Healthcare in China
Healthcare in China
Healthcare in China consists of both public and private medical institutions and insurance programs. About 95% of the population has at least basic health insurance coverage. Despite this, public health insurance generally only covers about half of medical costs, with the proportion lower for serious or chronic illnesses. Under the "Healthy China 2020" initiative, China is currently undertaking an effort to cut healthcare costs, and the government requires that insurance will cover 70% of costs by the end of 2018.
The Chinese government is working on providing affordable basic healthcare to all residents by 2020.
China has also become a major market for health-relate multinational companies. Companies such as AstraZeneca, GlaxoSmithKline, Eli Lilly, and Merck entered the Chinese market and have experienced explosive growth. China has also become a growing hub for health care research and development.
Traditional Chinese Medicine (TCM) has been practiced for years, and served as the basis for health care in China for much of its history. Western-inspired evidence-based medicine made its way to China beginning in the 19th Century. When the Communist Party took over in 1949, health care was nationalized, a national "patriotic health campaign" attempted to address basic health and hygiene education, and basic primary care was dispatched to rural areas through barefoot doctors and other state-sponsored programs. Urban health care was also streamlined. However, beginning with economic reforms in 1978, health standards in China began to diverge significantly between urban and rural areas, and also between coastal and interior provinces. Much of the health sector became privatized. As state-owned enterprises shut down and the vast majority of urban residents were no longer employed by the state, they also lost much of the social security and health benefits. As a result, the majority of urban residents paid almost all health costs out-of-pocket beginning in the 1990s, and most rural residents simply could not afford to pay for health care in urban hospitals.
Since 2006, China has been undertaking the most significant health care reforms since the Mao era. The government launched the New Rural Co-operative Medical Care System (NRCMCS) in 2005 in an overhaul of the healthcare system, particularly intended to make it more affordable for the rural poor. Under the NRCMCS, some 800 million rural residents gained basic, tiered medical coverage, with the central and provincial governments covering between 30-80% of regular medical expenses. Availability of medical insurance has increased in urban areas as well. By 2011 more than 95% of the total population of China had basic health insurance, though out-of-pocket costs and the quality of care varied significantly. The health infrastructure in Beijing, Shanghai, and other major cities were approaching developed-world standards, and are vastly superior compared to those operated in the rural interior.
Current healthcare system
Further information: Healthcare system reform in the People's Republic of China
All major cities have hospitals specializing in different fields, and are equipped with some modern facilities. Residents of urban areas are not provided with free healthcare, and must either pay for treatment or purchase health insurance. The quality of hospitals varies.
The best medical care in China is available in foreign-run or joint venture Western-style medical facilities with international staff available in Beijing, Shanghai, Guangzhou, Shenzhen, and a few other large cities. They are highly expensive; treatment there can often cost up to ten times more than a public hospital.
Public hospitals and clinics are available in all Chinese cities. Their quality varies by location; the best treatment can usually be found in public city-level hospitals, followed by smaller district-level clinics. Many public hospitals in major cities have so-called V.I.P. wards or gaogan Bing fang.
These feature reasonably up-to-date medical technology and skilled staff. Most V.I.P. wards also provide medical services to foreigners and have English-speaking doctors and nurses.
V.I.P. wards typically charge higher prices than other hospital facilities, but are still often cheap by Western standards. In addition to medical facilities providing modern care, traditional Chinese medicine is also widely used, and there are Chinese medicine hospitals and treatment facilities located throughout the country. Dental care, cosmetic surgery, and other health-related services at Western standards are widely available in urban areas, though costs vary.
Historically, in rural areas, most healthcare was available in clinics providing rudimentary care, with poorly trained medical personnel and little medical equipment or medications, though certain rural areas had far higher-quality medical care than others. However, the quality of rural health services has improved dramatically since 2009. In an increasing trend, healthcare for residents of rural areas unable to travel long distances to reach an urban hospital is provided by family doctors who travel to the homes of patients, which is covered by the government.
Reform of the health delivery system in urban areas of China has prompted concerns about the demand and utilization of Community Health Services Centres; a 2012 study, however, found that insured patients are less likely to use private clinics and more likely to use the centres.
A cross-sectional study between 2003 and 2011 showed remarkable increases in health insurance coverage and inpatient reimbursement were accompanied by increased use and coverage. The increases in services use are particularly important in rural areas and at hospitals. Major advances have been made in achieving equal access to insurance coverage, inpatient reimbursement, and basic health services, most notably for hospital delivery, and use of outpatient and inpatient care.
Nowadays, with substantial urbanisation, attention on health care has been changed. Urbanisation offers opportunities for improvements in population health in China (such as access to improved health care and basic infrastructure) and substantial health risks including air pollution, occupational and traffic hazards, and the risks conferred by changing diets and activity. Communicable infections should also be re-focused on.