The long road to reform

Post-1949: Governments cover over 90 percent of medical expenses for urban residents. In the rural areas, people have access to subsidized health clinics via "barefoot doctors".

1985: In order to increase hospital efficiency, China launches market-oriented reforms. Public hospitals are encouraged to make their own income after reduced government funding. Public organizations are also encouraged to run medical institutions. But reforms soon resulted in an over-commercialization of hospital practices, as doctors often overprescribed drugs and tests in order to make profits.

1997: The State Council issues a historic decision, defining medicine as a public welfare sector, changing the previous concept that it was a commercial product.

1998: China begins to establish a medical insurance system in urban areas.

2002: The government decides to strengthen medical services in rural areas by planning a new rural cooperative medical care system.

2003: The outbreak of severe acute respiratory syndrome (SARS) exposed weaknesses in the ailing public health system, especially in rural areas.

2005: A report by the Development Research Center under the State Council harshly criticizes health sector reforms and concludes that reforms over the past decade were "basically unsuccessful", as statistics showed that over half of the medical fees are covered by the patients themselves, compared with over 20 percent in 1978.

2006: The State Council sets up a joint working team to draft a new health reform plan.

2007: China introduces a comprehensive medical insurance program that will cover all urban citizens, including children and the unemployed.

February 2008: Initial edition of the reform plan is worked out.

March 2008: The rural cooperative medical insurance system covers more than 804 million rural residents, accounting for 91.05 percent of the rural population.

October 2008: The reform plan is released for public debate.

January 2009: The State Council endorses the reform plan in principle, but holds it for further revision.

April 2009: The reform plan is officially published for implementation.

(China Daily 04/27/2009 page12)