With limited resources, China has made significant strides in healthcare over the past half a century. But it still has a long way to go.
Large disparities in healthcare exist across geographical localities and socio-economic groups — and these disparities are growing at a time of significant transition and transformation, as China's economic boom benefits millions but also leaves millions behind. China's poor and vulnerable, particularly in rural areas, benefit little from public spending on health. In poor regions, the authorities provide fewer and lower quality services, and individuals end up paying a higher share of the costs out of their own pockets. For many, healthcare is not even an option — it is simply unaffordable.
Indeed illness is often a ticket to financial ruin. Surveys estimate that between 30 to 50 per cent of China's poor are driven into entrenched poverty by costs related to illness and injury. Many simply refuse treatment. Some 75 per cent of rural residents and 56 per cent of urban residents cite being unable to afford the bills as the reason why people refuse hospital care following a doctor's referral.
Health-related responsibilities are spread across many ministries and government agencies in China, in addition to the China's Ministry of Health. This creates a health system with broad political foundations. But it also makes it difficult and costly to develop policies on health that are consistent from ministry to ministry and based on common principles. In addition, health financing in China, both public and private, is biased towards treatment rather than the more cost-effective approach of prevention.
WHO China's Health Sector Development team works with the Chinese government to improve China's health system. Specifically, this work emphasizes the benefits of adopting health policies that are based on evidence and capable of giving China's poor fairer access to essential health services.