PROMISING GOOD MANAGEMENT

The broad principles contained in China's new reform "are in line with what the World Health Organization (WHO) is promoting. For example, the principle of equity, the principle of having the poor (covered by) health policies," WHO Director-General Margaret Chan told reporters in Beijing on Tuesday.

The government promised good management and supervision of funds for the insurance programs, and it said it would explore more rational and convenient methods for people to use the programs.

To lower prescription costs, which have drawn much criticism, the government will promote a system of essential medicines for state-run hospitals, clinics and pharmacies. A list of essential drugs will be published this year.

Due to longstanding low government funding for state-run hospitals, which in many places only covers 10 percent of operating costs, doctors often aggressively prescribe expensive, sometimes unnecessary medicines and treatment, in order to make profits for the hospital.

This situation has meant high medical bills and corruption in the medical profession.

The reformers want to designate essential drugs, at controlled prices, to cut the cost of hospital services, while promising to increase funding to non-profit state-run hospitals and clinics, which account for 80 percent of medical institutions in China.

This forms part of the arduous reform of state-run hospitals to improve efficiency and quality. The plan said pilot work would be carried out this year in chosen hospitals, without giving details.

IMPROVING PRIMARY CARE, TRAINING

To improve primary health care facilities, China will give priority to construction of about 2,000 county-level hospitals so each county would have at least one hospital that was essentially in compliance with national standards.

The central government will fund the construction of 29,000 township hospitals this year and the upgrading of 5,000 township hospitals, under the plan.

The central government will also finance the construction of village clinics in remote areas so that every village will have a clinic in the next three years.

It said 3,700 community health centers and 11,000 community health stations would be set up or upgraded in cities.

Liu Xinmin, an official with the health ministry, said the plan is aimed at improving the medical service network at grassroots level so that patients do not have to travel far to see a doctor.

He said the distribution of hospital resources was extremely unbalanced at present, with about 80 percent of hospital resources in cities.

Even in places where village or township clinics are available, many patients opt for big hospitals in the city just because they do not trust local medics, he said.

In the next three years, China will train 1.37 million village doctors and 160,000 community doctors. Also, city-level hospitals, which usually have better expertise and equipment, will each be required to help three county-level hospitals to improve the skills of medics.

Doctors at city hospitals and disease control agencies will be asked to serve in rural hospitals for at least one year before they can be promoted.

Other measures include setting up a universal medical records database, which will be strictly managed, regular exams for those older than 65 or younger than three, and pre-natal check-ups.

In addition to programs to prevent or control major diseases such as tuberculosis and HIV/AIDS, China will launch new projects to help those below the age of 15 receive hepatitis B vaccines, eliminate risks from coal-burning fluorine poisoning and improve rural water and sanitation facilities.

It will also provide folic acid to rural women who intend to get pregnant or are in the early stages of pregnancy, to prevent birth defects.

China Central Television, the state broadcaster, has been ordered to open a TV channel for health education.

According to the plan, China will increase investment in the public health service at a standard of 15 yuan per person a year in 2009, and 20 yuan by 2011. This translates to a huge investment of between 19.5 billion yuan and 26 billion yuan each year.

"Such investment is very necessary for China because people must understand that disease prevention and control will eventually help save more money," Liu Xinmin said. "In China, many people become ill just because they don't know how to prevent."

(Xinhua News Agency April 8, 2009)