Updated: Jun 28, 2020
By Elaine Zhang, Graphics Editor
China is comprised of nearly 1.37 billion people, run by a single-party autocratic government, and characterized by its rapid transition toward modernity. Its healthcare system, reformed countless times in the past century, has shown massive progress. Since 2011, publicly-financed health insurance in China has impressively covered around 95% of the population as compared to the mere 9.6% in 1984. Clearly, major improvements have been made; however, there is still a long way to go.
When China transitioned to a free market economy in 1984, the development of its healthcare system lagged behind while the government focused on other affairs. As a result, today, the Chinese healthcare system faces a consistent lack of appropriate funding, exploitation of patients, and an unreliable workforce. In order to provide affordable healthcare, medicine prices were raised and service prices lowered, resulting in overall dissatisfaction among low-wage healthcare workers.
Throughout history, financing for the health sector has stemmed from prescription drug markups. Now that there are government-imposed markup limitations, healthcare institutions struggle with budgeting, as subsidiaries do not compensate for decreased drug revenue and are forced to turn to other ways to make money: for instance, in-patient care. Doctors are also often paid money by drug manufacturers to prescribe certain drugs. Over-prescription and antibiotic abuse goes hand-in-hand with economic incentive — a legacy from the traditional financing system — leading to rising antimicrobial resistance.
Despite nearly-universal health coverage in China, a large disparity persists. Between urban and rural sectors, experienced doctors are unevenly distributed and gaps in quality of care are common. Some doctors are often underpaid, untrained, and overworked; thus, China finds itself in a tight bind. Increasingly few people choose to become doctors. Moreover, many young doctors also express desires to quit their job. Without any incentive, how can quality care be given? The public’s general distrust of not only the Chinese healthcare system but also its doctors comes as no surprise. China’s current healthcare system also faces environmental, technological, and social limitations. Combined, these issues could lead to the collapse of the healthcare system altogether.
In order to improve the current state of the healthcare system, the Chinese government has committed to the Healthy China 2030 plan, passed on October 25, 2016. It serves as a guideline for the promotion of public health and movement toward the higher health standards of other wealthy countries. After all, as President Xi Jinping proclaimed, “health is a precondition for social and economic development.”
Healthy China 2030 outlines an expanded medical industry, increased expenditures, and optimized public healthcare systems. This plan is concentrated on four major principles: prioritization of health, innovation (the need for speedy reforms in the healthcare industry), scientific development (in terms of both Western and Eastern medicine), and equity (equal access to healthcare between rural and urban areas). China is beginning to reorient itself from economic growth to health development.
Thirteen indicators of health, such as environmental health and life expectancy, will be used to compare progress to the health targets over the years. In addition, numerous government programs will be launched, the national health investment capital will be raised to 16 trillion yuan, and three of every 100 citizens will be certified as doctors by 2030.
This ambitious plan, if successful, will ensure national health and provide economic benefit. While there still exist many underlying issues in the Chinese healthcare system, Healthy China 2030 will direct the nation towards vastly improved public health.