Commentary

China Watch

Forum Digests

Columnists

Letters

Primary healthcare

(China Daily)
Updated: 2008-10-16 07:42

A World Health Organization (WHO) report once again reveals the appalling inequities in access to healthcare and the imbalance in healthcare services delivered within or between countries. It is a reminder that the increasing disparity between the haves and have-nots poses a threat to human efforts in poverty alleviation.

The report published Tuesday points out that more than 100 million people are pushed below the poverty line each year by rising healthcare costs and disarrayed systems for financial protection. And vast differences in healthcare occur within individual countries and sometimes even within individual cities.

In addition to the increasingly widening gap between the rich and poor, lack of enough attention and dereliction of duties by various governments in delivering primary healthcare to their people have contributed to such a dismal situation.

This report coincides with the publication of China's guiding document for further reform of its public healthcare system.

The Chinese report reiterates the emphasis on the public welfare nature of its public healthcare system. It thus sends out a strong message that the Chinese government has realized the potential danger of its public hospitals turning into just profit-seeking organizations.

The report points out that inequities in access to care and in health outcomes are usually the greatest in cases where health is treated as a commodity and care is driven by profitability. This is exactly what has happened to some public hospitals in China in the past decades when market mechanism was introduced.

Ever-increasing costs of healthcare, resulting largely from unnecessary tests and procedures, more frequent and longer hospital stays, have forced those who cannot afford such care out of the system. Little wonder there have been increasing public complaints in recent years about the expenses and inconveniences of healthcare .

The WHO report calls for a return to primary healthcare. It argues that its values, principles and approaches are more relevant now than ever before.

The national healthcare security network that is mentioned in the Chinese report and covers all residents, village clinics, community hospitals and a list of basic drugs has best epitomized the nature of primary healthcare.

The ultimate goal of the reform is to finally ensure Chinese people get equal access to basic healthcare. And behind it is the conviction that a market mechanism will not naturally lead to a fair and efficient public healthcare system. It is therefore the responsibility of a government to establish such a system and ensure its healthy development.

This is also what the WHO report calls on various governments to ensure.

As the report says, primary healthcare makes the difference because it promotes a holistic approach to health that makes prevention as important as cure in a continuum of care.

The emphasis China's public healthcare reform has placed on village clinics and community hospitals will provide residents with enough service for prevention of diseases.

China's reform of its public healthcare system will hopefully provide clues for the rest of the world.

(China Daily 10/16/2008 page8)