China's plan to reform its healthcare system to move towards a universal medical service for its 1.3 billion people triggered a storm of debate when it was published on October 14. A National Development and Reform Commission (NDRC) website, set up to take public comments, was inundated with complaints and criticisms, many of which simply said the plan is too difficult to understand.

On October 20, Minister of Health Chen Zhu attempted to clarify the reform in a speech at the Great Hall of the People.

Chen said the reform's top five priorities are to:

- Speed up the establishment of a universal healthcare system

- Set up a basic drug system

- Improve the grassroots health service network

- Provide equal access to public health care for urban and rural residents

- Push forward reform trials in state-run hospitals

On the first point Chen acknowledged that, due to disparities in development between urban and rural areas, at present China effectively has a two-tier healthcare system. But he pledged that the future healthcare system would cover more than 90 percent of urban and rural residents by 2010.

On the basic drug system, Chen said basic medicines meant those that were accessible and approved, could cure common diseases and were affordable to individuals and society. The system would take into account medicine production, supply, circulation and reasonable use. It would also seek to control costs and diagnostic methods.

To improve the grassroots health service network, especially in central and western regions which are severely short of healthcare resources, general practitioners and nurses would be dispatched to work in townships and counties. They would be offered good working conditions and social status, Chen said.

As for providing equal access to public health services to rural and urban residents, Chen said the Ministry of Health was planning to provide a single package of care to the entire public covering inoculations, care for chronic complaints, measures to control tobacco use and high blood pressure, road safety, hygiene, and food safety.

Chen acknowledged that the last point concerning reform trials in state-run hospitals was the most difficult but also the most necessary.

Chen said once these objectives were realized, current problems of soaring medical fees, a lack of access to affordable medical services, poor doctor-patient relationships and low medical insurance coverage would be eased and the disparities between healthcare services in different areas would be gradually reduced, which was the essential purpose of the reform.

He also emphasized that as the healthcare service was for the public, it would be necessary to inject public money and that was the responsibility of the government.

(China.org.cn by Zhou Jing October 22, 2008)