In China, Farmers Become Health-Care Monitors – Nicholas Zemiska
Page One from the Wall Street Journal:
XINLIAN, China — In this remote mountain village, residents were complaining about a local doctor. Some suspected he was prescribing drugs that weren’t necessary. That set off an unusual response: A special council of local health-care monitors — formed as part of an experiment to address sweeping problems in China’s health-care system — swung into action. In 2004, they fined the doctor 100 yuan, or about $13 — a significant amount of money in this poor part of China — for overprescribing drugs.
In 2003, William C. Hsiao, a senior professor of economics at Harvard’s School of Public Health, began enrolling about 60,000 farmers in a health-insurance program he and other academics designed. In Xinlian, the annual cost is about $4.50 a person, with farmers paying a little less than half of that. The rest has been subsidized with private funds organized by Dr. Hsiao. Last year, a city in Guizhou province adopted the program for 1.7 million people.
The World Health Organization in Beijing issued a report on rural China that cited rampant overprescription and said markups for drugs can be as high as 40% to 80%. One study, published in the academic journal Health Policy and Planning in 2000, found that 61% of drugs prescribed by rural doctors for influenza patients were unnecessary. [Full Text, subscribers only]