Despite all that’s going on in Beijing and the sorry press it suffers these days, we’re starting to get a glimpse of the terms of the internal debate on health care reform as it spill out in the local media. A recent story in the Beijing Review points to the domestic battle over the role of the market when it comes to health care. It presents the contrasting views of two professors over why China’s health care system has failed its citizens. Professor Cai Jiangnan, from the School of Economics, Fudan University reveals a distinctly Chinese view of social equity and the distribution of health care resources between the majority of citizens who use the system infrequently and those who are seriously ill. Cai believes that the present system is designed to meet the minimal needs of the relatively well, while postponing meeting the needs of the seriously ill until some point in the future when the economy can afford health care to this minority. The government needs to change this priority, he says, with everyone having an “equal opportunity” for health care security. Since the government ” is still weak in market regulation and short of experience, it’s necessary to slow down the pace of the market-geared reform of health care services.”

A Professor Zhou Qiren, from the China Center for Economic Research, Peking University, in response argues that there is something seriously wrong in the supply and demand for medical services in the country. He lays the blame precisely at the feet of state-owned hospitals (where mostly all physicians in China are employed) and the government control and administration of the prices of medical services and medicines. Zhou observes, “some people criticize the marketization of medical services. I’m puzzled: This is by no means marketization”.

I’ve got the feeling that this is only the tip of the iceberg when it comes to the fierce exchanges that are now taking place all over China when it comes to health care reform.