'Healthcare for all' drives reforms

Sydney forum discusses challenges as China moves to middle-income status and population ages

One of the major challenges China faces as it continues on its path toward becoming a middle-income country lies in the government's avowed aim of providing "basic healthcare for all".

Cancer, heart disease and obesity - once considered diseases of the developed world - have become major health issues for the country.

The fact that China's population is growing older continues to add further strain on an already overstretched healthcare system. These were some of the issues discussed at the University of Sydney's China Business Forum on Nov 2.

The event, organized by the university's China Studies Centre, brought together public officials, business leaders and academics from both countries to discuss the opportunities and challenges faced by China's healthcare sector.

A report on Australia-China healthcare opportunities, released at the forum said as China moves toward becoming a middle-income country by 2020-21, the key challenge "will be to have a good, all-around living standard for its population".

"Even in the space of a few years, Chinese people will be wealthier, have higher expectations for public goods, and will increasingly live in cities and work in the service sector.

"Keeping this all-important emerging middle class - which could amount to 750 million people by the end of the decade - happy and healthy will be politically and economically crucial for the government and the country as a whole," the report said.

Produced by the China Studies Centre, National Australia Bank and the George Institute for Global Health, the report said healthcare will be one of the key beneficiaries from the China-Australia Free Trade Agreement.

"China's changing disease profile is having a fundamental impact on healthcare in China," Kerry Brown, the outgoing head of the China Studies Centre, told the conference in a pre-recorded message to launch the report.

He cited China's addiction to smoking as an example of the problems it faces. "China is the biggest manufacturer, grower and consumer of tobacco in the world," he said. "The health and financial burden this habit has placed on the Chinese healthcare system is only now starting to be realized."

The report also said the Chinese government plans to build 7,500 public hospitals over the next decade, which should create significant opportunities for private hospital operators from Australia.

In one of the panel discussions that focused on aging, Robert Glynn, who heads international development for the Ramsay Health Care Group, one of Australia's biggest private hospital groups, spoke about the company's development activity in Chengdu, capital of Southwest China's Sichuan province.

"People often ask, 'Why go to a second- or third-tier city? Why not Beijing or Shanghai?' I guess cost is one factor, but Chengdu is not a small city It has over 13 million people," he said.

Glynn added that Chengdu is a vibrant city that requires a wide range of healthcare services. "With China's aging population, this provides a good opportunity for us to expand down the line."

Liu Chuyang, trade commissioner at the Australian embassy in Beijing, said caring for the aged as well as hospital development and management provide excellent investment opportunities for Australian companies.

"China is currently shopping around the world to see who has the best system" for senior care, she told the forum.

Jin Zhiyong, the consul for science and technology with the Chinese consulate in Sydney, said China has entered a new stage in its healthcare reform.

"President Xi Jinping emphasized that the health of people was an important component in building a moderately prosperous society, and was the basis for everyone to grow up and lead a happy life," he said.

Major gains have already been made in China's healthcare system, he added.

"The universal health insurance system, the medical service delivery system, the basic public health service system and the drug supply security system have all seen continued development and improvement," he told the forum.

Increasingly, new services to meet people's health needs are also among the gains, Jin said.

"The economic burden of people in seeking medical services has been alleviated with the increased rate of expenses per visit in large hospitals in the cities dropping from 9.1 percent to 5.3 percent."

"The rate of hospitalization expenses had dropped from 12.7 percent before the reform to 3.9 percent."

Jin said the population health status has been further improved, with life expectancy increasing to 75 years, maternal death rate decreasing to 21.7 per 100,000 live births and infant deaths declining to 8.9 per 1,000 live births.

But despite China's progress in healthcare reform, "there is still a gap between what we have achieved and what we are aiming at, which is to realize basic healthcare for all", he said. "We are going to break down the systematic obstacles that hinder health development."

He said measures will be taken to further "eradicate" the system of compensating medical practitioners through drug-selling profits. Modern hospital management systems will be established and improved to elevate the standard of scientific management of hospitals, Jin said.

"Public hospitals will be directed to return to the path of providing public welfare, to further reduce the economic burden of people seeking medical services," he said.

Jin said China is going to "drive forward" a system of universal medical insurance coverage.

"Reforms of the management and operation systems of medical insurance schemes will be actively explored to further improve standards," he said. "Commercial medical insurance programs will be strongly promoted to meet the diversified and multi-phased needs of people on medical insurance."

Jin said the reform of local health institutions will go deeper to motivate health workers and strengthen the training of general practitioners. By 2020, it is hoped that every family in China will have access to a qualified general practitioner, he added.

He also said the ordering and distribution of drugs will be regulated as part of the reform efforts.

"The ability to maintain drug supply and drug security at local levels and remote areas will be strengthened, and the mechanism of seldom-used drug supply and early warning will be improved to further secure drug supply and quality," Jin said.

Another area that was widely discussed at the forum was the use of technology to improve the collection and analysis of medical data.

Barry Lerner, chief information officer for the South Pacific region at Huawei Technologies, told the forum how big data was now "coming together".

"We are working in some countries now where you can monitor someone from the cradle to the grave," he said.

David Feng, who heads the University of Sydney's School of Information Technologies, cited a project in China that is collecting health data on more than 100 million people.

"This is a massive project. But once the data is collected, you will have one place to go to get the full picture of a person's health. The possibilities are endless," he said.

Xu Weiwei contributed to this story.

karlwilson@chinadailyapac.com

(China Daily Africa Weekly 11/13/2015 page23)