China healthcare under spotlight

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The UK-based medical journal, The Lancet, is launching a major series of scientific papers in Beijing on China's plans for healthcare reform.

The spotlight comes as the country is debating an ambitious programme which aims to provide health insurance for all its 1.3 billion people by 2020.

The Healthy China 2020 plan is intended to create a universal health service.

Critics say the Chinese health system presently falls far behind the needs of those it is supposed to be treating.

Changing needs

China is facing a real problem with this new phenomenon of health poverty where people either can't afford to get the care or else, having received the care, are then bankrupted by it Bill Summerskill Executive Editor, The Lancet

Primary healthcare, especially for the poor, disintegrated in recent decades when the old state system was dismantled and medical fees introduced.

Healthcare is a top public complaint - many cannot get access to it or simply cannot afford it. Many of the 700 million people in the countryside have to travel to cities to get decent care.

Bill Summerskill, the Lancet's executive editor, says the current system just is not working.

"More than half the money comes out of pocket. And if people end up in hospital, the average hospitalisation is greater than an average person's wage," he told the BBC.

"China is facing a real problem with this new phenomenon of health poverty. Where people either can't afford to get the care or else, having received the care, are then bankrupted by it," he added.

The government's recently unveiled plans for health insurance for all are being closely watched.

Many want to see if it is possible to introduce a system which covers 1.3 billion people, hundreds of millions of them still poor.

Money also needs to be poured into preventative medicine. Rapid social changes mean disease is changing too.

Shifts in diet and lifestyle - and widespread smoking - mean chronic diseases, including heart attacks, strokes and cancers, are set to increase dramatically.

About 177 million Chinese people have high blood pressure. At the moment, only about one in 10 gets adequate treatment.