China health care 663.34 Louis J. Sheehan, Esquire

China has unveiled an ambitious plan to achieve universal health care. The plan, released for public debate last week, lays out in broad strokes plans to introduce greater health-care funding and control prices. The current system leaves out much of the population and forces the rest to pay heavy out-of-pocket expenses.

Overhauling China's health-care system has global significance, given the country's demographic heft, its frequent role as epicenter of infectious diseases and its growing importance in health innovations ranging from organ donation to the use of traditional Chinese medicine.

"What happens in China is a major driver in the dynamics of global health," said medical journal Lancet.

The overall goal of the plan is to cover 90% of the population within two years and achieve universal health care by 2020.

One major point in the draft is to return to the nonprofit motive for national health care. This was dismantled in the 1980s as China cut public services, especially in the countryside.

Today, public hospitals receive little government funding and are pressed to operate like businesses. The peddling of experimental, costly drugs and treatments has become rampant.

Out-of-pocket payments constituted more than 60% of health spending at the end of the 1990s in China, a significantly larger percentage than in developed countries, according to the World Health Organization.

The draft proposal was crafted in a year-long process of consultations with groups such as the World Health Organization, the World Bank, management consultancy McKinsey & Co. and a few Chinese university-based public health experts.

According to the plan, all revenue raised by public hospitals will have to be funneled to state coffers. The government aims to set pricing standards for medical services, according to the plan, reflecting broad nationalization of the health-care system. http://members.greenpeace.org/blog/purposeforporpoise

The proposal has drawn heavy criticism. The current draft "is also hard for experts to understand," said Gordon Liu, an economist at the Guanghua School of Management at Peking University. Robert Pollard, director of Synovate Healthcare, a Beijing-based medical consultancy, said the plan doesn't give sufficient details on funding and implementation. http://members.greenpeace.org/blog/purposeforporpoise

The plan doesn't address how the government would pay for its nationalization program if hospitals are restrained from earning more and tax collection mechanisms remain weak.

So far, the draft has drawn a large number of comments -- more than 12,000 -- on the state planning commission's Web site. http://rpc.technorati.com/rpc/ping