a speech at the event and highlighted that more reforms would be implemented for the country's medical system in order to break the monopoly of public health care institutions.

His speech was published on the Ministry of Health (MOH) website on November 28.

In his speech, Gao highlighted two things that would help reform. One is that the monopoly of public hospitals must be broken. Public hospitals currently provide most of the medical services. According to the statistics from 2003, public hospitals accounted for 96 percent of all the hospitals in the country, and private hospitals only 4 percent.

The other issue is that management styles have to change. Hospitals are categorized according to their ownership structure. Public hospitals are considered non-profit, while private hospitals are considered for-profit. But the reality is that most public hospitals conduct their business for profit, yet they enjoy exemptions and government allowances that private hospitals are denied. The policy effectively means that public hospitals are more loosely supervised, and the private ones aren't given the room to develop. 

"The number of public hospitals in a locality depends on the development of the local economy, availability of government funds and demand," Gao said, adding: "There are now too many public hospitals for the government to support."

In Gao's opinion, the problem of funding can be solved by encouraging more private funding of hospitals. "We could change the ownership structure of some public hospitals by allowing private enterprises or individuals to buy and manage them," Gao said.

Gao added: "The government should centralize its funds and take charge of some of the public hospitals, and it can focus on creating high quality, low priced medical services. The hospitals managed by the government should stick to the low prices and non-profit principle, and staff salaries will be controlled by the state."

On Tuesday, a source close to the MOH told the beijingnews.com that a new medical reform scheme has been submitted to the State Council for approval. According to the source, the scheme proposes using four medium-sized cities as test cases. The aim of the supposed scheme is to cover 90 percent of the population in these four cities with basic medical insurance, meaning they need only pay half of their medical expenses.

According to the press office of the MOH, the scheme has yet to be approved by the State Council. Moreover, the four-city test-case scenario cannot be confirmed.

(China.org.cn by Li Xiaohua, November 30, 2005)