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How a village doctor sees health reform

(Xinhua)
Updated: 2009-04-08 14:33

BEIJING -- Mou Yang called it a day after seeing about 20 patients. Together with another village doctor, Mou oversees the care of about 1,600 villagers in Xihu Village in Fengdeng Township in Jinfeng District in Yinchuan, Ningxia Hui Autonomous Region.

The clinic has been under a pilot medical reform for almost two months. villagers can see the doctor for 30 common sicknesses and it costs only one yuan ($0.15). And they can get 74 kinds of basic medicines at nearly cost prices.

It's a small step in China's journey to provide improved medical services to all.

"The patients visiting my clinic have doubled every day now. They welcome the changes," Mou said.

Similar changes will follow in more villages across China.

The country unveiled a three-year action plan Tuesday, which the government said would lay a solid foundation for equitable and universal access to essential health care for all.

Under the 850 billion yuan plan for 2009 to 2011, the government promised universal access to basic health insurance, introduction of an essential drug system, improved primary health care facilities, equitable access to basic public health services and a pilot reform program of state-run hospitals.

The old medical system has been criticized for its imbalances in medical resource distribution.

"In the past, villagers would go to hospitals in the town if they were sick and neglected the poorly-funded village clinics," said He Weidong, director of Jinfeng District Health Care Department in Yinchuan.

"Now the government dispatches basic drugs to village clinics and villagers can get them at almost cost prices. An increasing number of villagers are now willing to turn to village clinics for help if they are suffering from minor illnesses," He said.

According to the action plan, China will institute an essential medicine system within three years to drive down prescription costs. The system includes a list of essential medicines that would be produced and distributed under government control.

Though the reform has been anticipated by many, it isn't a cure-all to village doctors like Mou.

"I can feel the pressure," Mou said, "I earned about 2,000 to 3,000 yuan a month in the past, but now I can only earn about 1,500 yuan a month.

"We can treat 30 kinds of minor sicknesses such as a cold or a cough, but if villagers were suffering from other illnesses, they would turn to the other clinic in our village," Mou said.

That clinic did not join in the pilot health care reform.

"Now it earns much more money than before. They could provide services for chronic diseases such as high blood pressure and heart problems, but we are not even allowed to provide drip services -- the drips are beyond the 74 very lowly-priced medicines," Mou said.

Mou's house served as an outpatient room, too. He receives patients in the daytime and sleeps there at night.

"Now the government said the clinic has to be standardized and must be used to receive patients exclusively. So I can't live in the room and my wife and I have to share the other room with my seven-year-old daughter and my mother."

"I spent 30,000 yuan on the house in 1998, but don't have a decent place to live in now. The other room has to be used as an outpatient room to make a living," Mou said, "I hope the government could invest more on rural clinic construction."

"We hope the reforms could help improve rural doctors' condition," Mou said.

Mou's mother, Mou Xiuzhen, had been a bare-footed doctor since the late 1960s. She watched the village clinic turn from a collectively-owned one to a private one in the 1980s.

"She took care of the villagers for decades, but now she could receive no pension or anything after the retirement," Mou said.

Credited with providing basic free health care to all Chinese, China once won honors from the World Health Organization and the World Bank in the 1960s for its excellence in medical services.

The public health system, however, was largely dismantled in the 1980s amid economic reforms. Seeing a doctor became far more expensive and the gap between rural and urban health care began to grow.

The health care reforms should stress social equality to provide basic medical services to all, said Xiang Chunling, a professor with the Party School of the Central Committee of the Communist Party of China.