"Not long before the date for our wedding, my fiance was diagnosed with uremia. We borrowed as much money as we could but we still couldn't afford the cost of the operation," said Chen Yuehua, a young woman from north China's Inner Mongolia.

The diagnosis last November cast a shadow over the life of Chen and her fiance, both of whom are very poor. They needed over 100,000 yuan for the kidney-transplant operation, but only had 2,000 yuan.

Luckily for the young couple, many people read Chen's help-letter on a web chatroom and enough donations came in for the surgery to be successfully conducted in February.

Yu Fucang, a 43-year-old laid-off worker in Chaoyang city in northeastern Liaoning Province, was not so lucky.

"My wife went to hospital with hepatitis," Yu said, with a lump in his throat. "But later I could no longer pay her medical bills."

A few months later, Yu's wife died of hepatocirrhosis in her own bed with her husband sitting by side.

"Charitable donations can't save every poor person's life. If we really want to make 'couldn't afford the medical bills' a thing of the past, we must set up a sound medicare system that covers everyone," said Zhang Kangkang, famous authoress and member of the National Committee of the Chinese People's Political Consultative Conference (CPPCC).

At the end of last year, basic medicare covered 157 million Chinese urban residents but another 400 million -- low-income residents, laid-off workers, students and old people -- have no access to health insurance.

Even those who enjoy medical cover face thresholds on expenses which means they cannot afford the high medical expenses if they are taken seriously ill.

"People are reluctant to pay too much for medicine so they put off going to the doctor. Then a minor disease may develop into a serious one and hospital ends up consuming all their savings." This point of view is often heard among ordinary people.

"Many well-off families tumble into poverty - almost overnight - when they start paying medical bills," said Zhang. "Extending medicare coverage should be at the top of the government's agenda."

To the extent that affordable medicare services are unavailable, individual provinces or cities can take measures such as subsidizing public hospitals or setting up "benevolent hospitals," Zhang added.

Since 2003 eastern Zhejiang Province has set up a few "benevolent hospitals" where low-income patients can get discounted care if they contract a serious illness. A uremia patient in one of the "benevolent hospitals" pays only 3 percent of the regular price, said Zhang.

This year the central government says it will start a trial basic medical insurance covering major illnesses for urban residents, with the government subsidizing poor people.

"The state council has begun formulating a plan for deepening the reform of the medicine and health care systems in order to make medicare services more accessible, an issue of genuine public concern," Chinese Premier Wen Jiabao said.

"Health comes first, whether you are rich or poor. If everyone had access to reasonably priced medical services, they would not lose hope even when they are deadly ill, " Chen Yuehua said, after learning of the premier's pledge.

(Xinhua News Agency March 10, 2007)