System now worse off, with huge bills and the poor ignored, report finds Beijing should shoulder the blame for malpractice in the country's ailing health system that has resulted in exorbitant medical bills and excluded the poor from proper care, says a report by a group of health policy analysts and advisers. In a damning annual report on the state of the nation's health, the analysts said 10 years of medical reform had created a system plagued with problems caused by a 'lack of government financial support, inadequate official supervision and improper government intervention in some areas'. The report - the 'Green Book of Health' published by the Chinese Academy of Social Sciences Academic Press - said that instead of improving the quality of the health service, the central government-led reforms had made the system more inefficient and inequitable. Outlining the system's main maladies, the report said sick people did not dare to go to hospital; hospitals had extravagant infrastructure, including star-rated wards and hi-tech machines; doctors had been turned into businessmen; and low-cost medicine had become scarcer at hospitals. A report last year by the State Council's Development Research Centre declared the reforms a failure, mostly because of commercialisation. But the Green Book's authors argued this was not the main reason. Du Lexun , the report's editor-in-chief and commissioner of the Ministry of Health's Policy and Management Research Commission, said poor financial support from the government starved state-owned hospitals of cash, forcing them to charge patients. Government allocations accounted for only 15 per cent of the nation's health-care costs in 2002, less than a half of the 38 per cent two decades ago. 'For instance, if the 1982 spending ratio had continued, the government should have spent another 134 billion yuan [in 2002]. But it only spent 90 billion. The problem of the high cost of seeing a doctor is the result of government action,' Professor Du said. The report, said health authorities, supposed to defend the rights of patients, often sided with public hospitals because they were also the facilities' 'general manger'. 'In the current system, the government has a triple status of athlete, coach and referee,' Shi Guang , head of the National Health Economics Institute's Policy Study Department, said in the report. The report's authors advocated setting up a state-level regulatory body emulating the US Department of Health and Human Services, to monitor all health-related departments. To tackle the most urgent problem - high medical costs - the report suggested 'completely separating pharmacy charges from the hospitals'.
