Chinese villages eye health care for 1 RMB

Zhou Yujin and his wife Jin Qinglian spent their savings on Zhou's medical care.
One of the most telling things about China’s health care is a quote I once read from a construction worker who earns about $150 a month: "If you get cancer in China, don’t bother going to the hospital. They might not cure you, but you will go broke."

That pretty much sums up the current state of health care for millions of people in this country. Earlier this year, I met Zhou Yujin and his wife Jin Qinglian. Zhou does not have cancer, but his kidneys are failing and he is broke. “To (get) great treatment we need money. I don’t have money to stay in the hospital. I don’t have money so I get treated at home.” He used to work in a factory, and when he first fell ill, hospital bills wiped out the family savings in a month — about $7,000. Then the family racked up another $1,200 in bills, and they have been paying $150 a month for most of the year to buy Zhou’s medicine. His wife Jin works double shifts at a Beijing juice factory, but they can barely make ends meet. “We just eat noodles or buns. We expect nothing but to clothe and feed ourselves. We do not have extra to spend,” Jin said. Zhou seemed a little uneasy, embarrassed even, when he said: “In this family, most of the expenses are for me. They don’t spend a lot,” he said, referring to his wife and son.

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Not only is Zhou broke, but the family is deeply in debt to his parents — farmers who were hoping to have retired by now — as well as friends. Without proper medical care, there is little chance he will ever be well enough to get a job, so there is little chance the family will ever be able to pay off their debts. Beijing knows the health care system is in trouble. There’s little to show for past reform efforts. So, the government says over the next three years it will spend $125 billion (or less than $97 for each of China’s 1.3 billion people) to build more than 2,000 new hospitals and clinics, as well as cap the spiraling cost of prescription drugs. A pilot program is under way where patients in small villages receive health care for just one RMB (US$0.15). I went to a clinic in Xinshui, a tiny village in the Ningxia Autonomous Region in northwest China, which is participating in the pilot program. Arriving unannounced, I met Dr. Na Jing. Patients with flus and fevers, aches and pains, come and leave her small but busy clinic, and no one is charged more than 15 cents — and that includes medication. “I’ve been to the homes that are very poor, if we can give them better health care for less money, then their lives will be much better off,” she said. The villagers pay an annual insurance premium, a little less than $3, and the clinic is limited to treating just 30 medical conditions, like coughs and colds. Na also can prescribe only 74 different medicines. “If we can treat illnesses early, then the patients don’t have to spend a lot of money being treated at hospitals,” she said. This type of basic health care is similar to what were known as the “barefoot doctors” who during the days of Chairman Mao, went door to door, village to village. It was basic but effective health care. But economic reforms during the 1980s meant an end to the barefoot doctors, leaving hundreds of millions without any health care.

China is aiming to have some kind of universal health care coverage by 2020, but that will not be soon enough for Zhou. “How can I talk about the future in this condition We will take it one step at a time and see how far we get.”