Guo Liu, a villager in north China's Shanxi province, has been bed-confined for two years because of rheumatism, but could hardly afford any regular medical treatment for his family's wretched economic conditions and absence of an accessible clinic nearby.

Whenever Guo could not endure the pain, he could do nothing but taking a piece of anodyne at the cost of only 0.04 yuan (about US$0.004).

Guo's case is not rare in China's countryside as the former rural cooperative health network in the country gradually sank into oblivion when a market-oriented reform was launched in the late 1970s. To cope with this situation, the Chinese government undertook to solve the issue pertaining to medical service for approximately 900 Chinese farmers.

With disappearance of rural communes in China in late 1970s and early 1980s, rural cooperative medical system disintegrated and, in 1996, only 10 percent of the rural residents in the country was covered by cooperative medical service network.

Farmers in China's countryside became less worried as the government began to resolved to cope with the problem. At the current session of the national legislature, Premier Wen Jiabao vowed to improve medical and healthy conditions in the vast rural areas and carry out new-type pilot projects of rural cooperative medical care system.

"We need to focus our medical and health efforts in rural areas, upgrade the medical and sanitation infrastructure and train a growing number of medical and sanitation personnel to ease the shortage of medical services and medicines in the rural areas," said the premier.

Nowadays, less than 10 percent of villagers could enjoy the cooperative medical services, whereas over 90 percent of rural residents were covered by the cooperative medical network in the 20-odd years from the 1960s to the early 1980s.

Patients in China, both in urban and rural areas, paid same prices for medicine and medical services. The annual growth of the villagers' income, nevertheless, was merely four percent over the two decades between 1979 and 2003, only half of that of urbanites.

"So, urban residents and farmers feel differently at medical prices," said Zhao Linzhong, a deputy from east Chin's Zhejiang province to attend the NPC conference, "While most of urban workers enjoy government subsidies or are covered by medical insurance, villagers have to pay for it by their own."

According to a recent survey, 72 percent of rural patients could not afford to see doctors and 89 percent of those with severe diseases could not be hospitalized for the same reason.

The outbreak of severe acute respiratory syndrome (SARS) in early last year propelled the government to accelerate the pace in rebuilding a rural medical network. In the same year, the government decided to attain the goal within eight years.

Under the government scheme, a villager only needs to pay an average of 10 yuan (about US$1.2 ) for medicare insurance, and the central government and local government pays additional 10yuan for it respectively. The sum of 30 yuan will be deposited in the pool of a so-called Rural Cooperative Medicare Fund. In case of illness, a villager who has joined the fund can get hospitalized and has part of his medical expenses covered by the fund.

Farmers are asked to join the cooperative medicare scheme on a voluntary basis.

According to the premier, the government will press ahead steadily with the pilot projects for a new type of rural cooperative medical care and health services system based on the specific conditions in different regions.

"Our objective is to set up a rural medical care system at the sponsorship of the government, based on mutual assistance of the participants, and with voluntary participation of locals and diverse sources funding from individuals, collective units and the government, one which takes treatment of serious diseases as its main responsibility and ensures that the rural population benefits from," Wen said.

Qiao Zhanshan, a NPC deputy and a village leader from north China's Shanxi province, was satisfied with premier's work report, saying, "Judging by his report, the government is determined to resolve the issue."

"There is no theoretical disputes about it, but the crucial question is how to operate it in a regularized manner," said Cai Renhua, director of the China Institute of Medical Economics, a government institution to study the pilot program.

(Xinhua News Agency March 6, 2004)