Healthcare in China
[1] Despite this, public health insurance generally only covers about half of medical costs, with the proportion lower for serious or chronic illnesses.
In 2020, the country's commercial health insurance premium income amounted to 817.3 billion yuan, with an average annual growth rate of 20%.
Companies such as AstraZeneca, GlaxoSmithKline, Eli Lilly, and Merck entered the Chinese market and have experienced explosive growth.
[4] According to Sam Radwan of ENHANCE International, China's projected healthcare spending in 2050 may exceed Germany's entire 2020 gross domestic product.
The special administrative regions of Hong Kong and Macau maintain their own separate universal healthcare systems.
When the Chinese Communist Party (CCP) took power in 1949, national "patriotic health campaigns" and local governments successfully introduced basic sanitary measures and preventative hygiene education.
Health care was provided through the place of work, such as the government bureaucratic unit, the enterprise, factory, school, or, in the countryside, the cooperative or commune.
On June 27, 1952, the Instructions of the Administration Council on the Practice of Free Medical Treatment and Prevention for State Functionaries of People's Governments at all levels, parties,[10] organizations and affiliated Institutions were issued.
[9]: 9 However, beginning with economic reforms in 1978, health standards in China began to diverge significantly between urban and rural areas and coastal and interior provinces.
[19] Urban residents also faced healthcare privatization as they were laid off from state-owned enterprises and lost much of their social security and health benefits.
By 2011 more than 95% of the total population of China had basic health insurance, though out-of-pocket costs and the quality of care varied significantly,[4] particularly when it came to serious illnesses among children.
[24] CCP leadership cadres have access to a dedicated healthcare system under the jurisdiction of the General Office of the Chinese Communist Party.
Their quality varies by location; the best treatment can usually be found in public city-level hospitals, followed by smaller district-level clinics.
Dental care, cosmetic surgery, and other health-related services at Western standards are widely available in urban areas, though costs vary.
The threat from non-communicable disease is worsened by behaviors like sedentary lifestyles, high alcohol consumption, and smoking as well as air pollution.
[35] In 2022, the BBC's chief international correspondent Lyse Doucet said China had a very good healthcare system including at the provincial level.
[50] Neither of these regulations, though theoretically still in effect, reflect the full reality of undergraduate and postgraduate degree programs in the early decades of the 21st century.
Various traditional preventative and self-healing techniques such as qigong, which combines gentle exercise and meditation, are widely practiced as an adjunct to professional health care.
[62] In the 1950s and early 1960s, employees of enterprises covered by the Labour Insurance Regulations were required to pay for medical treatment, surgery, hospitalization, and general medicine for general illnesses, non-work-related injuries, and disabilities, but the cost of expensive medicine, hospital meals, and travel expenses were borne by the employees themselves.
[62] In 1966, the Ministry of Labour and the All-China Federation of Trade Unions issued the "Circular on Several Issues Concerning the Improvement of the Labour Insurance Medical System for Enterprise Workers,"[62] which appropriately lifted the burden of medical treatment on individual workers to prevent phenomena such as "soaking the sick" and "treating small illnesses in a big way.
Only the most seriously ill patients were referred to the third and final tier, the county hospitals, which served 200,000 to 600,000 people each and were staffed by senior doctors who held degrees from 5-year medical schools.
To ensure a higher level of care, several state enterprises and government agencies sent their employees directly to the district or municipal hospitals, circumventing the paramedical, or barefoot doctor, stage.
[70] Due to the state's failure in regulating prescriptions drugs in general and silencing discourse related to trans people, many trans people have to access such prescription hormone replacement therapy (HRT) drugs through black markets, which comes with its own risks of inappropriate dosage/wrong combination and subpar quality.
[71] In recent years, despite the state cracking down on queer content online, progress has been made in regards to gender affirming care.
[77] In 2016, a study reported that a large number of doctors and patients conspired to erode medical insurance funds in China.
[78] Several media outlets have disclosed that the ways of eroding the medical insurance fund included farmers being "hospitalized" for non-medical reasons, treating patients without illness, falsely reporting the number of days a patient is hospitalized, fake medication prescription, fake surgery, excessive unnecessary examinations, serious treatment of minor illnesses, repeated charges, creating empty charges, listing surgical treatment expenses that are not within the scope of reimbursement, and retail pharmacies accepting medical insurance cards for daily necessities.
Therefore, in addition to the common phenomenon of hospitals investing in pharmacies, it was also a norm for salesmen of many pharmaceutical companies to travel to doctors' homes to offer dividends.
This presents a feasible way for hospitals to make money by instructing patients to purchase medicines in certain pharmacies at their own expense.
In the beginning of 2019, the General Office of the State Council issued the document "Opinions on Strengthening the Performance Evaluation of Tertiary Public Hospitals".
At this stage, patients, unfortunately, encounter problem of having to pay for certain medicines their own expense when they didn't have to, but they can defend their rights and interests using legal disputes listed below:
