"Once the ambulance siren wails, a pig is taken to the market; once a
hospital bed is slept in, a year of farming goes down the drain; once a serious
disease is contracted, ten years of savings are whittled away," said Dr Ma
Wenfang, quoting a well-known Chinese countryside saying.
"The annual average income of farmers in my village is only 500 yuan, (about
62.5 U.S. dollars). After paying for children's tuition fees and living
expenses, they have nothing left to cover medical expenses even in county-level
hospitals," said Ma, 55-year-old doctor of Suliuzhuang Village of Tongxu County
in China's central Henan Province.
He has been the village doctor for 40 years and is responsible for 2,500
farmers. But his clinic only has three pieces of medical equipment: blood
pressure gauge, thermometer and stethoscope.
"Despite these limitations, 98 percent of farmers came to me," he said,
"because at least it is much cheaper for them. Sometimes I give them free
medical treatment." For serious cases far beyond the capability of his clinic,
Ma encouraged his patients to seek help at county-level hospitals. "But they
would rather lie in bed than go to hospital," said Ma, "because it is far too
expensive and 25 kilometers away."
The situation in Suliuzhuang Village is not rare. In 2003, the average annual
income for China's 800 million rural population was 2,622 yuan (328 U.S.
dollars) while the average medical expenses were 2,236 yuan (280 U.S.dollars),
according to the Ministry of Health in 2004.
The latest national health survey in 2003 revealed that about 73 percent of
people in rural areas who should have sought medical treatment chose not to do
so because of the cost.
In urban areas, the figure was 64 percent. As China's socioeconomic system
moves increasingly market-oriented and the role of the government as a provider
of public services diminishes, the country's health care system, traditionally
one of core elements of Chinese socialism, is suffering.
The health care system is dominated by pay-for-service care, notes Ge
Yanfeng, deputy director of the Department of Social Development with the
Development and Research Center (DRC) of the State Council. "Patients have to
pay for treatment out of their own pockets with large differences in quality and
access among income groups and between rural and urban populations," he said.