China was fourth from the bottom on the 2006 list of World Health Organization member countries in terms of granting its citizens equal access to and financing healthcare. This is a telling statement on a country that is on way to becoming the world's second largest economy.
Healthcare reform is stuck in a quagmire. Many experts have come up with suggestions for healthcare reform. But Li Dun's ideas are different from the current reformers. The sociologist with the Center for the Study of Contemporary China in Tsinghua University says the government is trying to cure the symptoms instead of the disease inflicting the healthcare system.
"As the report of the 17th National Congress of the Communist Party of China says, there should be all-round reform. I emphasize that the reform focus at the institutional level," says Li, who has been part of the healthcare policymaking process for a long time. Li supposes the direction of healthcare reform reflects the authorities' governing philosophy: whether it is for the people and whether it would achieve social harmony.
The root of China's healthcare problems lies in the imperfect and complicated system. The old form of thinking, rooted in the planned economy, clashes with rules of the market economy. Li once told the media that the healthcare system combines the drawbacks of both the systems.
According to the healthcare reform plan, the basic system will have three main parts: medical insurance for urban workers, basic medical insurance for the urban unemployed and a new type of rural cooperative medical care system. This means the reform will still follow the planned economy's pattern: different treatment for city and rural residents.
It is against the principle of social equity, he says. "And equity is the core idea of any socialist security system, especially medical care." By the end of last year the country's floating population had reached 211 million. So if the authorities continue to treat urban and rural residents differently, it will be difficult to provide all migrant workers' with medical insurance cover. Plus, the transfer cost will be rather high.
Li suggests setting up a minimum-level and equal medical security system for cities and rural areas. Considering the regional economic differences and practical difficulties in some areas, the basic medical security system should be fully funded by the central government.