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Brief Introduction of the Health System in China
By Yan Huang

Health System in China is developing rapidly. It has made great achievements and provided benefits to many Chinese people. However, the existing system has some problems that we have to face and solve. My paper will show the structure of this health system; how is it financed; how does the prevention work and also some health issues. I will find and discuss the problems found in these fields.

When discussing the health system in a country, we are going to look at many different aspects. Just like every skyscraper needs the support of groundwork, a health system is largely influenced by its structure. The stability of the structure decides whether the health system will run effectively or not. So today let's start with the structure of the health system in my country China first.

There is a proper description about the structure of Chinese health system. It says that the health system is structured by a three-ladder net. It is correct as we follow the mode of "Central Ministry----Urban Ministry----Rural Department".

These three ladders are the stanchions of the health system and they also manage several different branches: health administration; health research and development department; health prevention and protection department; health education department and the department in charges of the management, distribution and inspection of pharmacy and other equipment. Every department is leaded by the upper level and is responsible for different fields of health in order to maximize the working efficiency.

However in these years, the structure of the Chinese health system has changed a lot. Now it does not look like ladders. People give it another visual description------an upside-down pyramid.
Why? It is mainly because of the unbalance of the structure and overmuch using of facilities and human resources. Nowadays in China, most health facilities centralizes in urban areas, while at the same time there are only less than 8.9% in rural areas. The resources I've mentioned include most of the resources in health system such as financing, hospitals and clinics, health insurance and human resources. I would like to say something more about human resources. Every year, we have more than 100, 000 new medical workers however we are still facing the deficiency of medical workers in rural areas. There are only 2.7% professional medical workers in rural areas now. The denseness in urban areas and the deficiency in rural areas have become a livid contrast. They just like the top and the bottom of the health system and make it like a pyramid. This kind of structure causes serious social problems.

Next, let's talk about how the health systems are financed.

The financing of Chinese health system largely depends on the bankroll of government for a long time. And it is almost the only way.

These years, with the rising of health service cost and medicine price, people seem to be less affordable to get health services. For example, the one-off expense of outpatient and inpatient rises from 10.9RMB and 473.3RMB to 79RMB and 2891RMB separately from 1996 to 2006. Facing this abyss, the funds from government is not enough to fill it. May be it is time to change our mind. Some experts suggest that we should welcome social financing into the health system. The government has also realized this, now they are trying to find out the way to restrict the social financing and let them be am active role in their part.

One of the issues of health system is prevention the disease. Before we start talking this issue in China, we need to have a general idea of it.

Prevention is implemented in three different levels called "Three Levels of Preventions".

The Primary Prevention: it is taken as a primordial prevention in order to avoid the danger of the disease. From a large view, every country takes primary prevention to minimize the latent threatens of disease considering the national development. The third aim of primary prevention is to prevent the disease effect on a human's body.

The Secondary Prevention: it means to discover; diagnose and treat in clinical forepart. As each disease takes a long period of time. So it will be beneficial to take early medical treatment before it goes worse. The best way of secondary prevention is propaganda and education. It is also necessary to improve the diagnostic skills of doctors. The Tertiary Prevention: it is a kind of prevention during the clinical treatment. The prevention is taken to stop the disease becoming worse, to reduce the syndromes and deformity. For those patients of serious diseases or some one who has lost labor ability or even is handicapped, the aim of tertiary prevention is to make them available to some light works and to prolong their lives.

The prevention work in China is urgent and necessary. Former experiences show the achievements and also point out the problems during the work. These years with the leading by national disease prevention center and effective implementation of local departments, we have some great achievements.

In the primary level, the danger of disease is fully recognized, the government is taking action aiming at putting the disease prevention into effect on everyone no matter sick or not. All different health levels have also used effective methods such as regular medical examinations to every one. All these work are important to prevent the disease before it occurs. Also, we have stopped variola, leprosy and some other disease in our country.

In the secondary level, propaganda and education are put much more attention. A recent example is the national health promotion event. It is the biggest national activity. In fast three years, this event was hold in 23 provinces especially in 460 rural areas. There were over 8000 hospitals and 33000 doctors educated during the time, over 3, 000, 000 people got benefits from the event.
In the tertiary level, we also have some achievements. After hard prevention, we have successfully controlled the death rate of heart and cerebrovascular disease. And the living rates of one, three and five years of liver cancer patient are up to 74.1%, 43.5% and 21.2%.

Although we have these achievements, our country is still facing some hard issues. The minister of health said in this year we still have some problems in preventing fateful epidemic disease. The existing problems are: lack cognition of epidemic disease; prevention is less efficient and the feedback of the epidemic situation is not timely especially from rural areas.

One major health issue is about children's health.

We regard children as our future, so their health level is closely linked to our nation's development. Our prevention work on children's health these years has some achievement. We have successfully reduced the infant mortality to 2.84% since 2004 and have over 95% cover rate of bacterin inoculation in most areas. However, we are still facing some issues. The
Children's Health and Development 2006 shows that now in the country, many children are facing health problems such as cacotrophia, decayed tooth, infectious disease and adiposis. These years in some rural areas, the measles has the increasing trend.

Another issue which should be realized is the health problems of so called "moving children".
The moving labor force is very common in China. There are large population of labor force moving from one area to another with their family and children. The health quality of these children is discomforting. The National Disease Prevention Center promulgate that in the moving population of children, the death rate and the incidence of infection disease are much higher than the fixed population. These groups of children have low bacterin inoculation rate and receive little preventive support.

The government has noticed this hard situation and has taken actions to deal with it. Although the huge moving labor population is not common in other countries, we still found the way to deal with this problem from other countries.

Several years ago, the government started to lean the idea of "community" from western countries such as US. The community service at that time was new to China but was very mature in these countries. And the our government started to distribute some of the social services to each community such as health services, social insurance and work of education and family planning. These attempts gave very good results.

Now with the further popularization of community services, the government uses this way to deal with the children's health problems. We can see that health service and disease prevention work of moving children are brought into every community. The government takes the way called "centralized control and dispersive management." Also, these moving children are involved into the local disease prevention plan and have the same rights and interests as the local people.

This work is really meaningful, it is an example shows how the government deals with large and unfixed population. What's more, it is an effective method to abate the conflicts between large population and economy and labor force development.

The issue of children's health is just one example. As a country with large area and population, China is facing some hard issues. The unbalanced economy causes the huge difference of health level in different areas; the concentrated and sparse population in different areas makes the prevention work even harder.

The fact shows the primary success of prevention work in China. The work starts from the actual country situation, fully consider the interlocal and economic difference, and implement in the way combined with central control and management and local implementation and feedbacks.

It is also a good model for those countries have the same situation----large population and huge differences in health and economic development. Experiences tell us only wholly considering the needs of all different social classes and dealing every issue with idiographic methods will bring the maximal achievement. But one point which should be always put in the first is the improvement of the health quality of the entire nation.

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