Aiming to provide basic medical service to 900 million residents in vast rural areas, China has begun to streamline a health care network that was brought to the verge of collapse in the past decade.
The network, based on state-funded medical centers in rural towns and villages, will also be composed of private hospitals and clinics with trained staff and standard services.

Cooperative medical care

More farmers will be able to afford medical services if they join a pool system, known as "cooperative medical care," which collects funds from individuals, collectively-owned businesses and governments.
" It is very important and urgent to establish an affordable and effective network of primary health care in rural areas," said Zhang Wenkang, the country's health minister.

He said an increasing number of rural residents are victims of "unfairness" while receiving medical services.

No money to visit doctors

The rocketing price of medical service is the main health care worry for many farmers as the income gap in urban and rural areas continues to widen.

Only 20 percent of the nation's medical resources, such as hospitals and doctors, are estimated to be shared by rural residents, who account for 70 percent of the total population.

A study by the Ministry of Health indicated that in 1998, 37 percent of all ill farmers did not visit the doctor, and 65 percent of patients who should have been hospitalized failed to receive treatment simply because they were unable to pay.

"Such ratios are still growing," Zhang said.

Old welfare system collapsing

In China's planned economy era, the government provided urban residents with welfare "from the cradle to the grave," including health care.

The health of rural people was also guaranteed by the old cooperative medical care system, to which farmers paid a little to enjoy basic services from grass-roots doctors.

As the country was on track to becoming a market economy, the system could no longer be sustained, mainly due to shrinking investment. The Chinese gradually learned that seeing a doctor was no longer welfare but a way of spending money.

However, the health minister stressed that the government is responsible for ensuring fairness for the disadvantaged by building a reasonable health care system.

Central government's plan

The State Council, China's cabinet, has mapped out a plan of reform aiming to improve medical services in rural areas. Local governments are allowed to conduct different trials.
" Our aim is to set up a system to provide basic services for treatment, disease prevention and health promotion for every farmer," Zhang said.

The work will focus on the control of infectious diseases and the prevention of non-infectious chronic illnesses such as tumors and diabetes.

Special attention is to be paid to health care for children, women and the elderly, as well as to the improvement of drinking water and sanitation.

Medical workers in rural areas are required to conduct health education activities to promote awareness of healthy lifestyles.

The central government is formulating policies for the management of township hospitals, investment in the rural health care sector and the training of countryside doctors, to regulate the service.