China Bio Law

I’ve decided to devote a section of my blog to maintaining up to date profiles of certain aspects of Chinese Biolaw.  My first will be the reform of the Chinese public healthcare system.  I recently read a book called China: Bioethics, Trust, and the Challenge of the Market, which I have mixed feelings about, but it nevertheless had a wealth of information about the history and current status of China’s developing healthcare system.

There is currently no shortage of journal articles written on this topic.  However, information gets dated fast and the language barrier can also act as an impediment to the dissemination of information.  So I hope to create an easily accessible online index of valuable English and Chinese resources for doing research on China’s healthcare system, and continuously input any major updates.

I’m first looking at the WHO‘s current (2009) country profile for China.

Demographically and socioeconomically, it’s the same old story:

• The largest population, 1.3 billion people (although by 2025 India’s population is projected to be roughly commensurate with China’s);
• An aging population, by 2035 a quarter of the country will be more than sixty years of age; 
• An urbanizing population, by 2030 fully half of China’s population will live in urbanized areas (although the rural population as of 2007 was already 56%);
• A population lifted out of poverty, over the past 30 years ~400 million people have been lifted above the international poverty line (US $1) (accounting for ~75% of the developing world’s poverty reduction!);

Politically, healthcare is part of the vanguard of China’s new policy direction.  China’s 11th Five Year Plan (2006-2011) is seeking to introduce “five balances,” and among them is a balance between social and economic development.  The portion of social development that interests us here is the push to support medical care and public health.

This is a no-brainer for the Chinese; solving China’s health care problems will be a key part of resolving social unrest in China.  There are clearly existing and emerging trends in threats to the people’s health that are distributed primarily into environmental, workplace, and lifestyle problems.  The divide between rural and urban health and income continues to grow and is another one of the targets of China’s newest Five Year Plan.  Up to 30% of China’s poor state that health is the primary cause of their poverty (it leads to reduced earning capacity on top of potentially financially-catastrophic medical expenses).  The economic recession also presents dangers for China, because reduced local government earnings may interfere with local governments’ budgetary allocation for healthcare or even encourage them to seek extra revenue by increasing fees or otherwise reducing costs in the healthcare system.  Worse, despite the central government’s social development policy, countervailing economic considerations may encourage the promotion of consumption (e.g., unhealthy food, alcohol, tobacco) at the expense of health considerations.

This is the brief background presented by the WHO report.  I do not think I adequately presented the key link between China’s healthcare status and social unrest, but that’s really a topic in itself.  In the next post I will start giving the nitty gritty on health specific statistics and a description of the development of China’s healthcare infrastructure.