Deepening Medical Reform for the Benefit of All

Editor's note: This article is a compilation of the speeches of Li Keqiang, member of the Standing Committee of the Political Bureau of the CPC Central Committee and vice premier of the State Council, at the National Conference on Deepening the Reform of the Medical and Health Care System, and the 9th Plenary Meeting of the Leading Group of the State Council for Deepening the Reform of the Medical and Health Care System, along with excerpts from speeches made at other meetings.

The issue of medical and health care reform is a contentious issue worldwide. In recent years, many countries have promoted the reform of their medical and health care systems, yet they have faced seemingly insurmountable problems at every stage.

China's deepening of its medical and health care reforms is an important livelihood project which aims to safeguard the health and happiness of more than 1 billion people. In the more than two years since its launch, the reform has had a positive impact and made significant progress. Thanks to the trailblazing nature of its scope and reach, much has been learned and a solid foundation has been laid for the next stage of the reform process. Certain problems remain, however, and they must be solved as a matter of urgency; therefore, it will still take some time to hit the 2020 overall targets set for the reform of the medical and health care system.

I. Importance and Urgency of the Reform of the Medical and Health Care System

The initial results of the reform of the medical and health care system are as follows:

First, the expansion of the coverage of basic medical security. Nearly 6 million retirees from state-owned enterprises which are no longer operating have had their medical insurance-related problems comprehensively addressed. Medical insurance programs now cover 1.28 billion urban and rural residents. This means that the country's basic medical insurance programs have so far benefited 95% of the Chinese population.

Second, the service capabilities of grassroots medical and health care institutions have been significantly enhanced. More than 2,000 county-level hospitals and more than 30,000 grassroots medical and health care institutions have been renovated. Training programs have been instigated in order to nurture grassroots medical and health care practitioners, especially general practitioners. So far the programs have provided free training for around 10,000 medical students for grassroots institutions in western and central China. They have also facilitated the hiring of more than 20,000 medical practitioners for health clinics in towns and townships, and trained millions of practicing medical staff.

Third, progress has been made in ensuring that basic public medical services are received fairly and equally. The ten categories of national basic public medical service programs and seven key public medical service operations have been carried out across the country. Per capita expenditure has been gradually increasing and a wider range of people are now benefiting from public medical services.

Fourth, the establishment of the essential medicine system and pilot reform of public hospitals continue to be advanced. The essential medicine system has been implemented in all government-sponsored grassroots medical and health care institutions. As a result, the price of essential medicine in these institutions has fallen by approximately 30 percent and the expenses of outpatient and inpatient services have decreased correspondingly. The pilot reform of public hospitals and the pilot comprehensive reform of county-level hospitals are being carried out meticulously and methodically.

Fifth, the public health budget has increased year-on-year and from 2009-2011, the central government allocated an additional 331.8 billion yuan for the reform of the medical and health care system. Local governments also increased their budgets for the same reason. There have also been substantial increases in public expenditure on medical and health care services. This, combined with the continuing decline of the proportion of personal expenditure in the total cost of medical and health care, has taken the burden of medical care costs away from individuals.

The reform is now at a critical stage and is touching on more deep-seated problems, and will continue to do so. However, ensuring the progress of the reform is like battling against the current – we must forge ahead or be driven back.

First, it is crucial that we push ahead with the reform of the medical and health care system because of the desperate need to safeguard and improve people's livelihoods. Second, the further advancement of the reform of the medical and health care system is an excellent way to accelerate changing the method of economic development. Third, further advancing the reform of the medical and health care system is an important revolution in the country's social-economic sector.

Chinese Vice Premier Li Keqiang (second left) presides over a State Council meeting on deepening the country's healthcare reform in Beijing on November 29. [Xinhua]