China’s Rural Medical Health-Care Reform


China with more than 1.3 billion population must be commended for its effort in providing health care even to the remote rural areas.

It’s by no means an easy task, reflecting the care & consciousness of the Central Government to do their utmost for the people who had contributed much to the victory of the Communist Party.

Now, it’s the political will & desire and financial resources, which China has plenty of, to bring about this needed medical reform of its health-care system for millions of rural folks.

 In the early years, China’s rural medical scene was covered by teams of “Barefoot Doctors”. Such doctors were in fact farmers who received minimal basic medical and paramedical training who worked in rural villages in the People’s Republic of China. Their purpose was to bring health care to rural areas where urban-trained doctors were reluctant to go. They promoted basic hygiene, preventive health care, and family planning and treated common illnesses. The name was derived from southern farmers, who would often work barefoot in the rice paddies.

In the 1930s, the Rural Reconstruction Movement had pioneered village health workers trained in basic health as part of a coordinated system, and there had been provincial experiments after 1949, but after Mao Zedong’s healthcare speech in 1965 the concept was developed and institutionalized. In his speech, Mao Zedong criticized the urban bias of the medical system of the time, and called for a system with greater focus on the well being of the rural population. China’s health policy changed quickly after this speech and in 1968, the barefoot doctors program became integrated into national policy. These programs were called “rural cooperative medical systems” (RCMS) and strove to include community participation with the rural provision of health services. Barefoot doctors became a part of the Cultural Revolution, which also radically diminished the influence of the Weishengbu, China’s health ministry, which was dominated by Western-trained doctors.(Wikipedia)

The New Rural Co-operative Medical Care System (NRCMCS) is a 2005 initiative to overhaul the health-care system, particularly intended to make it more affordable for the rural poor. Under the NRCMCS, the annual cost of medical coverage is 50 yuan (US$7) per person. Of that, 20 yuan is paid in by the central government, 20 yuan by the provincial government and a contribution of 10 yuan is made by the patient. As of September 2007, around 80% of the rural population of China had signed up (about 685 million people). The system is tiered, depending on the location. If patients go to a small hospital or clinic in their local town, the system will cover roughly 70-80% of their bill. If the patient visits a county clinic, the percentage of the cost being covered falls to about 60%. If the patient requires a specialist in a modern city hospital, the plan would cover about 30% of the bill.(Wikipedia)

The Government’s effort is further augmented by non-profit organisations, individuals & doctors themselves who undertake to provide free service. 

Receiving expensive medical treatment is a challenge for many people, particularly those from rural areas. Many have to travel from village to town, to big city hospitals in search of medical care. It’s both time-consuming and costly, besides not being able to find the right needed expert help.

But now, with this new ‘Doctors for Rural Areas’ initiative, doctors and other medical experts come to their communities. There are no fees and no waiting lists. The doctor-patient relationship is simple and direct.

A patient says, “The great thing is that, for us ordinary people, getting to see a doctor is easy. We’re happy because we don’t have to go to the towns or cities. But there are too many people here!”

Liu Yong, the founder of the ‘Doctors for Rural Areas’ scheme, also deputy director of the department of medical oncology, came up with this idea two years ago which won support from the hospital. He says providing practical help is a doctor’s duty.

Liu says, “I am concerned about health conditions at the grassroots. I work in a large city hospital, and although we see some farmers, the majority of rural people, especially in rural areas, don’t always get access to the treatment they need.”

After seeing a patient, a doctor will often give them their phone number so they can keep in contact. This isn’t a hospital requirement, the doctors do it out of care for the patients.


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Liang Jun of “Doctors for Rural Areas” scheme, says, “I’ve found that by providing these free clinics, we ensure people overcome the often expensive and difficult problem of getting to see a doctor. For me, it is a glorious thing.” Liu also says, “This work is helping me find a clinical focus for my future work. By combining my specialty with the needs of the people, I hope that I can really apply what I have learned. “

Zhang Peiying, president of Xuzhou central hospital, says, “We run ‘Doctors for Rural Areas’ in order to get medical care direct to the people. It’s also good for the doctors. It gives them a real sense of providing service to the community.”

Seeing a doctor in the rural areas is no longer a problem or a major challenge. The free clinics, medical staff are also bonding in a way that seldom happen in a doctor-patient relationship.

Crucial medical reform is truly happening

With professionalism & dedication growing!


3 thoughts on “China’s Rural Medical Health-Care Reform

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