China's Health Care Crisis

I'm Celia Hatton and this Letter from Asia comes to you from a country where over 700 million people lack access to basic health care - a nation grappling with health problems ranging from the threat of the bird flu to ballooning levels of obesity.

So what country is it? If you guessed China, you're correct.

The economy in China's cities is burning hot, but it's a different story in the country's rural areas - home to a majority of the population. As one Chinese health official put it, China faces problems on both ends of the spectrum - rich and poor.

All along, it's had to deal with illnesses common in the developing world -- problems like tuberculosis and malnutrition. But now, China's grappling with the same problems as developed countries: soaring cancer rates due to smoking, heart disease and an aging population.

This potent mix leaves China's government trying to stretch health dollars to deal with all these problems, leaving individuals who can afford it to make up the difference.

It's a fact that worries W.H.O. Representative, Dr. Henk Bekedam. According to Dr. Bekedam, "It is not right that people first have to look into their pockets before they actually can get the health care and the support that they need."

Luckily for Chinese leaders, many people living in urban centers have deep pockets; they're usually able to cover the costs of their own care.

But the health care gap isn't as easy to bridge in rural China. A pilot project provides 156 million people with basic insurance for just $1.50 a year, but critics argue it doesn't go far enough. Dr. Bekedam says, "There is not, in China, a good safety network. The insurance is very limited. The coverage is very limited and even those people who are insured, not all the drugs are actually available."

It wasn't always this way. In the heyday of Communism, China took care of its own, giving the same basic services to all and radically improving the nation's health in the process. But as the Chinese economy began to privatize, the safety net began to disintegrate. Today, government spending pays for the costs of just one in six Chinese.

Now, Chinese leaders are coming full circle. An outbreak of the highly contagious SARS disease, soaring AIDS rates and the bird flu could threaten economic progress, leading President Hu Jintao to unveil an ambitious plan to reform the country's health care system, eventually offering basic services to all 1.3 billion Chinese. But it will take time… A lot of time.

Every morning, elderly Chinese all over the country wake up to perform tai chi. It's thought to calm their minds and keep their bodies strong. These people, who witnessed the creation of China's Communist health care system and have also seen its decline, are now the most vulnerable as they age, and least likely to see the benefits of health care reform that could take decades to become reality.
By Celia Hatton