China's far-from universal health care

Here and Now

This story was originally covered by PRI's Here and Now. For more, listen to the audio above.

China recently announced that it is launching an ambitious plan to expand the nation's health care coverage. The plan is, in some ways, an acknowledgement that after years of focusing on economic growth, it's time to improve the nation's neglected health care system.

While Mao Zedong was in power, the country provided basic health care. After his death, the uninsured rate grew to between 90 to 94 percent in many rural areas, Martha Bebinger reported to Here and Now. Bebinger recently spent three weeks in China on a program with the Harvard School of Public Health visiting health care facilities throughout the country.

One of China's biggest health care priorities today is closing the disparities in coverage, according too Yuanli Liu, a professor at the Harvard School of Public Health. He told Bebinger that the government is trying to rectify serious disparities between rural and urban populations, and between rich people and poor people.

Urban citizens are often more healthy and have longer life expectancies. There's also a disparity in the quality of care. A doctor at a big city teaching hospital earns at least 10 times what doctors in rural areas earn, according to Bebinger. Many rural doctors have less experience and education, and the system is less regulated.

The World Bank says that medical expenses are a common reason for bankruptcy in rural China. For many, Bebinger says, "there is not really a safety net yet, although they're starting to add the pieces of that."

For urban residents, Bebinger says that the government is working to make employers contribute to the health care system. For now, half of the money that runs the health care facilities and hospitals comes from markups on the cost of drugs. That system is not carefully monitored and invites abuse.

Recently, President Hu Jintao and President Obama announced a public-private partnership in an effort to improve China's health care. China is welcoming U.S. pharmaceutical, technology and even insurance companies to take part in China's health care market. And experts believe the market for health care goods in China will continue to grow.

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