Home
News
In Focus
Business
Metro
Nation
World
Sports
Feature
Opinion
View more »Opinion Columns
Wan LixinOpinion deputy editor of Shanghai Daily
Forum emphasizes BRI cooperation between China and Arab countries
Rights to lower sleeper berths should be softened by empathy for fellow passengers
Sunday
- Subscribe
Home » Opinion » China Knowledge
Urban drive turns fit farmers into fatsos
May 11, 2010, Tuesday
|
Print Edition
Print Edition
ALTHOUGH Chinese might have more money to spend on health care thanks to the their country's rapid economic growth and their own increased spending power, a range of constraints make it difficult for many of them to receive the care they need.
Health care spending per capita has been increasing in China, growing 16 percent annually on average since 1978 and is expected to grow 20 percent in 2009 and 2010, according to data from China's Ministry of Health.
"We see the potential that economic growth will eventually create more demand for health care," said John Cai, a former professor of economics at Fudan University in Shanghai and an expert on health care reform in China. "At the same time, there are some barriers holding back improvement."
One striking result of China's rapid economic growth is that the country "shows very similar problems now to developed countries," noted Cai, a senior health policy analyst with the Massachusetts Health Care Finance and Policy Division and has been part of expert teams focusing on health care reform in both China and the US.
While the number of cases of infectious diseases has decreased in China, chronic disease is rising. One reason for the increase is the country's aging population. The United Nations projects that by 2050, nearly 24 percent of China's population will be 65 years of age or older, far above the world's projected average of about 15 percent.
As China's population ages, chronic disease will increase significantly, according to various research and surveys carried out in recent years.
For example, one survey in 2006 - of Shanghai residents by the Shanghai Academy of Social Science - found that 74 percent of respondents 65 years old and above suffered from chronic disease, compared with 5 percent of respondents between the ages of 18 and 34.
Urbanization is another factor affecting China's health problems.
In 1952, 12.5 percent of China's population lived in urban areas; in 2008, nearly 45 percent did. The lifestyle changes that come from living in a city have increased chronic health problems, such as obesity, diabetes and high cholesterol.
For example, according to a 2002 survey published by People's Health and Hygiene Press, 10.6 percent of the population in China's large cities was obese, compared with 4.3 percent in rural areas. Urban Chinese also reported a greater number of cases of cancer, hypertension and heart problems.
Rural China faces its own health problems. According to the Health Ministry, life expectancy in large cities like Shanghai and Beijing is around 78 years, compared with an average 64.4 in semi-urban areas. The mortality rates of newborns, infants, children and pregnant women are far higher in rural than in urban China.
Rural residents do not spend as much money on health care as their urban counterparts. In 2007, rural residents spent 349 yuan (US$51) per capita, while urban residents spent 1,480 yuan.
Health insurance is not filling the gap. Although coverage today is widespread thanks to rural cooperatives introduced a few years ago - around 13 percent of China's population is uninsured, compared with 16 percent or so in the US - health insurance benefits are often thin.
One upshot is that patients often end up paying a large part of their medical bills themselves. Sheldon Dorenfest, an international expert on health care systems improvement, said almost 60 percent of health care costs in China are paid directly by patients.
Medicine accounts for a big part of the cost of hospital visits, according to data from the Ministry of Health that Dorenfest presented.
The cost of an average outpatient hospital visit in 2007 was 136 yuan, or about US$20. Of that, about half was spent on drugs, slightly more than one-third on tests and even less than that on medical services.
Poor doctors
China also suffers from a lack of qualified physicians. Although China has more physicians per capita than in many other countries - including India and Nigeria - few are fully educated.
"Less than 1 percent of physicians (in China) receive a doctoral education and only one-third of physicians have received college-level education or above," Cai said.
China's education system isn't to blame. Enrollment in China's medical schools has been high. Between 1998 and 2007, 1.46 million students graduated from medical schools in the country.
But less than one-fourth become physicians. "That is a huge problem," Cai observed. "Why don't people want to be doctors? It's the opposite in the US."
The small numbers could be linked to the profession's low salaries.
"Physicians are not compensated the way they are compensated in other countries," said Dorenfest. "That creates a variety of incentives to earn money in certain illegal, and some corrupt, ways. Those incentives mess up the health care system."
Many medical school graduates decide to join the sales teams of pharmaceutical companies rather than becoming doctors because the pay is better.
In China, physicians' salaries are kept low by government regulation and drugs are sold by hospitals instead of pharmacies.
The result: Doctors' consultations are cheap but medicine is expensive, because hospitals mark up the price. Hospitals "have to make money from the drugs because they can't really compensate for their labor or services," Cai said.
Dorenfest and Cai reckoned reforming physicians' salaries in China is a pivotal step to increasing the supply of doctors and improving China's health care.
(Reproduced with permission from Knowledge@Wharton, http://www.knowledgeatwharton.com.cn. All rights reserved. Shanghai Daily condensed the article.)
Health care spending per capita has been increasing in China, growing 16 percent annually on average since 1978 and is expected to grow 20 percent in 2009 and 2010, according to data from China's Ministry of Health.
"We see the potential that economic growth will eventually create more demand for health care," said John Cai, a former professor of economics at Fudan University in Shanghai and an expert on health care reform in China. "At the same time, there are some barriers holding back improvement."
One striking result of China's rapid economic growth is that the country "shows very similar problems now to developed countries," noted Cai, a senior health policy analyst with the Massachusetts Health Care Finance and Policy Division and has been part of expert teams focusing on health care reform in both China and the US.
While the number of cases of infectious diseases has decreased in China, chronic disease is rising. One reason for the increase is the country's aging population. The United Nations projects that by 2050, nearly 24 percent of China's population will be 65 years of age or older, far above the world's projected average of about 15 percent.
As China's population ages, chronic disease will increase significantly, according to various research and surveys carried out in recent years.
For example, one survey in 2006 - of Shanghai residents by the Shanghai Academy of Social Science - found that 74 percent of respondents 65 years old and above suffered from chronic disease, compared with 5 percent of respondents between the ages of 18 and 34.
Urbanization is another factor affecting China's health problems.
In 1952, 12.5 percent of China's population lived in urban areas; in 2008, nearly 45 percent did. The lifestyle changes that come from living in a city have increased chronic health problems, such as obesity, diabetes and high cholesterol.
For example, according to a 2002 survey published by People's Health and Hygiene Press, 10.6 percent of the population in China's large cities was obese, compared with 4.3 percent in rural areas. Urban Chinese also reported a greater number of cases of cancer, hypertension and heart problems.
Rural China faces its own health problems. According to the Health Ministry, life expectancy in large cities like Shanghai and Beijing is around 78 years, compared with an average 64.4 in semi-urban areas. The mortality rates of newborns, infants, children and pregnant women are far higher in rural than in urban China.
Rural residents do not spend as much money on health care as their urban counterparts. In 2007, rural residents spent 349 yuan (US$51) per capita, while urban residents spent 1,480 yuan.
Health insurance is not filling the gap. Although coverage today is widespread thanks to rural cooperatives introduced a few years ago - around 13 percent of China's population is uninsured, compared with 16 percent or so in the US - health insurance benefits are often thin.
One upshot is that patients often end up paying a large part of their medical bills themselves. Sheldon Dorenfest, an international expert on health care systems improvement, said almost 60 percent of health care costs in China are paid directly by patients.
Medicine accounts for a big part of the cost of hospital visits, according to data from the Ministry of Health that Dorenfest presented.
The cost of an average outpatient hospital visit in 2007 was 136 yuan, or about US$20. Of that, about half was spent on drugs, slightly more than one-third on tests and even less than that on medical services.
Poor doctors
China also suffers from a lack of qualified physicians. Although China has more physicians per capita than in many other countries - including India and Nigeria - few are fully educated.
"Less than 1 percent of physicians (in China) receive a doctoral education and only one-third of physicians have received college-level education or above," Cai said.
China's education system isn't to blame. Enrollment in China's medical schools has been high. Between 1998 and 2007, 1.46 million students graduated from medical schools in the country.
But less than one-fourth become physicians. "That is a huge problem," Cai observed. "Why don't people want to be doctors? It's the opposite in the US."
The small numbers could be linked to the profession's low salaries.
"Physicians are not compensated the way they are compensated in other countries," said Dorenfest. "That creates a variety of incentives to earn money in certain illegal, and some corrupt, ways. Those incentives mess up the health care system."
Many medical school graduates decide to join the sales teams of pharmaceutical companies rather than becoming doctors because the pay is better.
In China, physicians' salaries are kept low by government regulation and drugs are sold by hospitals instead of pharmacies.
The result: Doctors' consultations are cheap but medicine is expensive, because hospitals mark up the price. Hospitals "have to make money from the drugs because they can't really compensate for their labor or services," Cai said.
Dorenfest and Cai reckoned reforming physicians' salaries in China is a pivotal step to increasing the supply of doctors and improving China's health care.
(Reproduced with permission from Knowledge@Wharton, http://www.knowledgeatwharton.com.cn. All rights reserved. Shanghai Daily condensed the article.)
- About Us
- |
- Terms of Use
- |
-
RSS - |
- Privacy Policy
- |
- Contact Us
- |
- Shanghai Call Center: 962288
- |
- Tip-off hotline: 52920043
- 沪ICP证：沪ICP备05050403号-1
- |
- 互联网新闻信息服务许可证：31120180004
- |
- 网络视听许可证：0909346
- |
- 广播电视节目制作许可证：沪字第354号
- |
- 增值电信业务经营许可证：沪B2-20120012
Copyright © 1999- Shanghai Daily. All rights reserved.Preferably viewed with Internet Explorer 8 or newer browsers.
