Josie Liu: New Health Care Reform Blueprint: Offering both Hope and Doubt

In setting up the new health care reform guideline, the Chinese government did the right thing by putting public interests before profit-making, and by striving for equality between rural and urban areas.

Millions of Chinese people who have suffered in various ways from a twisted and corrupt health care system would probably feel relieved upon reading the news: At least on paper, the government clearly stated that it is on our side. China’s vast group of farmers would probably hail the new reform plan as well, since it sets the tone for setting up a health care system that will provide equal care to both urban and rural residents, limit drug prices, and build more health care facilities in rural areas, according to a story in the South China Morning Post.

But a lot of people would not jump up and down over the new plan just yet. As Chinese people have learned over so many years and so many things, a good plan does not guarantee a good result.

Yes, the government is now saying that public hospitals should no longer pursue profits as their priority and treat patients based on their ability to pay. But how to maintain or improve the quality of health care?

The current plan is issued by the central government and serves as a guideline, while the local governments get to set up specific rules and regulations for hospitals to follow. Will local governments faithfully adhere to the line set by the government? Many people would doubt that because in many places, the local authorities no longer treat directions from the state government seriously.

Even if good rules and regulations will be in place, no one can be sure that they will be well followed. Can the good rules get through bad officials who have their hands in all fields that could bring them extra cash and a bureaucratic system that is so corrupt? Will China’s medical education system produce enough practitioners with not only deft hands but also good hearts, who can therefore sustain a health care system that truly serves the public?

On the surface, it sounds like a good thing that the government finally decided to intervene and do its part in fixing a corrupt health care system. At the same time, however, the reform nevertheless falls into the old circle of relaxing and tightening control, whereby the government relaxes rules to encourage reform in a certain area, only to rush to get the control back after market-oriented behaviors went awry and hurt the public.

China’s health care system is now a big mess but can’t afford to remain unfixed. In a society that is already threatened by all kinds of social conflicts, a sick health care system could only aggravate public grievances. Fixing it is a big challenge and it remains to be seen whether the Chinese government can meet the challenge.


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