A new "co-operative medical service" system is being piloted in numerous areas around the country which collects funds from individuals, collectively owned economies and governments.

In China's planned economy era, the health of rural people was guaranteed by an old co-operative medical care system, to which farmers paid a minimal amount to enjoy basic services from grass-roots doctors.

As the country was on track to become a market economy, the system was brought to the verge of collapse, mainly due to shrinking investment.

At present, the government cannot afford the large medical expense incurred by people in rural areas, the majority of whom cannot afford to pay for healthcare themselves.

"In 2000, 87.3 per cent of sick people in rural areas paid the medical expenses fully by themselves, with 25 per cent of them having to borrow money to pay the fee," said Wang Longde, the country's vice-minister of health.

"More than 60 per cent of patients had to leave hospital before recovery because they could not to continue to pay for the cost."

In 1998, 37 per cent of all sick farmers reportedly did not see doctors, and 65 per cent of patients who should have been hospitalized failed to receive medical treatment.

Among them, 38 per cent of those who should have seen the doctor and 65 per cent of those who should have been hospitalized did not do so simply because they were unable to pay.

"It is an urgent and harsh task to carry out affordable healthcare protection measures in rural areas," Wang said. "The government is responsible for ensuring fairness for the disadvantaged by building a reasonable health care system.

"Local governments of towns and villages are trying various methods of medical protection, such as setting up a mutual medical fund between the people and the government."

Only 20 per cent of the nation's medical resources, such as equipment and doctors, are estimated to be shared by rural residents, who account for 70 per cent of the total population.

Wang said: "The surplus medical resources in urban areas can be shifted to the rural, private and joint-stock hospitals and clinics with trained staff, and standard services are encouraged to be set up to improve the rural medical service network.

"Our aim is to set up a system to provide basic services for treatment, disease prevention and health promotion for every rural resident."

(China Daily February 19, 2002)