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China Demonstrates Open Mind on Health Care Reform

by Fred Fortin

Today’s Wall Street Journal feature article (subscription required) “China Seeks Advice on Health Overhauls” confirms what I have observed in my several recent trips to China (see my earlier post): namely, that China is casting a very wide net for ideas on how to address the serious problems it confronts in health care. Peking University, Fudan University, Beijing Normal University, the Chinese cabinet’s development-research center, the WHO, World Bank, McKinsey and others, both foreign and domestic, have been asked to wade in on the matter.

A number of conferences in China and around the world (both private and public) have been dedicated to the exchange of ideas on national health care models. China government continues to experiment with various pilot efforts, especially in rural areas, (see my earlier post) that seek to play out certain coverage schemes. And while the WSJ article makes clear that a consensus has yet to emerge, (we can all understand this dilemma) the wide ranging views being publicly entertained is a hopeful sign of some healthy internal debate.

In October 2006, Mao Qun’an, spokesman for the Ministry of Health, said the government would build a health care system with “Chinese characteristics“, rather than simply copy a “European model” or “American model”. This is a frequent refrain in these debates with the question being, what is the nature of these cultural and political dimensions that have to be included before the Chinese people will embrace the effort?

In this question lies some interesting considerations. Should China look to its history for the development of health care? By that I mean, is the tweaking (through more funding) and ongoing expansion of its government programs the way to achieve better access and outcomes? Or should China look towards its entrepreneurial and market strengths and place more reliance on private sector initiatives to bring the health care system into the 21st century. The Chinese government is considering both, and as we read in the WSJ, bureaucracies are lining up on all sides of the issue.

What I suspect to be ‘characteristically Chinese’ in these considerations will be in the blend of these forces that eventually crystallizes into a national program. I believe we are seeing history in the making here since the course that China follows will have implications far beyond health care and far beyond its borders.


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