Opinion     

Universal healthcare should be substantial, easily accessible

China.org.cn, September 6, 2012

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  On Aug. 30, Chinese authorities issued new guidelines for public critical illness insurance. The new policy stipulates that urban and rural residents be compensated for no less than 50 percent of the expenses incurred by treatments for critical illnesses, on the top of their basic insurance reimbursement.

  The reform, an attempt to prevent people who receive treatment for serious ailments from plunging into poverty, seems to be stronger in intensity than America's recent health insurance reforms.

  But can China's healthcare reform help to establish a complete and effective healthcare system without overwhelming the country with financial burden? In order to better serve the public, the government should consider the following issues:

  First, the government should consider how to appropriately raise and efficiently manage healthcare funds on a large scale. Although experts have calculated the premium that ordinary people will have to pay to keep the healthcare system functioning, the figure is just a theoretical estimate.

  Similar to life insurance, the healthcare scheme has seen a spike in funding as the number of participants rises. But unlike the former, the latter has to cover an increasing number of seriously sick people and assume an increasingly heavy burden. As a result, the actual compensation amounts make the proposed premiums look ridiculous. Determining appropriate premiums is always a headache for every government that attempts healthcare reform.

  Every country has adopted national backup funds for its health insurance system. The Chinese government may have to brace for the overwhelming burden that this kind of fund would bring about. Other countries use funds for minor diseases to complement those intended for serious diseases.

  Taxing the rich to help the poor is another crucial way to raise funds. But China has never identified its rich class, nor has it categorized their premium rates in its scheme. The country needs a system that will mandate that the rich accept a higher level of responsibility for carrying the burden.

  The second question is about how to use healthcare funds. Some insurance companies have made a negative impression on people when selling life or property insurance policies. Trying to persuade people to buy their policies, salespeople treat potential customers well and make rosy promises. But when the time comes to pay claims, insurers make customers to go through a rather complicated procedure while enjoying large room for maneuvering and manipulating.

  The healthcare system is a government welfare program, but it should have accessible and efficient procedures and quantified standards for payment of claims. If its operation is entrusted to a commercial organization, the public may face rigid management and complicated compensation procedures. Therefore, the authorities should prevent the public getting trapped in a situation that prevents them from receiving proper reimbursement.

  Thirdly, health care funds must be managed and audited effectively to ensure proper functioning of the healthcare system.

  China claims to have established proper regulations to manage public funds. But the cases of misuse and mismanagement of property maintenance funds and the housing provident fund illustrate various loopholes in the regulation structure. In case of relatively advanced property maintenance fund management, it is a frequent occurrence in some regions that someone forged document papers to claim reimbursements or claimed more compensation than they should. In addition, there are a lot of media reports of officials who have fled to foreign countries with millions of yuan.

  Therefore, it is absolutely necessary for the general public to call for the efficient, effective management of public healthcare funds. Maintaining the fund's transparency and emulating foreign countries' management methods are the effective ways to reduce operating risks.

  In a word, China needs to set up a complete and efficient management system for its healthcare fund covering the fundraising, usage and management of public money if it wants to better ensure the well-being of its people. The government should not transfer its responsibilities to individuals or commercial ventures, but instead make the healthcare system a cornerstone of public welfare.

  (This post was first published in Chinese and translated by Pang Li.)

  Opinion articles reflect the views of their authors, not necessarily those of China.org.cn.

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