Embed Size (px)
Citation preview
Catalogue
Economy Development and Society Advancement..........................................................................4
1.Circumstance of the Province........................................................................................................4
2.Primary Characters of the Economic Development......................................................................5
3.The Population and Its Primary characters....................................................................................7
4.Traffic, Post and Telecommunications Facilities..........................................................................9
5.Education, Culture, Science and Technology..............................................................................10
6.Living level of Residents.............................................................................................................10
7.Social Security System................................................................................................................14
8.the Policy for Disadvantaged Groups..........................................................................................16
9.The Main Objects of Economy and Society in the Tenth Five-Years Plan..................................18
The Health Reform and Developing Actuality...............................................................................19
1.The Health Standard and Situation of disease.............................................................................19
2. The Demand of Hegelian Service...............................................................................................22
3. The Amount and Configuration Structure of Hygiene Resource................................................26
4.Quality and Efficiency of Medical and Health Care Service.......................................................30
5.The total amount, distribution and increasing rate of health care funding..................................32
7.Health care administrative management system..........................................................................35
8.Main issued health care policies and the effects of implement...................................................37
1.Health care economical policy.....................................................................................................37
2.Health care policies in the countryside........................................................................................38
3.Policies on the reformation of the health care prevention and supervision execution system....39
5.Policies on the reformation in drug distribution system..............................................................39
6.Policies on the price of medical health care service....................................................................40
Analysis on the main health care policy.........................................................................................40
1.The transformation of the government’s function does not apply to the development of the
communist market-oriented economic system...............................................................................41
3.The development of health care supervision executive department and personnel seriously lags
behind the need by the development of the market-oriented economy..........................................42
5.The public health care awareness and health care consumption sense need to be improved......43
6.The unbalance among the health facilities, insufficient investment and wasting of sources......44
7.The investment environment of the development of health care for the private companies
should be improved.........................................................................................................................44
9.The problems in the health care insurance for residents in the countries are prominent.............45
1
The suggestion on the main health care policy...............................................................................47
1.Reinforce the government’s function, support by the policies and macro management.............48
4.Continue to reform and renovate, improve the quality and efficiency and the health care service
........................................................................................................................................................53
5.Quicken the implement of the modernization in health care technology....................................54
6.Establish the system to share the risk of diseases, alleviate the diseases’ burden of the masses.55
Introduction
People’s health has dual meanings in the development of our country’s socialism
modernization. On one hand, health is the essential character of labor force, it is the precondition
that makes the education and economy input to converse more effectively, it also can expedite the
development of economy; on the other hand, health is the purpose of economic development and
the important content of the social development.
Our government think much of the people’s health, concern the development of the hygiene
business, and establish a series of hygiene policy that suits our country, tallies with the public
opinion and adapts to the market economy gradually to improve the development of the hygiene.
In the field of the country’s socialism development, hygiene is the component of the
macroscopic policy. Hygiene policy
has a close relationship with the country’s politics, economic system and the economy level; it
includes the economic policy, population policy and social security policy related with the
hygiene business. Hygiene policy embodies the character of the hygiene business, determines the
level of hygiene service, it has important effect to maintaining and improving the people’s health.
2
From the 50 years since the foundation of our country, especially the 20 years since the opening
reform in our country, through putting the series of hygiene policy making by our country into
practice, the hygiene business has greatly changed and achieved remarkable accomplishment in
our province as in other provinces. Retrospecting this course, summarizing and evaluating the
experience in the procedure of establishing and implementing the hygiene business are the
important work to improve the continuance development of hygiene business in our province.
It has four parts in this report:
The first part is to retrospect the main achievement getting through the development of
economy and socialism since the reform of our province. It reflects the character of innovating
the system, fostering the market, developing the demotic economy as one of the early areas in the
along the sea cities which developed the market economy.
The second part reflects the procedure of the reforming and developing of the hygiene business
in our country with the development of the economy and society in the 20 years. Surrounded the
basic aim of improve the health level of the people, it can reflect the hygiene reform and
development at its best from the need of hygiene service, the stock and configure structure of
hygiene source, the quality of the hygiene service and the rate of the increase in the hygiene fees,
the difference of the economy and hygiene level, management system and the main policy
conducted in these years.
The third part is the analysis to the main hygiene policy of Zhejiang province. The facing to the
pressure of curing infectious disease and chronic disinfectious disease, the prophylactic
difficulties of the large numbers of exotic people, the people’s economy funding setting foot in
hygiene business, etc. can be used for reference.
The fourth part is the thought and suggestion to the hygiene reform and development in the
future. In this, we considered the character of the economy and society development carefully in
order to making our province to fulfil the aim of the modernization of the socialism ahead of
time. The hygiene policy expatiated the thought of realizing the modernization of the socialism.
Through this report, we hope that, it can bring useful revelation to the people who established
the policy and performed it, in order to promote more effective management. Through the
implement of the policy, the hygiene organization can offer better service, the people can enjoy
fairly and effective service, and to raise the health level of our people.
In the drafting out procedure of this report, the related department of our province offer many
precious information to us, some specialist gave us technical consultation, the related official and
specialists of our country brought forward precious amending suggestion to the primary draft.
3
Especially the Statistical and information commission gave us great care and help to our work,
the west pacific area of the World Health Organization offered financial aid to us, we give the
deepest thanks to them all.
4
Economy Development and Society Advancement
1.Circumstance of the Province
Zhejiang Province, having the position of lat 118º123º E and long 27.12º31.31º N, is on the
southeastern seaboard of China and the south of Changjiang Delta, and neighbors on Shanghai,
the biggest city of China. Owning the beautiful scenery and glorified by talents and great men,
Zhejiang is well known as "the land of fish and rice, silk, cultural relic, and travel industry sites".
It was named after the flexuose Qiantang River, which is the biggest river of the province and has
the alias of "Zhejiang River". The abbreviation of Zhejiang is Zhe.
The distance from the north to the south of the province is about 450 km, as long as the distance
from the east to the west. Of the land area, which is about 101,800 square km, mountain and hill
area account for 70.4%, plain and basin area account for 23.2%, river and lake area account for
6.4%. The province has a expansive sea area, 3,061 islands whose area is larger than 500 square
meters, 6,486 km of coastline, 1,607,000 hectares of plough, and 6398,000 hectares of woodland.
Hangzhou, Ningbo, Wenzhou, Jiaxing, Shaoxing, Jinhua, Quzhou, Zhoushan, Taizhou and
Lishui, are the 11administrative areas of the province. And it exercises jurisdiction over 39
counties, 24 county level cities and 25 county level districts. Hangzhou is the capital, and Ningbo
is an independently listed city. The province has a population of 45.01 million. The population of
the total 47 minorities in the province is 0.4 million and accounts for 0.85% of the province's. The
She and Hui are the two minorities having the largest population therein.
Zhejiang has ascendant geographical conditions, vivid economic characteristics, and large
developmental potentials. It has the longest coastline in China, about 160 km, can be built 26
deep water berth over ten thousand displacement tons. Rivers, lakes, sea, mountains, wood,
caves, stones and humanity sights make up of the abundant tour resources. The province has 11
state and 27 province regions of scenery, and 5 historically and culturally famous cities. Being the
north of sub-tropic, influenced by the monsoon, having trenchant four seasons and plenitudinous
sunshine, the ground is very fit for the cropper’s growing. The Hangjiahu and Ningshao plain are
the famous producing areas of tea and silk. Zhoushan has the biggest fishery of China. Tea, silk,
small commodities, orange, bamboo production and other etceteras have important status in the
country. Zhejiang has a good industrial base, especially in machine and electron manufacture,
light and textile, chemistry, food and architecture industry. The output of Baichang silk and satin
5
account for one third of the nation. A lot of professional talents in science, technology and
management compose the abundant human resources of Zhejiang. Taking market as the direction,
Zhejiang's economy started early and developed quickly.
2.Primary Characters of the Economic Development
Zhejiang is one of the coastal provinces that having the developed economy and open to the
outside world. Over the past 20 years, especially the years from 1996 to 2000, Zhejiang
implemented the historical turn from a province short of resources to a developed province,
through deepening the reform, opening further and expanding the socialist market economy
intensively.
Gross domestic production of Zhejiang increased from 12.4 billion Yuan in 1978 to 603.6
billion Yuan in 2000, by 10.4% every year. At the same time the place of the province,
municipality directly under the Central Government and self-government region, rose from 12th
in to 4th. And the average per-capita GDP increased from 331 Yuan to 13,461 Yuan, with the
place rose from the 16th to the 4th, only less than Shanghai, Beijing and Tianjin (Table 1).
Table 1 Zhejiang’s GDP from 1996 to 2000
Index 1996 1997 1998 1999 2000
GDP（in billion Yuan） 414.606 463.824 498.75 536.489 603.634
GDP per-capita（Yuan） 9455 10515 11247 12037 13461
The industry structure of Zhejiang had a distinctness change. In agriculture, economy cropper
planting, stockbreeding and aquiculture developed very quickly. The proportion of economy
cropper to all croppers has risen from 43.6% in 1978 to 64% in 2000. And in industry, three
traditional industries, cotton spinning, silk and cement production, had reduced losses and
increased profits through compressing gross and regulating structure. The proportion of machine,
electron, chemistry and medicine industry to the accessorial value of state enterprises and non-
state enterprises having the sales income more than 5 million Yuan had risen from 36.2%to 45%.
Zhejiang also has a rapidly developmental hi-tech industry, which has annual increments of 20%,
7.2% more than the average increment of the industry in same time. The tertiary industry,
especially traffic, communications, commerce, tourism and social service, has expanded its area,
enhanced its service levels and is 36.2% of the GDP in 2000, which was only 18.6% in 1978. The
fast developing of economy of Zhejiang contributes the country more and more (Table 2).
6
Table 2 Zhejiang’s GDP of every sectors from 1996 to 2000 (in billion Yuan)
Sector 1996 1997 1998 1999 2000
Agriculture 60.918 63.748 63.131 63.194 66.416
Industry 196.280 225.490 244.543 263.000 288.337
Construction Industry 23.739 25.466 26.365 27.281 30.010
Wholesale, Retail, Hotel 56.784 61.769 66.580 71.242 82.778
Traffic and Communication 23.489 28.893 32.175 36.491 42.830
Finance and Insurance 15.866 15.794 17.219 19.091 20.925
Social Servers 11.106 13.199 14.716 16.626 22.020
Nation, Party and government
organizations, Social
organization sodality
7.033 8.178 9.305 10.421 12.671
Others 19.391 21.287 24.716 29.144 37.647
The marketization of Zhejiang is enhanced obviously. Advancing the urbanization, regulating
the social structure and fostering special markets, Zhejiang has established 4347 markets for a
wide assortment, has the total finished transaction amount of 360.6 billion Yuan, whereas 409
markets have the amount more that 100 million Yuan therein by the end of 2000. The Yiwu China
Small Commodity Market's and Shaoxing China Light and Textile Market's finished transaction
amount were 17.54 billion and 19.1 billion Yuan in 2000 respectively. The industry consumable
market is the primary in folk markets. The establishment agricultural by-products markets made
peasantry being rich, and created a road of "the markets link to the bases, and the bases bring
peasantry on". These years, lots of the markets had gotten great evolvement on exploiting the out-
province and overseas markets. The establishment and development of the markets bring nice
future to Zhejiang's economy revitalization.
With the strategy of realizing the business and trade of higher levels, Zhejiang took a great effort
to increase the amount of foreign trade operational entities and help the middling and small
enterprises, especially the private enterprises to take part in the international competition and
market. By 2000, Zhejiang had established business and trade relation with more than 200
countries and regions, the full year's total imports & exports achieved 27.93 billion US dollars,
52.1% higher than 1999's, whereas the imports was 19.44 billion US dollars. The exports of key
merchandise, especially the hi-tech, dress and textile products enhanced more quickly, making
7
the export structure better. The collectively owned and private enterprises' exports in 2000
achieved 3.37 billion US dollars, 1.1 times more than the year before. The number of the foreign
trade enterprises except the ones invested by foreign merchants has exceeded 2000 in Zhejiang
now. And there were 1,642 foreign merchants investing enterprises authorized in 2000, 47.5%
more than 1999, and used negotiated foreign capital of 3.07 billion US dollars and virtual foreign
capital of 1.61 billion. State, foreign, collectively owned and private enterprises have a complete
development in the province totally (Table 3).
Table 3 Situation of Zhejiang’s import and export from 1996 to 2000
(in million US dollars)
Item 1996 1997 1998 1999 2000
Export 8041.47 10111.13 10866.23 12871.25 19443.69
Import 4499.79 4166.19 3987.59 5434.15 8389.85
Balance of trade 3541.68 5944.94 6878.64 7437.10 11053.84
The tax revenue of Zhejiang increased annually with the economy development, and it was
36.572 billion Yuan in 2000(not including expropriated by the customs), 4.7% more than the
34.92 billion in 1999.
3.The Population and Its Primary characters
The total population of Zhejiang was 46.7698 million (including the extraneous registrants) in
the fifth national census in 2000. And there were total 14.4497 million families, having the
average population of 2.99. And 24.0186 million men accounted for 51.35% of the total
population, and the sex ratio (male/female) was 1.0557.
The primary characters of population are:
(1) The population birth rate drops relaxedly, the total population has been controlled availably,
and the growth of population has been slowed. Over the population of 41.4460 million in the
fourth national census (1990), the total population of Zhejiang had an increase of 5.3238 million.
In those ten years and four months, it increased 515.2 thousand persons every year, had an annual
average increase rate of 1.18%, more lower than the period before the implementing of birth
control (1950-1978), which is 2.05%. The population accrual rate in 2000 was 4.85% less than
that in 1990. Over the past 50 years since the founding of the people's Republic of China, the
increase model of Zhejiang population turned from the traditional model (high birth rate, high
death rate, and low accrual rate) to the transitional model (high birth rate, low death rate, and high
8
accrual rate), and now be the modern model (low birth rate, low death rate, and low accrual rate).
(2) The scale of Family dwindles with the total family amount increasing. The national census in
2000 shows that there were total 14.4497 million families in Zhejiang, and each had the average
population of 2.99. The total family amount increased 2.765 million more from that in the fourth
national census (1990), and the average population reduced 0.47 at the same time.
(3) The agedness is the main group of all the age-brackets. And the process of greying in
Zhejiang quickens more and more. Of the total population, people in the age-bracket 20-30
account for 18.07%, 5.22% less than that in the national census in 1990, and people in the age-
bracket 15-64 account for 73.09%, 3.21% more than that in 1990, and people over 65 account for
8.84%, 2.01% more than that in 1990.
(4) The quality of population has been enhanced observably, and the rate for illiteracy and
semiliterate of the total population dwindled annually. People having the college education
increased from 1,171 per 0.1 million people in 1990 to 3,189 per 0.1 million people in 2000, with
9
an increase of 172%. And in the same period, people having the senior high school education
increased from 7,021 per 0.1 million people to 10,758 per 0.1 million people, with an increase of
53%, people having junior high school education increased from 23,766 per 0.1 million people to
33,336 per 0.1 million people, with an increase of 40%, and people only having primary school
education reduced from 39,660 per 0.1 million people to 36,622 per 0.1million people, with a
reduction of 8%.
The gross illiteracy rate (the share of people over 15 and having no literacy or little in the total
population) for the province, reduced from 17.61% in 1990 to 7.06% in 2000, with 10.55%
reduced.
10
(5) The population density in Zhejiang is much higher, compare with the other provinces in the
nation. It has achieved 442 people per square km in 2000. Especially with the fast economic
development in the last ten years, the population flow had turned from 0.7 million moving out in
1990 to 3 million moving in now.
4.Traffic, Post and Telecommunications Facilities
The Zhejiang's traffic of road, rail, air, water and so on, had a great development since
implementing of the policies of reform and open-up. In Zhejiang, highway is the main traffic. The
total province had a mileage of 41,970 km (including 627 km express highway), 41.2 km per 100
square km in 2000, which were 29,509 km and 28.9 km per 100 square km in 1990. 99% of the
townships and 96.3% of the administrative villages had been connected with the highway. And
there are 250 thousand transportation specialist households, 603 thousand professionals, and 450
thousand passenger and cargo motorcars. The post and telecommunications industry had a great
development too. The total installation amount of fixed-line telephones achieved 8.822 million in
2000, and the popularization rate was 30.61 telephones per 100 people.
5.Education, Culture, Science and Technology
The education of Zhejiang has been a great step forward. All the counties of the province had
completed the mission of basically popularizing the elementary education by the year 1989. The
enrolment rate for children of school age (in the age-bracket 7-11) was 99.7%, and the stability
rate for enrolled students was 99.4% in1989. The nine-year compulsory education had been
basically popularized by the year 1997, with 99% of the pupils entrancing the junior high school,
and having the stability rate for junior high school students of 99.3%. And 68% of the students
who having finished junior high school entranced the senior high school in 1999. There were 150
thousand students (including 7,460 graduate students), 109 programs for doctor's degree and 269
for graduate's in the regular institutions of higher learning. And in addition, there were 127
thousand students in adult schools.
Richly endowed by nature and glorified by talents, Zhejiang has been well known as a land of
culture. At the end of 2000, Zhejiang had 1,932 mass culture institutions, 83 public libraries
totally owning 15.29 million books, 2,129 institutions those were permitted to screen films, and
79 professional troupes.
Fast developing in the reform and open-up, Zhejiang's science and technology contributed more
to the economic building and social development. It had enhanced the developmental ability of
the institutions for scientific research through reforming the managing system and operational
11
mechanism, adjusting the institutions, resettling the labor force, deepening the reform, aiming at
the integration of researching, production and management, carrying out the system of "two
different rules in one institution", sharing the labor income as the scientific and technical
elements, and setting up economic entities. The scientific and technical investment is being
multiplication. The total societal scientific and technical investment in 2000 was eight billion
Yuan, increased by 45.5% from that in 1999.With the rapidly development, the total 648 hi-tech
industry enterprises had the sales income of 611.15 billion Yuan, and handed the tax of 10 billion
Yuan over.
The governmental financial investment on education, science, technology, culture, and
sanitation, is increased annually with the economic development of Zhejiang. It was 12.91 billion
Yuan in 2000, when the total financial appropriation of provincial government was 43.136 billion
Yuan.
6.Living level of Residents
The residents of city and countryside have benefited straight from the reform and open-up. In
1978, city residents of Zhejiang had the average disposable income per-capita of 332 Yuan one
year, which was 3.6% lower than the average of the nation. And in 2000, it had achieved 9,279
Yuan, 27.95 times more than that in 1978. The net income of countryside residents increased
from 165 Yuan one year in 1978 to 4,254 Yuan one year in 2000, it had an increase of 25.78
times.
The significant improvement for the income level of city and countryside residents, improved
the quality of life obviously. Assessed with 14 criterions of city little comfortable standard in five
aspects constituted by the State Statistical Bureau, Zhejiang's city little comfortable total score
was more than 93 in 1997. 11 criterions had achieved the little comfortable standard. These were
the average per-capita GDP, average residential area per-capita, rate of housing set, average
virtual income per-capita, average daily calorie intake per-capita, average daily protein intake
per-capita, average daily fattiness intake per-capita, average anticipant life-span, enrolment rate
of middle school, working days per week, and average garden and greenbelt area per-capita. It
showed that the residents of Zhejiang had anticipated owning a little comfortable life. The human
development index of Zhejiang was the sixth in the nation in 1997(Table 4).
Table 4 Zhejiang’s human developing index in 1990 and 1997
Average
anticipant
life-span
Education GDP Human
developing
Sex Seating
arrangement of
GDP in the
Seating
arrangement of
human
12
nationdeveloping in the
nation
1990 0.780 0.694 0.446 0.640 … 6 6
1997 0.780 0.735 0.949 0.821 0.767 4 6
The living level of Zhejiang's residents has turned from warm-and-full phase to little
comfortable phase. The particular manifestations of this are in several fields:
(1) The consumption structure is being rationalized with the distinct advance of consumption
level. The cities and villages’ average payout of living per-capita were 6,170.3 and 3,944.8 Yuan
in 2000, 19.5 and 24.1 times more than those of 301 and 157 Yuan in 1978 respectively. The
average food expenditure per-capita of countryside residents in 1978 was 92.71 Yuan, and the
Engel’s coefficient was 60%. The average food expenditure per-capita of city residents in 1981
was 264.43 Yuan, and the Engel’s coefficient was 55.6%. But in 1997, the Engle’s coefficient of
city residents and countryside residents were low than 43.9% and 48.52% respectively.
(2) The living environment has obviously been ameliorated with the expanding consumption
domain. Residents now expend more on the education, medical treatment, communication and
services than before. The small-scale peasant consciousness, which is self-sufficiency and self-
service, is disappearing in the rural residents' minds. The ceaseless change of life style and the
annual increase of currency consumption make people depend on the market more and more.
Especially the payout of residential consumption, increased more quickly than others with the
obvious improvement of residential condition. The average residential area per-capita in cities
and towns increased from 5.77 square meters in 1980 to 14.04 square meters in 2000. And the
rural average residential area per-capita increased from 16.07 to 46.42 square meters at the same
time.
(3) In cities and countries, the spiritual life of residents has been abundance increasingly with
the improving of material life conditions. The possession amount of color televisions per one
hundred families in cities and towns increased from 0.53 in 1981 to 139.17 in 2000. And the
purchase amount of color televisions per one hundred rural families increased from 0.70 in 1985
to 9.02 to 2000. In 2000, Zhejiang had published 4110 kinds of books with the total press amount
of 270 million, 90 million magazines, and 1.7 billion pieces of newspaper. The population
coverage rate of broadcast and television increased from 71% and 42.5% in 1982 to 93.7% and
95.8% in 2000. And people began to choose the tour as their new leisure manner.
Analyzing the income of urban and rural residents by five-part measure, there were 62.4% and
13
62.1% of the residents in cities and villages being under the average level in Zhejiang. The
difference of average income per year between the highest and the lowest was not small yet, and
it had the trend to be much larger. From 1996 to 2000, the difference between the highest and the
lowest in city enlarged from 3 times to 3.5 times, and it enlarged from 5 times to 5.5 times in the
countryside (Table 5-6).
Table 5 Average income per year of Zhejiang’s residents from 1996 to 2000
Income
level
1996 1997 1998 1999 2000
Covering
group%
Average
income
(Yuan)
Coveri
ng
group
%
Average
income
(Yuan)
Covering
group%
Average
income
(Yuan)
Coverin
g group
%
Averag
e
income
(Yuan)
Coverin
g group
%
Averag
e
income
(Yuan)
First 20% 20.2 4141 21.6 4127 21.5 4242 21.4 4410 21.4 4534
Second
20%
20.4 5413 20.5 5646 20.4 5873 20.7 6223 20.6 6801
Third
20%
20.5 6473 20.3 6941 20.3 7352 20.3 7859 20.4 8650
Forth
20%
19.6 7876 19.5 8587 19.3 9136 19.4 9952 19.4 10959
Fifth
20%
18.7 11339 18.1 12324 18.5 13370 18.3 14592 18.3 16520
Table 6 Average income per year of Zhejiang’s rural residents from 1996 to 2000
Income
level
1996 1997 1998 1999 2000
Coverin
g group
%
Average
income
(Yuan)
Coverin
g group
%
Average
income
(Yuan)
Coverin
g group
%
Average
income
(Yuan)
Coverin
g group
%
Avera
ge
incom
e
(Yuan)
Coverin
g group
%
Average
income
(Yuan)
First
20%
21.8 1369 22.1 1267 21.5 1337 21.2 1356 21.1 1574
Second
20%
21.3 2280 20.6 2383 20.7 2421 20.8 2501 20.5 2737
14
Third
20%
19.8 3115 20.0 3316 20.3 3339 20.3 3457 20.5 3800
Forth
20%
19.3 4174 19.1 4463 19.3 4442 19.2 46606 19.5 5058
Fifth
20%
17.8 7066 18.2 7674 18.2 8210 18.5 8350 18.4 8679
The consumption structure of urban and rural residents showed that the rate of food expenditure
had been obviously reduced in city, but in countryside, of the group with the lowest income
(about 20% of the total rural population), it was not less than 60% of the total expenditure yet.
Not only in city, but also in countryside, lower the total expenditure was, and higher the rate of
payout for medical care would be (Table 7-8).
Table 7 The share of expenditure per-capita in income of Zhejiang’s urban residents
Expendi
ture
level
Food Clothing Living Education
and
Entertainm
ent
Health
care
Others The
share
of
expen
diture
per-
capita
in
incom
e %
Expe
nditu
re
(Yua
n)
Prop
ortio
n
（%
）
Expe
nditu
re
(Yua
n)
Prop
ortio
n
（ %
）
Expen
diture
(Yuan
)
Prop
ortio
n
（ %
）
Expe
nditu
re
(Yua
n)
Prop
ortio
n
（ %
）
Expe
nditu
re
(Yua
n)
Prop
ortio
n
（%
）
Expen
diture
(Yuan
)
Prop
ortio
n
（ %
）First
20%
2059 45.4 294 6.5 467 10.3 502 11.1 297 6.6 695.5 15.3 95.2
Second
20%
2567 37.8 454 6.7 530 7.8 736 10.8 447 6.6 1092
．4
16.1 85.8
Third
20%
2761 31.9 586 6.8 578 6.7 938 10.9 564 6.5 1391
．5
16.1 78.9
Forth
20%
3081 28.1 669 6.1 712 6.5 1072 9.8 626 5.7 1913
．6
17.5 73.7
Fifth 3409 20.6 898 5.4 737 4.5 1416 8.6 814 4.9 3341 20.2 64.3
15
20% ．8
Average 2752 29.7 570 6.1 600 6.5 917 9.9 541 5.8 1639
．8
17.1 75.7
Table 8 The share of expenditure per-capita in income of Zhejiang’s rural residents
Expendi
ture
level
Food Clothing Living Education
and
Entertainm
ent
Health
care
Others The
share
of
expen
diture
per-
capita
in
incom
e
Expe
nditu
re
(Yua
n)
Prop
ortio
n
（ %
）
Expe
nditu
re
(Yua
n)
Prop
ortio
n
（ %
）
Expe
nditu
re
(Yua
n)
Prop
ortio
n
（ %
）
Expe
nditu
re
(Yua
n)
Expe
nditu
re
(Yua
n)
Prop
ortio
n
（ %
）
Expe
nditu
re
(Yua
n)
Prop
ortio
n
（ %
）
Expe
nditu
re
(Yua
n)
First
20%
955 60.7 89 5.7 305 19.4 174 11.1 107 6.8 248 15.8 119.5
Second
20%
1142 41.7 124 4.5 290 10.6 277 10.2 155 5.7 355 13.0 85.2
Third
20%
1332 35.1 157 4.1 505 13.3 323 8.5 254 6.7 467 12.3 79.7
Forth
20%
1553 30.7 194 3.9 539 10.7 377 7.5 203 4.0 665 13.2 70.0
Fifth
20%
2146 24.7 287 3.3 1348 15.5 512 5.9 291 3.4 1084 12.5 65.3
Average 1406 32.2 167 3.8 580 13.3 328 7.5 200 4.6 548 12.5 73.9
7.Social Security System
In 1997, according to the fundamental of "uniform policy, uniform management, and separation
of affair from administration." Zhejiang established the provincial Social Security Committee and
the Social Security Bureau. The provincial Social Security Committee is a coordinating and
discussing institution for the reform of the provincial social security system. And the Social
Security Bureau is a administrative management institution for managing and coordinating the
16
reform of the provincial social security system. At the same time, Zhejiang established the special
office and supervisory institution for the social security fund, and it had formed the Social
Security Manage System with the administrative, fund and surveillance, those were detached and
coordinating to each other.
Zhejiang has made a lot of beneficial explorations for the reform of the Social Security System
about the endowment insurance, unemployment insurance, medical insurance, social salvation
pay and so on.
Carrying out the Provisional Regulations on the Social Security Fees, the Regulations on
Unemployment Insurance and the Regulations on the Employees' Basal Endowment Insurance of
Zhejiang, the local people's government at all levels and the relational departments enlarge the
amount of people having the social security gradually. By the end of 2000, 5.6715 million
employees, 92.53% of the all, had joined the endowment insurance in the cities and towns. In
31.4 thousand administrative villages of 1,464 villages and towns, there are nearly six million
people, about 34% of the all, having joined the rural endowment insurance, which was begun in
1992.
From the year of 1992, the comprehensive arrangement for serious disease fees has been the
main medical insurance in Zhejiang. In 2000, the medical insurance for serious disease had been
actualized in more than 50 counties in the province. After the provincial government put out the
Measures on the Employee Medicare System of Cities and Towns, the employee medical
insurance of cities and towns had been roundly developed in the province. By the end of 2000,
2.28 million people, about 37.56% of the all had joined it.
There are 244 thousand unemployed people in the cities and town of the province (the
unemployment rate was 7.2%). Because Zhejiang's economy had a sustaining development, and
the private enterprises engaged lots of the social work force, the amount of unemployed people
reduced to 211.7 thousand in 1999 (the unemployment rate was 3.4%). And in 1995, Zhejiang
had already put out the Regulations on the Employee Unemployment Insurance, and it was the
first in the nation. The unemployment insurance cover rate was constantly extended in the five
years after the putting out of the regulation. Of the total province, the amount of people who had
joined the unemployment insurance increased to 3.88 million in 2000. With the combining of
almsgiving and accelerating the re-employed, the unemployment insurance served for the
unemployed people on employment introducing, employment training and self-salvation through
production (Table 9).
Table 9 The population of joining the social insurance of Zhejiang from 1996 to 2000
(In thousand)
17
Species 1996 1997 1998 1999 2000
Endowment insurance 3571.8 3488.9 3780.6 5165.7 5617.5
Unemployment
insurance3322.3 3210.3 3003.4 3654.5 3885.0
Medical insurance 1072.8 1704.4 1907 2000.4 2280.5
Employee’s liability
insurance1794.4 1727.6 2299.7 2310.6 2120.9
Birth insurance 194.40 195.92 202.67 213.86 200.02
The rural community-sponsored medical treatment was a way created by the rural residents for
medical treatment with mutual help, and it was widely extended in Zhejiang's country, covering
75% of the total farm population at that time. After the implementing of contract system with
remuneration linked to output, as the collective economy, which was the main source of the
community-sponsored medical treatment fees, had been weakened, and the crowd's attending
consciousness was not intense, the financial supervision was not enough powerful, lots of the
cooperation hospitals were closed. The CPC Central Committee and State Council again affirmed
that the system of community-sponsored medical treatment was a fit rural medical insurance
system for the realities of the country. According to the Opinions on Consummating and
Developing the Rural Community-Sponsored Medical Treatment, promulgated by the provincial
government in 1998, the province took the developing of the rural community-sponsored medical
treatment as the main point of the health work. At present, the main forms of rural community-
sponsored medical treatment in Zhejiang are: cured and using medicine together, cured but not
using medicine together, using medicine but not cured together, comprehensive arrangement for
serious disease when need to be in hospital, assistance for indisposition, giving attention to
outpatients and in-patients, subsidy system, giving compensation for onefold health care, and so
on. By the end of 2000, the amount of villages and towns that joined the community-sponsored
medical treatment cured and using medicine together was 39.97% of the total amount of the
province, and the attendees was 24.56% of the total farm population. In addition, 20.89% of the
population had joined the planned immunity, maternity and child hygiene, and other health work.
It made a great effect for the rural residents to gain the essential health care services. These years,
some places of the province began to actualize the rural insurance for serious disease, and it made
an active effect for solving the poverty of rural residents that caused by the disease.
18
8.the Policy for Disadvantaged Groups
Women
Under a series of lows for protecting women's legal rights and interests, women have the same
status, power and treatment as man. The provincial government laid a developing programming
for woman in 1997, to improve women's status and diathesis, and brought forward the idiographic
object and requirement on bringing out the woman's effect. Women assume the office of all
levels, and it shows the women's legal rights and interests (Table 10). It has been showed
statistically that there were 1,341 thousand women joining the labour union, which had the total
members of 3,651 thousand in 1997.
Table 10 Situation of women delegate to provincial People’s Congress and Political Consultative
of Zhejiang
Item
People’s CongressPeople’s Political
Consultative
The first
in 1954
The fifth
in 1977
The ninth
in 1998
The
second in
1959
The fifth
in 1983
The ninth
in 1998
Delegate amount 451 1008 598 155 625 648
Amount of women
delegate73 237 123 27 88 117
Rate of women
delegate（%） 16.2 23.8 22.1 9.3 14.1 18.1
The female youth and children have the same essential rights and interests as male. In the years
between 1996 and 2000, the share of female in the middle and elementary school students was
46%47%, and the share of female in the junior college and university students increased from
39.1% in 1996 to 43.3% in 2000.
Women work in every walk of life just like men. According to the statistics of 2000, the amount
of female employees in manufacture, retailing, catering, finance and insurance, social service,
health, sports, social welfare, education, culture, art, broadcasting and television, and other
industries was over 40% of the total employee amount.
The Handicapped
In 2000 there were two million handicapped people in the province, and it was 4.79% of the
total population. Of all the handicapped, there were 867 thousand audition disabled, 323 thousand
19
intelligence disabled, 266 vision disabled, 235 limb disabled, 83 mental disabled, and 225
integrate disabled.
The government takes the policy of "using any ways to arrange the handicapped to work pro
rata" to solve the employment problem of the handicapped. In 1997, there were 4,651 welfare
enterprises that placed nearly 100 thousand handicapped people and completed the total
production value of 35.04 billion Yuan, and realized the retained profits of 0.817 billion Yuan. In
2000, it placed more than 9,600 handicapped people, and in the country there were 370 thousand
handicapped doing the planting and breeding job. Thousands of people, each helps one
handicapped to get elevated from poverty, and then the amount of the poor handicapped reduced
from 145 thousand in the beginning of 2000 to 105 thousand at the end of year.
The government pays more attention to the education of handicapped child and youth. There are
62 special schools in the province. Among these schools two are for the blind, 37 are for the deaf,
1 is for the blind and deaf, 16 are for the retarded, and 6 are integrative. In general schools there
are 92 classes for the special education and 32,696 handicapped students. The enrollment rate of
blind, deaf and retarded child and youth is more than 90%.
The total province takes the community healing as the main point to roundly develop the healing
work for the handicapped. Leaded by the government and the Association for the handicapped,
assisted by all the sectors, sharing the resource, all the society offers the handicapped the
guarantee of healing. In 2000, through the operations more than 20 thousand cataract patients
were able to see again, and 563 limb disabled people had the orthopedic operation, 588 trained
deaf children were trained to talk, 720 asthenopia people got well, 623 retarded children and 996
limb disabled people accepted the healing training, and 43 thousand psychopaths were in custody.
All of these increased over 1999 in different degrees. The province established 95 up county level
direction institutions serving for the handicapped healing. The amount of social welfare
institution that invested by the government and managed by the civil administration sector
increased from 14 in 1987 to 59 in 2000.
The poverty group
By the end of 1997, the average income per-capita of the eight poverty counties in Zhejiang
exceeded 1,400 Yuan, and the average grain ration per-capita exceeded 250 kg, the poverty rate
reduced to 5%.
It took the way of combining the centralized fending and dispersedly fending to help the rural
poor household, with the five-guarantee (in food, clothing, fuel, education and expenses) fees
paid by farmers for overall villages and towns planning. 91% of the poor households were fended
20
by the society now. In 1999, the province issued the national relief and collective subvention of
233 million Yuan, 14 thousand people received the governmental term relief and 290 thousand
person-times received the governmental temporary relief, and there were 41.7 thousand five-
guarantee households fended by the collective, receiving the collective fending sum of 65.983
million Yuan, 1,580 Yuan per one person. It has formed a salvation system on the whole for the
typhoon. In the past 20 years, nearly 60 million people (person-time) had took part in fighting
with the disaster, and 6.9 million victims of a natural calamity (person-time) had been displaced
and nestled, 160 thousand persons were helped to rebuild their home. It solved the problems of
food, clothing, living, healing and so on for about one million people in the serious disaster area
every year.
The Old Group
In 2000, the population of people up 65 years old was 3.9791 million, 8.84% of the total
population. The greying has been paid attention to by the government and the society. The
building of senior citizens home has a durative development with the fast developing of economy.
The amount of rural senior citizens home increased from 34 in 1978 to 1,961 in 1997, having an
increasing of 50 times. And it realized the object of having senior citizens home in every villages
and towns on the whole. The government at all levels and the society at all circles increase the
devotion annually. According to the statistic, in 2000, it had been invested 304 million Yuan in
the building of "Xiyanghong project" (a project for the old group) in the province, and the share
of government was 34.7%. It had built 924 new active centers, 20 agedness houses, 44 senior
citizens homes, 5 beadhouses, 172 colleges for the old, and one healing center. The increasing
welfare establishments for the old people created conditions for the old on fending, healing,
studying and entertainment.
9.The Main Objects of Economy and Society in the Tenth Five-Years Plan
The main objects of economy and society in the Tenth Five-Years Plan of Zhejiang is "make the
speed of national economy growth be higher than the average of whole nation, improve the
quality and profit of economy growth, enhance the comprehensive strength obviously, to create
conditions for the average GDP per-capita of 2010 to double over that of 2000; improve the
socialist market system, hold the predominance for advanced system and mechanism, and take
part in the international cooperation and competition in the more ranges and deeper degree; the
increasing income of the city residents and rural residents could make the people having the
better little comfortable life; strengthen the environmental protection and the ecological building;
21
try to make the average GDP per-capita of one third of the cities and counties over 3,000 US
dollars, and up to the standard of medium-developed countries, realize the modernization
basically. The anticipative objects in main aspects are:
The economy retains a quick increase. The GDP increases by 9% per year, and will exceed 920
billion Yuan by the year 2005; and the average GDP per-capita approach to 20 thousand Yuan.
The whole social investment for assets and the total amount of import and export increase by 11%
per year, and the amount of export increases by 10% per year. The local finance income increases
by 10% per year, and the total price level would be steady.
Optimizing the industrial complexes, that will develop the profit agriculture quickly, enhance the
industrial predominance, and improve the proportion for the service industry. The proportion of
three industries (the first industry, the second industry and the tertiary industry) will be adjusted
to 8:51:41, and the increment of hi-tech industry will approach 25% of the total industrial
increment.
The information degree and the building of information network will be in the top of the whole
nation, and the main cities' will close to or approach the developed countries'. The telephone
popularization rate will over 86%, and 87% of the families will have the cable television, the
popularization rate of the families owning the data and multimedia service will be higher than the
average level of the nation.
The urbanization level will be improved obviously. The harmonious development of
metropolises, medium-sized cities, small cities and central towns, will enhance the leading action
of the central cities to the region economic development. The rate of non-farming population will
be 63%, and the urbanization level will be about 45% by the year 2005.
It will expedite the development of science education and society undertakings, increase the
contribution of science improvement to the economic development; the technological financial
investment of the province will be 7.8% of the total financial expenditure by the year 2005. It will
popularize the nine-year compulsory education with a high level, essentially popularize the
middle school education, and make the enrollment rate of higher education exceeding 20%; the
share of provincial education outlay in the total financial expenditure has an increase of 1.2% per
year. And the conditions and the coverage rate of the establishments for city and country's culture,
health and sports will be both improved.
The enhancement of the ability for preventing or controlling the flood and tide, fighting the
drought, and the water supply, will enhance the ability of sustainable development obviously. It
will make the using of land and other important resources more reasonable, and the total quality
of entironment will be advanced level in the nation. The natural population increase will be
22
controlled under 0.565%, the proportion of clean energy will be about 9%. The forest coverage
rate and the city greening coverage rate will be over 60% and 35%. And compare with the year
2000, the emission amount of the important contaminations reduces by 10%.
People will have a much richer little comfortable life. The city residents' average disposable
income per-capita and the rural residents' average net income per-capita will both have an
increase of 5% per year. The city residents' average residential architecture area per-capita will
increase to 22 square meters, when the rural residents will have a much better residential
condition too. The registered unemployment rate in cities and towns will be controlled below 5%.
And the living environment, living quality and social culture degree will all be improved
obviously.
The Health Reform and Developing Actuality
In the over 50 years since the founding of the people's Republic of China, especially in the
years of the reform an open-up, with the lead and care of the provincial Party committee and the
provincial government, and directed with the Deng Xiaoping Theory of building socialism with
Chinese characteristics, Zhejiang insisted the health work policy of "taking country as a focuses
and prevention first, paying equal attention to Western medicine and Chinese medicine,
depending on the scientific improvement and mobilize whole society to take part in, to serve the
people and the socialistic modernization building" in the new historical period since 1978,
deepened the health reform and had gotten a notable success. The main indicators of national
health have approach the average standard of medium-developed countries in the world. With the
improvement of economy, science and the living level, the people have more requirements on
improving the health service and the living quality. The health problems about the entironment
and living styles is being worse increasingly with the fast process of industrialisation,
urbanization and greying. With the deepening of reform, the deep-seated contradictions in health
department become more and more visible. The health development is facing the new challenges.
1.The Health Standard and Situation of disease
(1) The level of the people health has increased obviously. It is owing to the rapid development in
the social economy, the gradual increase in the hygienic input and the incessant improvement in
the medical treatment. According to the statistics of 2000, the birthrate of the population all
across the province is 10.30‰, and all inhabitants’ expectation of life is 74.88. Woman care aims
23
at reducing the mortality of pregnant and lying-in woman and concentrates on improving the
service quality of tocologist, in the course of women during and after pregnancy 42 days, it
carries out a complete medical care service. The rate of childbearing in hospital has been
increased to 98.7%, the mortality of pregnant and lying-in woman decline stepwise along with the
elevated rate of childbearing in hospital and the ascending overlay of systemic pregnant and
lying-in woman care. In 2000, the mortality of pregnant and lying-in woman is 19.59/100,000.
(Figure 5)
With regard to children care, it aims at reducing the mortality of infant and children below 5 years
old, to promote breast-feed and prevent the hackneyed disease of child. It established a healthcare
system for children below 7 year-old, of what the management rate had increased gradually. The
mortality of infant and 5-year-old children and below has been dramatically reducing. In 2000,
the mortality of infant is 15.57‰, and the mortality of children below 5 years old is 19.49‰.
(Table 11)
Table 11 The mainly index of health of resident from 1996 to 2000 in Zhejiang
Index 1996 1997 1998 1999 2000
The mortality of infant (‰) 23.54 21.59 19.44 17.67 15.57
The mortality of 5-year-old
children and below (‰)27.94 25.93 23.12 22.05 19.49
The mortality of pregnant
and lying-in woman
(1/100,000)
23.2 24.9 25.4 22.1 19.6
Expectation of life (year) 73.15 73.60 73.75 74.32 74.88
24
(2) The prevention and treatment of endemic and infectious diseases has obtained prominent
effect. Some endemic such as ague, filariasis, schistosomiasis, endemic goiter, endemic fluorosis
and lepra has been ever seriously prevailed in our province, for example, in fifties,
schistosomiasis was widely promulgated in 53 counties, there were 2040,000 patients. By means
of all-around step of prevention and cure, including shutting off the path of prevalence, enhancing
the people ’s immunity and improving the condition of sanitation in town and countryside, in
middle of eighties, the schistosomiasis, filariasis, ague and lepra had been controlled, and even
been annihilated basically. The incidence of endemic goiter and endemic fluorosis had also been
dramatically reducing.
The strict implementing of law and statute, such as the Law of the People's Republic of China on
the Prevention and Treatment of Infectious Diseases and the Law of the People's Republic of
China on Food Hygiene, the full advancing of planned immunity of children and the stepwise
improving of environmental establishment of town and countryside, the incidence of first and
second infectious diseases of legal report decrease year after year. The total incidence of diseases
in legal report’s infectious diseases of 2000 has decreased to 299.95/100,000.
In recent year, with the quick urbanization construct and the increased float population, the
incidence of acute and chronic infectious diseases relating to ill life style always very high, that of
some infectious diseases even has the increasing trend. For example, the local prevalence of
cholera and hepatitis appears in some year and some areas; there were 22809 cases of
tuberculosis in 1999 all across the province, 22991 in 2000, increased 0.29%; the incidence of
venereal disease increased quickly. Our province is the earliest one that found HIV infection in
our country, 4 cases of HIV infection had been examined in 1986,they are all haemophiles that
using the imported eighth gene. Because of someone’s ill life style, AIDS infection also
increased. Up to 2000, there are 236 HIV infected person that were examined all across the
province, and 31 people were taken bad and 23 people died. According to the experts’ estimate,
the actual HIV infected people in our province are more than 4000. (Table 12)
Table 12 The incidence of infectious diseases of legal report (1/100,000)from 1996 to 2000 in
Zhejiang
Name 1996 1997 1998 1999 2000
The incidence of first and
second infectious diseases 257.19 289.39 294.52 321.31 299.95
Virus hepatitis 113.10 108.80 101.90 115.10 105.00
25
Venereal disease 34.62 39.81 63.96 87.84 75.74
Phthisis -- 47.62 48.79 51.17 51.27
(3) The pedigree of illness and death reason of inhabitants in the whole province changed
obviously. In the order of death reason, the malignant tumour, cardiovascular, cerebrovascular
and breath system diseases have become the first three death reasons. By the survey of part
counties (section) in 2000, the mortality of malignancy is 148.3/100,000, and the order of the first
five malignant tumour is lung cancer, stomach cancer, liver cancer, esophageal cancer and colic
cancer. In the city, the incidence of lung cancer is higher than that in the countryside, it is reverse
for stomach cancer. The mortality of cardiovascular cerebrovascular diseases in the third order of
death reason in 1995,but in 2000,it go up to the second order. The incidence of hypertension, as
the most serious nosogenesis of cardiovascular cerebrovascular diseases, also has increasing
trend, increasing from 9.7%in 1991 to 25.6% in 1998 (figure 6).
(4) Along with the acceleration of industrialization, urbanization and greying, deterioration of
entironment and alteration of life rhythm and life style, accidental damage, old people’s disease,
mental handicap, cacotrophia and adiposity of children and occupational and environmental harm
that followed by have become new hygiene problems that affects health. For example, since from
1986, the mortality of accidental damage is in the fifth order of mortality of disease at all times.
In 2000, it was 59.79/100,000, and death because of traffic accident is 33.1%, suicide is 23.2%.
With the development of social economy and urbanization, life rhythm has expedited, social
competition has pricked up, all kinds of mental handicap has increased sharply and mental and
hygiene problem has stood out increasingly. Based on survey of Hangzhou in the early 90’s, the
26
incidence of mental disease is 12‰. From 1995 to 1996,the incidence of teen-age mental and
hygiene problem is 13% in primary school, 17% in high school, and 25% in college. In addition,
the incidence of mental handicap in the aged over 60 is 12.91%, among this, hypochondria cal
handicap is 18.4%, worrying handicap is 20.3%, and the unwellness caused by mental reason is
17.2%.
2. The Demand of Hegelian Service
In order to understanding the demand of hygiene service in our province and the actuality of
hygiene resource configuration, mastering the variety of hygiene resource investment and the
demand of hygiene service, providing the external gist for forecasting of the relationship of
supply and demand trend in hygiene service for the future, in 1998, according to uniform
deployment of ministry of health, our province carried out spot check of the demand of hygiene
service and hygiene resource, by means of multistage layered unitary stochastic sample , we
sampled sanitation institution of 12 county (city, section) ,7200 families and 25,000 people as
object. It divided into enquiry about familiar health survey and hygiene institution service survey.
The results provide us abundance material.
(1) Spot check of town and countryside’s inhabitants showed two-week incidence of disease is
12.8%, analyzing by sex, the incidence of disease of woman (13.3%) is higher than that of man
(12.3%), analyzing by classified disease system, two-week disease mainly include familiar and
frequent disease, five type of disease, breath system, digestive system, circular system, muscle
and bone system, damnification and toxicosis, is 80.63% in total disease. In city, the total
incidence of disease is higher than countryside, on the one hand, aged degree of city is higher
than that of countryside and the incidence of chronic disease is high, on the other hand, the
education level, health consciousness and cognition degree of disease of city inhabitant is higher
than that of countryside. (Table 13)
Table 13 Inhabitant’s two-week incidence of disease (%)of hygiene service survey by disease
classified stat. in Zhejiang province in 1998
Item
Total City Countryside
Incidenc
e of
disease
Percent Incidenc
e of
disease
Percent Incidenc
e of
disease
Percent
Two-week incidence of disease 12.80 20.60 11.50
Breath system disease 5.33 42.72 9.31 46.23 4.66 41.67
27
Digestive system disease 2.24 17.92 2.73 13.58 2.16 19.22
Circular system disease 1.02 7.93 2.57 12.62 0.76 6.52
Muscle and bone system
disease1.00 7.87 1.53 7.54 0.91 7.96
Damnification and toxicosis 0.54 4.19 0.81 3.98 0.50 4.25
Analyzing by age grouping, not only in city but also in countryside, two-week incidence of
disease showed U type curve in different age group. In the age group from 0 to 4,The incidence of
disease is 15.93%, in the age group from 15 to 29,the minimum is 12.16%, then it increased by
the increasing of age, in the age group from 60 to 69 and over 70, it is more than 21%, which
suggest that the children and the aged are the important population of disease prevention and
treatment.(figure 7)
Analyzing by medical safeguard system, two-week incidence of disease has relationship with the
degree of enjoying the medical safeguard system. In city, two-week incidence of disease of
people who enjoying the socialized medicine is highest, they are 24.55% and 20.67%
respectively. In countryside, two-week incidence of disease of people who enjoying socialized
medicine and labor insurance medicine is highest, they are 15.02% and 13.94% respectively.
Two-week incidence of disease of people who enjoying the medical insurance is lowest, it is only
6.73%, which is under the half of that of enjoying socialized medicine and labor insurance
medicine. (Table 14)
28
Table 14 Inhabitant’s two-week incidence of disease (%)of hygiene service survey by different
medical safeguard system in Zhejiang province in 1998
Item Socializ
ed
Labor
insuranc
e
Half-
labor
insurance
Medical
insurance
In
planni
ng
Cooperative
medical
treatment
Persona
l
Other
Total 19.14 18.49 15.37 8.91 16.67 7.61 11.87 3.88
City 20.67 19.52 17.33 20.51 24.55 -- 20.18 8.33
Countrysid
e
15.02 13.94 10.83 6.73 10.00 7.61 11.42 2.15
(2) Chronic disease is the chronic non-epidemic disease that investigated object sickened in half
year diagnosed by doctor. Results showed, the incidence of chronic non-epidemic disease is
12.1%, 11.8% in man, 12.4% in woman, in city it is 22.3%, but in countryside it is 10.4%, which
is under the half of that of city. The incidence of chronic disease increased by the increasing of
age. In the age group of 60 and above 60, it is double in city of that in countryside. In the age
group from50 to 59,it is 26% higher in civic woman than that in man. In the distributing of
disease type in chronic disease, in city and countryside, the incidence of hypertension is in the
first order and second order respectively. (Figure 8)
Professional analysis of chronic non-epidemic patient, not only man but also woman, for career
man, people in department and manager, the incidence of disease is maximum (Table 15).
29
Table 15 The incidence of chronic disease (%)of hygiene service survey by professional statistic
in Zhejiang province in 1998
Item
Manage
r
Career
man
Operation
man
Business
and service
man
Manufac-
turing
and
carrying
trade
Agriculture
Forestr
y and
breed
aquatics
Man 24.86 20.93 17.67 12.16 12.23 13.16 10.45
Wom
an
19.57 23.22 9.63 9.78 16.35 12.58 12.28
Total 23.02 21.97 13.74 10.84 14.06 12.88 10.71
(3) Healing of residents’ two-week disease: the two-week disease’s healing rate of the residents is
54.7% and 59.5% in cities and villages respectively. The non-healing, mainly adopted self-
treatment in city, but adopted nothing in countryside. The unit for patient, is the room of health in
hamlet and yard of health in villages and towns (the total is 66.4%), individual clinique is 10.7%
in countryside, is the hospital in county and the high level of county (the total is 65.3%). The
expense of outpatient has biggish difference in different level of medical hygiene institution.
(Table 16)
Table 16 The ratio of ()of inhabitant’s two-week disease (%)of hygiene service survey by the different
unit for patient in Zhejiang in 1998
Item
Individu
al
hospital
Health
room
Out-
patient
departm
ent
Yard of
health
The
hospital at
county
level
The
hospital at
city level
The
hospital
at
province
level
Total 9.32 35.23 2.01 21.46 15.72 11.22 2.93
City 4.50 16.75 5.50 4.75 11.25 42.50 11.50
Countryside 10.66 40.35 1.04 26.09 16.96 2.56 0.55
(4) Analyzing by the expenses of two-week outpatient: the average expenses of investigated
outpatient is 59.3 Yuan, by the further analysis of the data, the distributing of the expenses show
the obvious skewness distribution, the average obtained by calculating median is 32.5 Yuan. The
expense of outpatient has biggish difference in different level of medical hygiene institution,
below the yard of health in villages and towns level of medical institute, it is under 35 Yuan, in
30
the province level of hospital, it is 120 Yuan, and it is also the maximum. In the county level of
hospital, the expense every time in herbalist is 25 Yuan more than in other hospitals. (Table 17)
Table 17 The expense (Yuan, RMB) of two-week outpatient of hygiene service survey by the different
medical institute statistic in Zhejiang in 1998
Medical institute
The percent expense of outpatient The average
expense of
out-patient25% 50% 75%
Total 32.5 59.3
Individual 12 20 50 49
Room of out-patient 10 20 35 31
Clinic 20 35 63 64
Yard of health in villages and
towns20 33 60 52
The hospital at county level 40 75 150 112
The hospital at city level 40 70 150 107
The hospital at province level 80 120 200 155
Chinese medical hospital at
county level60 100 200 134
Other hospital 27 49 50 39
(5) Suffering inhabitant in hospital. The rate of suffering inhabitant in hospital is 2.9% in the year
before the surveyed; it is higher in city (4.5%) than in countryside (2.7%). The rate of the patient
who should be in hospital but not is 19.9%, it is also higher in city (21.6) than in countryside
(19.5%). It is 53.9% because of money difficulties, and it is 54.6% in city and 53.7% in
countryside; in addition, it is less than 1% because of no beds. With respect to medical institute,
in countryside, the first one is the county level of hospital (61.6%), the second one is the yard of
health in villages and towns (21.31%), and the third one is the hospital at city level (10.2%). And
in city, the first one is the city level of hospital (58.8%), the second one is the province level of
hospital (26%), the third one is the section level of hospital (13%). Among the 57.7% patient in
hospital, the expenses is within 3000 Yuan every time, and in the hospital of city (province, city),
the expenses is twice higher than that in and below the county level of hospital. The expenses of
patient every time of the people that enjoying different medical safeguard system has the large
difference.
(6) Hygiene habits of the inhabitants. Survey shows, the smoking rate of 15 and upwards of 15 is
31
25%, 44.2% in man and 1.8% in woman, it is 20.90% in city, 39.9% in man and 1.7% in woman,
it is 25.7% in countryside, 44.9% in man and 1.7% in woman. The drinking rate of 15 and
upwards of 15 is 20.4%, 33.9% in man and 3.6% in woman. The proportion of people aged more
than 15 who always take part in physical exercise is 10.5%, 38.3% in city and 5.5% in
countryside.
(7) Using the share system for the disease in city and countryside, the proportion of people who
enjoy the socialized medicine, the labor insurance medicine, the half-labor insurance medicine
and half-insurance of medicine, cooperative medicine, personal medicine and others is 3.5%,
7.2%, 2.6%, 5.7%, 79.4% and 1.6% respectively. The proportion of people who enjoy personal
medicine in countryside is 88.1%. They endure great pressure of disease. The depressed family
that caused by disease and damage is 35.7% of all depressed family, which is the important
reason of poverty.
3. The Amount and Configuration Structure of Hygiene Resource
(1) Zhejiang’s health institution takes the public-owned as the principle part, and has the two
forms of collective ownership and the ownership by the whole people. Up to 2000, there are 7465
medical hygiene institutes in our province, that held by hygiene department is 3696, that held by
industry and other department is 3736, that held cooperatively is 18 and held privately is 15.
Classifying by service function, there are 434 hospitals, 2736 yards of health, 18 sanatoriums,
3669 clinic, 303 prevention institutes, 68 woman and children care institutes, 75 medicine
inspection institutes, 21 medicine research institutes, 83 medicine education institutes and 58
other hygiene institutes in our province. Besides, there are 9531 personal clinics and 22725
country medical spots. A relatively perfect hygiene service system has come into being in our
province. There are 107221 beds in hospitals, the amount of beds is 2.38 every thousand people.
In hygiene system, there are 200307 health officers, including 157875 health technic officers. The
amount of doctors and nurses is 1.65 and 0.89 every thousand people respectively. (Table 18)
Table 18 The average amount of beds and health officer every thousand people from1996 to 2000
in Zhejiang
Item 1996 1997 1998 1999 2000
Bed 2.27 2.29 2.33 2.34 2.38
Health professional
officer4.23 4.33 4.37 4.39 4.45
Health technic
officer3.38 3.47 3.51 3.48 3.51
32
Doctor 1.57 1.63 1.58 1.64 1.65
Pharmaceutist 0.34 0.34 0.35 0.35 0.33
Nurse 0.79 0.82 0.87 0.85 0.89
Paramedic 0.05 0.05 0.05 0.03 0.02
Other 0.22 0.23 0.28 0.24 0.24
(2) Classifying by administration domination, the medical institute include 396 hospitals in the
county level and above, 38 other hospitals, 2736 yards of health in town and villages. The
proportion of medical beds of the hospitals in the county level and above is 80%, such hospitals
possess the relatively advanced furnishment and establishment, but in the wide countryside, the
basic sanitary establishment is still very weakness. The manpower resource is the main body of
medical institute. The county level and above of hospital possess of 109131 health technic
officers, classifying by educational background, the proportion of people who acquire the
diploma of junior college and above, the diploma of technical secondary school and no normal is
31.5%, 42.9%, and 25.7% respectively. But in the wide grass roots medical institute of
countryside, the proportion is 10.3%, 38.5% and 51% respectively. Furthermore, there are 23243
country doctors and 5011 health person in countryside, and the technology making of these
people is lower generally. (Table 19)
Table 19 The educational background statistic of the personnel in different level of medical
institute in Zhejiang in 2000
ItemThe sum of health
person
Classifying the health person by educational
background (%)
Undergradu
ate college
and above
Junior
college
Technical
secondary
school
No
educational
background
The county level of
hospital and above109,131 16.6 14.9 42.9 25.7
Other hospitals 2,457 3.8 12.7 28.4 55.1
The yard of health in
countryside48,169 1.5 8.8 38.5 51.0
In recent years, our province carried out the admittance test of professional physician (including
the professional assistant physician) and registered nurse.
(3) With the development of birth control, its technological guidance is receiving greater
33
attention. A great many of technological guidance institutes have been set up all across the
province, forming part of the whole society’s health care resources. According to the statistics of
2000, of the 1864 villages and towns (including residential districts) in the province, 1647 have
established the birth control service station. The province’s whole financial input (starting from
the county level) in birth control reached 0.29 billion Yuan, an increase of 21.23% over the
previous year.
(4) Inspired by the development of market economy, that of non-state run economy in particular,
motivated by the public’s varied demands for medical care service and stimulated by the great
potential for the development of medical care market, non-state investors of the province already
set their goal in the field of medical and health service even ten years ago, establishing non-state
run hospitals in some economically developed areas like Wenzhou and Taizhou. Up to sep, 2001,
the province has 42 non-state run hospitals (accounting for 9.7% of all the hospitals in Zhejiang)
with 2298 beds (accounting for 2.14% of the total beds in the province). Now most non-state run
hospitals are still located in areas like Wenzhou and Taizhou where the non-state run economy is
fairly developed. These hospitals are usually small or medium-sized (ten of which have more than
100 beds, 11 of which have beds ranging from 50 to 100 and 21 of which have beds fewer than
50), devoting chiefly to pediatry, rehabilitation and the treatment of heart disease, skin disease,
mental illness and tumour. Of the 920 works and staff members in the 42 non-state run hospitals,
professional medical and health workers account for 77.7%, but most of them do not have a high-
level academic degree (bachelor’s degree holders and those having a higher degree than that
account for 17.83%; those having the title of a senior professional post account for 16.05% and
those having the title of a junior professional post or having no professional title account for
77.9%). According to the statistics in 2000, on average every non-state run hospital in the
province received 240,000 outpatient and emergency calls and 790 inpatients (those discharged
from hospital after recovery averaged 14.9 days in hospital), with an annual income of 4,350,000
Yuan (the income from drugs accounts for 40%) and with an annual expense of 3,770,000 Yuan.
Individual investment is the chief capital resource for non-state run (NSR) hospitals (accounting
for 68.4%) and the remaining capital is gathered through the share-holding system or the share-
holding cooperative system. As most NSR hospitals have not received much investment and are
usually small, their equipment and service quality cannot be compared with those of public
hospitals.
Owing to the various methods used to develop medical care institutes, now these institutes have
been set up all across the province. According to a sampling investigation about health care, 85%
of the urban and rural residents can find a medical institute within the distance of one kilometer.
34
Therefore it has already become a reality that most people can receive basic medical and health
care near their houses. (Table 20)
Table: 20 The distance of residents that can find a medical institute of hygiene service survey in
Zhejiang in 1998
ItemShort of 1
kilometer1 kilometer 2 kilometers 3 kilometers 4 kilometers
Upwards of
5
kilometers
Total 79.83 9.90 3.89 4.13 1.26 0.99
City 88.08 7.25 2.58 1.50 0.17 0.42
Countryside 78.18 10.43 4.15 4.65 1.48 1.10
(5) The province has nine colleges and schools of higher learning, providing professional
medical and health workers. In 2000, these schools enrolled 3,465 students, the total students on
campus therefore reaching 12,972. These medical schools have more than 20 majors and have the
right to confer a doctor’s degree in 30 different areas and a master’s degree in 59 different areas.
The province also has three secondary medical schools (which have more than 30 majors), three
adult educational colleges of medicine, eight secondary medical schools for workers and stuff
members and 51 county in-service training schools of medicine, and has also initiated the further
education of clinic, nursing, prevention, pharmaceutics, and general medicine while carrying out
the policy of training, assessment and promotion.
(6) Scientific Research in Medicine. Centering with the prevention and treatment of disease
facing the demand of economic development and following the motif “science and technology is
the first productive force”, the province’s scientific research in medicine has promoted the
development of medical and health work. Now the province has 11 independent scientific
research institutes of medicine and 40 research institutes that are attached to the provincial
medical and health care institutes and the institutions of higher learning. These research institutes
include the WHO Human Reproduction Research Center, the Research and Cooperation Center
for helminthiasis research and 12 national and provincial key laboratories, laboratory bases and
research centers. From 1995 to 2000, the province won 8 national prizes for important
achievements in scientific research and 5 similar prizes at the provincial or ministerial level,
improving greatly therefore the quality and level of medical treatment and preventive service.
(7) Traditional Chinese Medicine (TCM). TCM, a great treasure of China, has a long history in
Zhejiang Province. To further the development of TCM in Zhejiang, the provincial People’s
Congress issued the “Regulations for the Development of TCM in Zhejiang” in 1997. Now the
35
province has 84 medical institutes of TCM with 11,285 beds. During the Ninth Five-Year-Plan,
the province’s total investment in the hospitals of TCM reached 0.32 billion Yuan. The
comprehensive hospitals at various levels have also established the TCM department and its beds.
Now there are 7.698 TCM physicians and 3,117 TCM pharmacists in the province and 74 TCM
physicians have been evaluated as the “Outstanding TCM Physicians of Zhejiang”. Now TCM
has achieved remarkable results in the treatment of acute leucocythemia, lumbago, nephropathy
and malignancy. Zhejiang is not only one of the important domestic producing areas for Chinese
medicinal material, but also has a highly developed TCM pharmaceutical industry one of the
important industries in the province. Now the province has 31 TCM pharmaceutical enterprises
with the sales income of Chinese patent drug reaching 2.34 billion Yuan. Some TCM
pharmaceutical enterprises like Tianmu Pharmaceutical Co. Ltd have issued shares and products
like “Canmai Injecta” and “Kanglaite Injecta” have brought a sales volume of more than 0.1
billion Yuan to their manufacturers.
4.Quality and Efficiency of Medical and Health Care Service
(1) Medical treatment service: Centering around the patient, the medical institutions of Zhejiang
received 65,203,507 outpatient and emergency calls with the person times of those discharged
from hospital after recovery reaching 1,616,167 in 2000. On average, one doctor (at a county
hospital or at a hospital above the county level) received 1749.9 person times of outpatient and
emergency calls per year, and saw to the hospital stay of 592.3 per year. And the utilization ratio
of beds in a county hospital or at a hospital above the county level is 74.9%, with those
discharged from hospital after recovery staying 12.7 days in hospital. (Table 21)
Table 21 the medical service circs of the county and above county level of hospital from 1996 to
2000 in Zhejiang
Item 1996 1997 1998 1999 2000
Average of hospital stay 14.7 14.3 14.2 13.2 12.7
Using rate of sickbeds（%） 78.6 74.0 72.5 74.1 74.9
Person-time of patient per
doctor every year
1549.4 1543.8 1595.4 1685.6 1749.9
Hospital stay per doctor every
year
592.3 587.7 566.9 591.6 592.3
Emergency medical service is an important part of medical service. Now except for one county,
the province has set up emergency centers in every county and city. The emergency in Hangzhou,
36
Ningbo, Wenzhou, Jiaxing and Huzhou are independent and those in other cities dependent on the
best hospitals, usually the No.1 Hospitals of these cities. The main responsibility of these
emergency centers is to undertake the task of emergency treatment and to provide the on-the-spot
first-aid to those injured in great accidents or disasters. The province’s emergency centers and
those hospitals undertaking the responsibility of providing emergency treatment service have
altogether 1200 emergency ambulances. 80% of the residents in cities and counties have access to
emergency treatment service through making the “120” emergency call. After receiving the
emergency call, the ambulance can average the spot within 20 minutes. On most occasions,
however, the ambulance functions only as a means of sending the patient to the hospital, because
the emergency treatment equipment on the ambulance is often old and ineffective. As a large
portion of the emergency patients suffer from heart or brain disease, or are injured or poisoned,
which demands instant emergency treatment on the spot, and as the knowledge of emergency
treatment has not yet widely spread among the general public, the death rate of emergency
patients is still rather high. The development of emergency treatment within the hospital,
however, is very fast and a relatively comprehensive emergency treatment system has been
established. All the city and county hospitals have now set up intensive care units.
Public health and preventive health care: Carrying out the policy of putting prevention first in
medical work and launching constantly the patriotic health campaign among the public, the
province has obtained remarkable achievements in public health and preventive health care
service. According to a sampling investigation about health care service, 100% of the urban and
rural children have the four conventional vaccination certificates, receiving 11.5 preventive
inoculations annually. 95.6% of the urban and rural pregnant women receive 7.16 antenatal
examinations and 72.7% of these pregnant women receive 1.7 postpartum calls per year. The
parturition rate in hospital is 95.5% (the rates for the urban and areas are 100% and 95%
respectively) (Table 22).
Table 22 Situation of public health service of Zhejiang from 1996 to 2000
Item 1996 1997 1998 1999 2000Inoculability rate of four bacterins for
children（%）90.0 98.1 95.9 96.8 98.7
Health management rate for the children below 7
year-old（%）83.0 87.70 87.55 88.72 91.81
37
Health management rate for pregnant and lying-in
woman（%）78.43 79.46 83.96 85.60 86.93
Parturition rate in
hospital（%） 96.49 97.64 97.94 98.67 98.70
Ratio of the farmer using
the tap water（%） 75.66 77.73 79.82 81.5 83.20
(3) Supervision and monitoring of hygiene (SMH): Institutes of SMH have been set up from the
county level up to the provincial level, employing over 6,000 supervisors and monitors, forming
thereby a preliminary comprehensive network of SMH. Owing to the cooperative efforts made by
both the supervisors and monitoring workers and those units supervised and monitored, the SMH
yield of food increased from 54% in 1997 to 85.3% in 1999, and 94% of the food supervised and
monitored has adopted preventive measures against radiation.
(4) Community health care service (CHCS): Recently CHCS in different areas of the province has
been developing in a favorable way. The province has formulated “Suggestions for the
development of urban and rural CHCS in Zhejiang”, conducted wide propaganda among the
public and important step by step the relative policies, thus prompting steadily the development
of CHCS.
Hangzhou has put the construction of normalized CHCS institutes into its key projects aiming at
serving the people. Up to 2000, 90% of the population in Hangzhou has access to CHCS. Ningbo
has also created a favorable environment for the over-all development of CHCS by improving the
relative policies. The government of Jiaxing put CHCS into the No. 1 projects of its eight key
projects and appropriated special funds to support it. Shaoxing, following the spirit of
“Harmonious development between the urban and rural areas”, has also improved and carried out
the relative policies for the development of CHCS. Now 34 cities proper, 57 counties, 430
villages and towns and 275 residential districts in the province have initiated CHCS stations (14
of which are regarded as models at the provincial level and 257 of which are regarded as models
at the city level), covering a population of 1,260 million. In the different areas of the province,
qualified CHCS institutes have also been chosen as designated units for medical insurance and
family beds are also given part of the whole society’s funds for medical insurance.
38
5.The total amount, distribution and increasing rate of health care funding
(1) The overall situation of health care expense
The total amount of health care funding in Zhejiang province is 20.781 trillion in 1999.
Compared with 13.638 trillion in 1996, it increased 52.38%, among which the increasing rate in
1997-1998 is the fastest as 23.92%, and the increasing rate in 1998-1999 is 5.66% with apparent
fall after the rise in previous year.
The proportion of health care funding in the GDP of Zhejiang province was 3.94% in 1998 and
3.87% in 1999, which is tending to decrease. And it is far lower than the proportion of total health
care budget in the GDP of China, which was 5.1% in 1999.
The health care expenses per capita in Zhejiang province increased from 309.95 Yuan in year
1996 to 465.17 Yuan in year 1999 with an increasing rate at 50.08%, at the same time that in
China increased from 233.50 Yuan to 331.90 Yuan with an increasing rate as 42.14% (Table 23).
Table 23 Overall situation of Zhejiang’s health care budget from year 1996 to 1999
1996 1997 1998 1999
Total health care funding (in
trillion)
13.638 15.871 19.667 20.781
GDP (in billion Yuan) 414.606 463.824 498.750 536.487
Proportion of GDP（%） 3.29 3.42 3.94 3.87
Expense per capita（Yuan） 309.95 358.89 442.27 465.17
(2) The funding proportion of total health care funding
The government’s expense, individual’s expense and society’s expense in the total health care
expense of Zhejiang province are all increasing of some extent, among what the increasing rate of
individual’s expense is fastest with an increasing rate of 63.91% in three years from 1996 to
1999; the next is funding from society, which increased with a rate of 46.35% in three years, the
slowest growing is that of government with a rate of 34.77% in three years.
From the distribution proportion of the total health care funding, the proportion of
government’s expense was 14.02% in 1999, which decreased 1.83% from 15.85% in 19996
39
(meanwhile that of China decreases 0.83% at the same time); the proportion of funding from
society of 37.82% in 1999, which is higher than that of China at 12.32%; the proportion of
individual’s expense is 48.17% in 1999 (Figure 9-10).
(3) The operation expense of health care service (including Chinese traditional medicine)
The operation expense of health care service increases every year; it is 1.10866 billion in 1999,
which increased 45.5% of 761.94 million in year 1996. The health care service expense per capita
increases from 17.32 Yuan in year 1996 to 24.82 Yuan in year 1999 with an increasing rate of
43.3%, the increasing rate and actual increasing amount are both higher than the average level of
China.
The proportion of operation expense from the government funding in total health care funding
has a tendency to decrease from 1996 to 1999, among which is lowest in 1998 and increased a bit
in 1999 (Table 24).
Table 24 The operation expense of Zhejiang from 1996-1999
1996 1997 1998 1999
Health care operation expense （ in
million）761.94 877.98 982.37 1108.66
Proportion in total health care
expense（%）5.59 5.53 4.99 5.33
Proportion of government
funding（%）35.26 38.81 36.75 38.06
Operation expense per
capita（Yuan）17.32 19.85 22.09 24.82
40
(4) The tendency of change in the expense of outpatients and inpatients.
Outpatient fee and hospital bed fee per time increase year by year with a fast speed in hospitals
at villages and towns’ level or above. In year 2000, the outpatient fee and hospital bed fee is
82.02 Yuan and 3760.30 Yuan respectively, increased by 70.63% and 63.65% compared with that
in 19996.
Meanwhile, the average residents’ expense in Zhejiang of year 2000 is 4366.00 Yuan, increased
27.96% compared with that in 1996. The outpatient fee and hospital bed fee both increase faster
than the average residents’ expense compared with the annual expense per capita (Table 25).
Table 25 expense of outpatients and inpatients in Zhejiang from 1996 to 1999
1996 1997 1998 1999 2000
Outpatient person-
time（persons）1076317
30
1020136
70
1045156
27
1072453
09
1127164
02
Outpatient time per
capita（times）2.45 2.31 2.35 2.40 2.50
Outpatient fee pre
time（Yuan）48.07 58.72 66.36 74.16 82.02
Actual bed occupied
date（day）2259479
2
2172044
3
2128608
7
2182440
4
2277893
4
Average inpatient day per
person（day）11.64 11.34 11.40 11.46 11.05
Hospital bed fee per
day（Yuan）197.36 232.32 268.02 302.45 340.21
Hospital bed fee per
time（Yuan）2297.80 2634.08 3055.71 3466.13 3760.30
Average residents’
expense（Yuan）3412.00 3670.00 3784.00 3877.00 4366.00
(6) The differences between the development of economy and health care
The development of economy all over the Zhejiang province has great difference due to some
factors as area, history, thought. After twenty yeas’ reformation and opening, currently, the north,
41
middle and east parts of Zhejiang are relatively well developed compared with south and east
part, whose GDP per capita, average disposable income of both urban and rural residents, average
net income of rural residents are the lowest in Zhejiang. The increasing rates of national economy
during the ninth five-year plan are the last two. So these two areas both are listed as now enough
developed economy areas (Table 26).
Table 26 the economical and social situation of 11 cities in Zhejiang
CITY
Total
population
（million）
GDP
per capita
（Yuan）
Average
disposable
income（Y
uan）
Average
net income
of rural
residents
Saving deposit
of both urban
and rural
resident
(billion)
The increasing
rate of GDP
during the ninth
five-year
plan（%）
Hangzhou 6.2158 22342 9668 4496 78.856 12.65
Ningbo 5.4094 21786 10535 4652 58.606 14.05
Jiaxin 3.3125 16359 9338 4457 32.689 10.99
Huzhou 2.5579 14794 8684 4067 16.028 10.70
Shaoxin 4.3269 18042 9422 4759 39.893 13.65
Zhoushan 0.9841 11586 8886 4228 8.539 9.18
Wenshou 7.3632 11360 12051 3951 46.415 15.46
Jinhua 4.4642 12271 9223 3464 30.92 9.90
Quzhou 2.426 6691 7592 2615 9.749 7.18
Taizhou 5.4662 12390 9225 4296 28.962 9.68
Lishui 2.4858 5515 7960 2227 9.478 7.69
About the configuration and utilization of the health care resources in every city, the number of
hospital bed per thousand residents is over 2 except Wenzhou, Taizhou and Quzhou. But the
number of doctor per thousand resident is below 2 in every city except Hangzhou and Zhoushan.
Analyzed the areas with relatively more health care and medical resources, Hangzhou is the
capital, Ningbo is a independent planning city and the reason for Zhoushan is that due to its
location: it locates on islands with dispersing residents who cannot share the resources (Table 27).
Table 27 Configuration and utilization of the health care resources of 11 cities in Zhejiang
42
CITY
Operation
fee per
capita（Yuan
）
Number of
hospital bed
per
thousand
residents
Number of
technicians
per
thousand
residents
Number of
doctors per
thousand
residents
Number of
nurses per
thousand
residents
Rate of
utilization of
hospital
bed（%）
Hangzhou 33.98 3.75 5.71 2.63 1.80 60.18
Ningbo 29.91 2.55 3.54 1.75 0.94 67.43
Jiaxin 16.60 2.58 3.22 1.57 0.91 58.82
Huzhou 13.64 2.88 3.38 1.61 0.96 56.27
Shaoxin 14.84 2.15 2.84 1.47 0.60 66.27
Zhoushan 36.54 3.29 4.24 2.08 1.25 59.35
Wenshou 19.30 1.64 2.90 1.24 0.57 59.50
Jinhua 12.69 2.24 3.65 1.81 0.82 64.68
Quzhou 13.63 1.89 2.87 1.50 0.67 52.34
Taizhou 16.00 1.73 2.71 1.19 0.60 70.34
Lishui 19.00 2.23 3.05 1.42 0.71 53.53
7.Health care administrative management system
The health care department or bureau of province, city and county is the health care
administrative management organization as the component of corresponding government and
areas managed, which form the directive relationship from top to bottom.
The health care department of Zhejiang province is a component of Zhejiang provincial
government. It organizes and leads Zhejiang’s health care service under the provincial
government, by implementing health care related general and specific policies, laws and
regulations of the nation and province. The health care department is lead by the chief, the vice
chiefs assist the chief to fulfill corresponding jobs. There are twelve executive business offices in
health care department.
The main function of health care department:
1). Investigate and draft bylaws, draft planning related with health care administrative
management, organize to implement after approved; formulate related standard policies;
investigate and work out the development planning and strategic goal of health care service in
Zhejiang; formulate and implement technical standard and local hygienic standard; investigate the
43
directive standard for the configuration of health care resources, verify and supervise the
implement of district health care planning.
2). Perform the management function of the whole health care field under law, responsible for the
management and announcement of health care information.
3). Perform the management function of health care executive supervision according to law,
supervise and control the prevention of infectious diseases, food, professional, environment
radiation and schools’ hygiene and blood donation under law.
4). Carry out the prevention as main principle, develop general health care education of the
nation; formulate the prevention planning of serious diseases for the masses, organize the
comprehensive prevention of major diseases; organize and manage the health care technical staffs
among the Zhejiang province, handle the accidental condition of disaster and epidemic situation.
5). Implement the principle to lay equal stress on the traditional Chinese and Western medicine,
responsible for the heritage, renovation and the combination with Western medicine of traditional
Chinese medicine, investigate and advance the modernization planning for traditional Chinese
medicine and implement the supervision.
6). Direct, supervise and manage the commune health care service, the health care service in rural
areas, basic health care service, the health care service for woman and children in Zhejiang
province; implement the specific technique for pregnant woman and newborns. According to each
responsibility, cooperate with the birth control department closely; provide birth control service
and health care service for bearing babies related with bearing children, birth control and sterility.
7). Formulate the development planning of medical technology and education in Zhejiang;
organize the implement of overcome of major medical academic difficulties; organize and
improve the transformation and promotion of the medical academic achievements; organize the
professional education as medical continuing education, general medical education and high
medical education.
8). Investigate and direct the formation of medical health care service; responsible for the
classification management of medical service.
9). Manage the internal medicine and utilities in the medical service, and accept the law-based
supervision by the medicine supervision and management department; responsible for the
analysis of the side effect of the medicine used in medical preventive department; manage the
tender on medicines with other departments.
10). Formulate the development planning and professional ethics standard for health care
personnel in Zhejiang province; formulate and implement the personnel force criteria and the
certificate of health care service personnel.
44
11). Investigate and formulate the development strategy and long-term development planning of
economy in Zhejiang; supervise the state-owned capitals of the department owned medical
service, coordinate the development of medical economy.
12). Organize and direct the bilateral and multilateral exchange and cooperation, both of
government and civil level in medical and health care field, together with the medical aid in
foreign countries; organize and coordinate the exchange and cooperation between Zhejiang and
WHO or other world organizations; manage and develop the exchange and cooperation with
Hong Kong, Macau SAR and Taiwan in medical health care field.
13). Responsible for the health care for leading comrades of the central authorities and important
foreign guest in Zhejiang; responsible for and manage the health care service to the subjects
defined by provincial health care committee.
14). Bear the daily operation of such organization as: provincial patriotic health campaign
committee, provincial basic health care committee, provincial local diseases prevention leading
group, provincial blood donation group.
15). Participate in the reformation of basic medical insurance system for both urban and rural
residents, participate and formulate the implement details of the management of fixed medical
service and the supervision on the service and management of such service, and the formulation
of <the list of basic medical insurance medicines in Zhejiang>; participate and formulate the
service range, charge standard and project charge standard for such service.
16). Responsible for and manage the health care institution on provincial level.
17). Undertake some business by the provincial government.
Meanwhile, the provincial health care department entrusts the 18 medical or health care
institutions on provincial level, which are directed by the provincial government administratively,
respectively. They provide specialized technical guide and supervision to Zhejiang in their
specialized field. The health care bureaus of each city or country bear the same administrative
responsibility and function in related district as that of provincial health care department.
8.Main issued health care policies and the effects of implement
With twenty years’ of reformation and opening, China issued most health care policies after the
foundation of the China. Especially after the national health care conference in 1997, the central
committee of the communist party of china and state council issued the Decision on Health Care
Reformation and Development; in year 2000, the state council transmitted the Directive Advice
on Reformation of Urban Medical and Health Care Service; this year, it transmitted the Directive
Advice on Reformation and Development of Rural Medical and Health Care Service.
45
After the announcement of every important health care policy by the nation, the provincial
government and party committee will formulate relative implement methods and series of new
policies according to the reality in Zhejiang. The main health care policies issued in Zhejiang
recently years include:
1.Health care economical policy
1). The funding of the health care service by the government should be suited to the development
of economy, whose increasing rate cannot be lower than the increasing rate of the local financial
budget in that yea; some qualified towns and countries should increase the proportion of the
funding of health care of the financial budget to 5. The operation fee for traditional Chinese
medicine should be the same or even higher than 10% of the general operation fee for health care.
2). The funds of health care administrative departments at all levels, the health care supervision
and execution organizations, and public health care services who provide public health care
service like diseases prevention, health care for woman and children are provided by fiscal organ
at the same level.
3). Some qualified towns and countries should step up the public medical succor funds, which is
used to help the health care service to bear some fees unaffordable caused by some accidental
events, and the debts caused by the humane succor for some patients disable to afford or without
relatives.
4). Establish regulation funds for the development of health care service, which is particularly
used for the development of prevention and the health care service in rural areas. The recourses of
the funds can be from many ways as the donation by the society, financial support by the
government, and the management charge on private hospitals (included joint stock, co-
investment, cooperation hospitals), clinics and private drugstores. The local government
according to the reality and economical development defines the concrete proportion or number.
2.Health care policies in the countryside
1). The health care service has been mainly managed by the collective. Commune hospitals
manage the health care service in villages as an organic whole according to management model
as unified management, personnel allocation, financial management, and the management on the
recourses of stocking, the vocation and distribution of the drugs.
2). Local governments at all levels are responsible for the implement of medical cooperation in
rural areas under their jurisdiction. Related departments like health care, planning, finance,
agriculture and civil administration are responsible for the direction of medical cooperation. The
46
funding of medical cooperation is mainly dependent on private input, with support from
collective and government. The some portion of the net income of the countries and collectives
should be used in medical cooperation. The governments at all levels also need to appropriate
proper fund, the specific amount and proportion should be defined by the local government.
3). We will continue to reinforce the prevention health care service and “three complete sets
without one” (complete sets of personnel, facilities and funds without any unsafe house)
construction of the commune hospitals. From 1997, the provincial government increases 10
million Yuan every year mainly as the subsidy for the development of commune hospitals in such
areas as poor, remote and poor-developed areas.
4). Hospitals at country level or higher should choose a commune hospital in poor areas, as the
counterpart object to assist; help it in personnel training, techniques, finance, utilities and
management, and try to put an end to the backwardness of these hospitals in three years.
5). In order to encourage students graduated from universities, colleges and professional trainings
to work in commune hospitals, every such health care technician graduated from universities or
colleges and so on, who married a rural resident and works in medical or preventive service in
rural areas or village for ten years, can be given consideration to let a single children under15
(under 18 as a high school student) to have non-rural registered permanent residence rather than
rural registered permanent residence. The promotion of health care technician in rural areas
should be based on the reality, concerning to such persons with professional skill and a high local
credit and also qualified with other standard; their requirement on thesis and foreign language can
relax.
6). Implement the system that all the health care technical staff in towns must serve in the rural
area for a fixed period before their promotion.
3.Policies on the reformation of the health care prevention and supervision execution system
1). According to Regulations of the Organization and Establishment of Sanitation and Epidemic
Prevention Station at all levels issued by health care department and former national editorial
broad in 1980, with carefully consideration of some factors like working responsibility and
population increase, we defined the establishment of the health care supervision sect and that of
disease prevention center reasonable. And we try to establish standard and advanced
comprehensive preventive health care system and form the health care supervision sect.
2). The operation fee of health care supervision office and diseases prevention and control center
is appropriated through the former sources as health care epidemic prevention station as the same
level; all areas should ensure the fund for health care supervision and disease prevention and
47
control according to the requirement by <the decision on the reformation and development of
health care> by the central committee of the communist party of China and state council. And
based on the need of the development and financial ability, they can revise the appropriation
portion and increase the funding of health care supervision and diseases prevention and control.
4.Policies on the reformation of both the management system and operation system in the
medical health care service both in towns and cities
1). Insist the principle that the public ownership as the main part, all sorts of ownership co-
develop; encourage social capitals hold medical service or other related service independently by
all means.
2). Enlarge the decision-making power of state owned medical service, positively investigate such
management system like hospital management committee, executive council, conscientiousness
by the lead doctor; perfect the conscientiousness by the head of the hospital, and let such
hospitals really to be an autonomous official person. Launch a pilot project the free job-seeking
system for skilled doctors.
3). Encourage the multiple cooperation and coalition between state owned hospitals by
techniques, funds and management, and they also can establish new medical service sect.
4). The enterprise’s hospitals in cities should be stripped off from the enterprises step by step, and
be put into the medical service system in towns and countries by sorts of means.
5). Such commune health care service in towns and countries, which are defined as non profitable
medical service, can be listed as official hospitals for basic health care insurance.
6). Some state owned hospitals, which implement property right system reformation, and
qualified with local health care planning, implement directive prices for medical service items
defined by the government and use the main income to improve the medical service conditions,
can be defined as non profitable medical service.
5.Policies on the reformation in drug distribution system
1). Medical service is the behavior subject of the tender of medicine. Medical service, which has
the ability to draft the tender documents and organize the accessing capability, can form the
tender by itself or together with several other medical services, and it can entrust the eligible
agency to invite tenders.
2). The medical service implements two management systems for revenue and expenditure. The
remaining portion of the balance of revenues and expenditure of the medicine should be turned
over to the finance at the same level. The finance should earmark this portion for its specified
48
purpose only, which should be used for health care service. The finance and health care
administrative departments at all level cannot divert or withhold this portion, and cannot
compensate and decrease the budget.
3). The remaining portion of balance of revenue and expenditure will be planned as a whole by
both the health care and finance departments, which is mainly used in the development of
hospitals, commune health care service and prevention health care service; the fund for commune
health care service and preventive health care service cannot exceed 10% of the remaining
portion of the balance of the revenue and expenditure.
4). Reasonable formulate the retail price for medicine purchased by tender. Concerning the
difference between the actual tender price for tender medicines and current retail price, we should
lower the retail prices of medicine step by step according to the principle as giving the most profit
to consumers with consideration of the initiative of the medical service in tendering and
allocating the lowered profit between the medical services and patients rationally after the
subtract of the reasonable price difference should acquired by the medical services and
distribution service.
6.Policies on the price of medical health care service
1). The price of medical service is practicing both government directive price and market
regulative price, and canceling the government fixed price. The government directive prices for
main medical service items are defined and revised by the province; other government directive
prices of medical service items are formulated and revised by each city.
2). Third level hospitals can float the prices 20% low or high according to current charge standard
by their selves; second level hospitals can float 10%. We can revise some charges as nursing fee,
operation fee and traditional Chinese medicine service charge; in addition, we lower several high
examination fees of large-scale medical facilities.
3). Relax the directive prices of the specialized service needed by non-profitable hospitals.
The implement of so many policies will bring new opportunity and vitality for the development
of health care service.
Analysis on the main health care policy
Although health care facility of our province has made great progress, it still lags behind the
fast economic and social development. It also cannot match the increasingly demand by the
49
masses on the medical service and health care. There are some drawbacks in some already
formulated and practiced health policies. The main problems as followings:
1.The transformation of the government’s function does not apply to the development of the
communist market-oriented economic system
Market economy is law-based economy. Under the socialist market-oriented economic system,
the main function of the government’s health care executive branch is to execute by the law,
reinforce the scheme, supervision and management of health care development. But neither the
policy circumstance at present nor the opinion of health care executive department does not adapt
to the fast development of the market-oriented economy. This behaves as several points: A). The
formulation of related health care policy is stagnant. For instance, the classification criterion of
the profit-seeking and nonprofit-seeking medical facilities is not clear. The medical and profitable
policy of the profit-seeking hospital is also not clear. There is no necessary policy available for
the reformation of health care system in the rural area. The permit system of health care lacks of
operation and authority. All of above affect the implement of the reformation. B). The function
division of different government department is not defined. The overlap of the function and the
multi-management appear. One example is the multi-investment and management in health care
facilities; a family-plan guide section is established in every small town, but due to the similarity
in function with that of hospital, it causes the unnecessary waste of the resource and the conflict
between the government department and the facilities. Meanwhile, enforcement and supervision
of some health-related products, like medicine, food are enforced by several departments like
quality supervision section, commercial supervision section, health care supervision section and
medicine supervision section. It not only causes the unclear of the major force, but also brings
difficulties to the dealer. But the management and investment of health care insurance policy,
which relates to the health guarantee for amply peasants like cooperative health care, is organized
and applied by the department, which is supposed to be in charge of supplying health care
service. This does not fit at all. And some tasks like the regeneration of the water-supply system
in the rural area and the transformation of the schistosomiasis, which should be interposed by the
construction department, agriculture department, water conservancy department and the forestry
department, but they are finally managed by the health care department; C). Health care executive
department itself does not change its role from the “runner” to the “manager”, it is busy with the
daily issues, but not the macro-supervision, investigation, law-directed execution of the fast
development of health care service.
50
2.The change in the charts of diseases, causes of death, population brings great pressure on
the reformation and development of health care service
From the report on the occurrence of official infectious diseases: the occurrence rate is
257.19/100 thousand, 289.39/100 thousand, 294.52/100 thousand, 321.32/100 thousand,
299,95/100 thousand for the year from 1996 to 2000 respectively, in which the occurrence in
2000 is lower than hat of 1999 but still higher than that of 1998. There is not apparent decrease in
the occurrence; some infectious diseases are still the major diseases, which harm the peoples’
health. No matters in towns or countries, the main diseases, which course the occurrence of the
infectious diseases, are viral hepatitis, venereal diseases and tuberculosis. The increase of the
venereal disease is especially apparent, which is double in the recent five years. The occurrence
of the tuberculosis also increases to some extent. As the occurrence of the diseases, hepatitis B,
gonorrhea and tuberculosis are the first three in the towns, in which gonorrhea is already in the
first place of the occurrence in the infectious diseases. Although the first three diseases with the
highest occurrence in the countries are the same as that of the towns, they increase with some
extent.
From the chart of the courses of death, the major courses of the death in our province are
tumor, cardiovascular diseases, diseases in the breath system. Tumor has been the first course of
the civilian in the town. The courses of death by the cardiovascular diseases have risen from the
5th position in the 1995 to the 2nd position in 2000. The occurrence of hypertension, as the major
course of death in the cardiovascular diseases also increases. The position of the chronic lung
diseases decreases from the 1st in 90’s to 2nd in the countries, 3rd in the towns. The course to
death by injury and toxification increases dramatically in both towns and countries; they are the
5th and 4th course in the towns and countries respectively. In addition, among the small village
and township enterprises in our province, there are a quiet number in such field like chemical,
electroplate, printing and dyeing and tanning. They pollute and injure the environment, water
sources and peoples’ health. The toxification by benzene and lead is very common in such
companies in the recent years, which remind us that we should reinforce the supervision and
investigation on health care, in order to protect the environment and prevent the professional
injury.
3.The development of health care supervision executive department and personnel seriously
lags behind the need by the development of the market-oriented economy
By the transformation of the system of health care supervision executive department, the
executive force has been reinforced to some extent. But there are still some problems. Nowadays,
51
there are over twenty regulations and laws issued by the government, but personnel of health care
supervision executive department are dispersed, the power of that is also weak and it lacks the
authority in that. The particular manifestations of this are in several fields: 1). Although we
already defined health care supervision section stands for health care executive department,
which keep the continuance of health care execution. But this does not resolve the problem in the
system of the administrative enforcement at all. Because health care supervision executive system
is not directly leaded, and the large amounts of the personnel are not government official workers,
both of which cause great difficulties in the enforcement. 2). The increase of the subjects of
health care supervision, up to the end of 1999 in our province, there are over three hundred and
eighty thousand companies in the food manufacture and supply field, along with over eight
hundred and thirty thousand workers in this field, sixty and five thousand public places with over
three hundred thousand workers, about three hundred companies in the cosmetic field with four
thousand workers, over five thousand companies in the water supply field, about three companies
with radioactive materials with a total number of workers around six thousand. But the total
number of the personnel in health care supervision in our province is only six thousand, and the
fund is insufficient, the facilities for the transportation, communication evidence collection and
supervision is obsolete, some facilities are even behind than the subject to be supervised, all of
these cause the ability falling short of our wishes. 3). Some currently in effect laws as “The
regulation in the prevention of infectious diseases”, was issued many years ago, the strength of
the punishment and manipulation of the clauses in such laws are weak and poor. And they cannot
meet current needs.
4.The influx of the nonnative brings new problems in the public health care and the
prevention of diseases
Based on the investigation, the total number of the transient population which stay in our
province over three months is from three million to four million, this maybe keep increasing with
the sustained development of the economy.
The direction of the influx is to the relatively active towns in the development of economy and
the developing villages. Among the influx, about thirty and forty percent is from other province,
mainly from relative poor provinces like Jiangxi, Anhui, Hunan, Guizhou, Sichuan. Other parts
are from the relative poor region in our province in the west. There are many examples of influx
that move with the whole family, so in about every forty and fifty transient person, there is a
child.
Due to the sustained increase in the transient population, some problems are increasingly
52
apparent in the public health care and the guarantee of the health in that population. 1). The
resident in developing towns and villages, which has a large influx of transient population,
increases dramatically. The public health care facilities as water supply system, housing, and
disposition of the excrement, urine and wastes lag behind the development, especially in the area
between the towns and countries. These affect the public environmental situation, and also cause
the breaking out and prevalence of the gastroenterological infectious diseases. 2). Due to the limit
in their education and techniques, the transient population are always engaged in labor-intensive
field, even physical labor with some poisonous materials, which easily cause the professional
injury and accidental casualties. And they are not acclimatized with the new place to some extent,
which maybe cause some problems in mental health. 3). This group has a relatively low income
together with a poor family, which also lacks essential social guarantee. So the rate of seeking for
medical advice after having a disease is obviously lower than the local residents. The necessary
health care for the children and women like the immunity of the children and health care for the
pregnant women should be reinforced. Additionally, the transient populations maybe cause the
input of the infectious disease like schistosomiasis, malaria and filariasis.
Based on the statistic report on the occurrence of official infectious diseases in our province,
the occurrences of measles, influenza, hepatitis B and gastroenterological infectious diseases are
higher than permanently residents. The occurrences of malaria, infection by HIV and tetanus in
newborns are even much higher. Therefore, as a high-risk group of above infectious diseases,
transient population should reinforce the prevention and be paid more attention on.
5.The public health care awareness and health care consumption sense need to be improved
Although the masses enter a relatively comfortable life, health care awareness still falls behind.
Smoking, indulging alcohol, such bad habits are increasing not decreasing, the unclean sexual
behavior among some persons cause the dramatically increase in the occurrence of venereal
diseases. Some would rather like to eat and drink extravagantly, spend wastefully for birthdays
and weddings, or buy any kind of nutritional products, but not to spend any money in physical
training, entertainment and health care insurance. When to choose for the medical service, some
for no reason whatsoever pursue the biggest, highest grade hospitals regardless of the situation of
the diseases, which increase the unnecessary pressure for the big hospitals but also increase the
burden for nation and individuals. Irresponsible advertisements by some drug-dealers, hospitals
and medias lead miscomprehension on health care consumption, but the improvement of health
care is still in the former low level of health dissemination due to some reasons like the lack of
the fund and intellectuals.
53
6.The unbalance among the health facilities, insufficient investment and wasting of sources
Because the establishments of the organizations are based on the administrative area and
department, hospitals and personnel are rich in the towns. The investment by the government to
the health care service also focuses on the towns. Some hospitals expand the scope blindly,
compete in buying expensive medical utilities, all of which cause overuse and waste in the
resource configuration and utilization, this also cause the fast increase in the public medical
expense. Compared with the towns, such works like the fundamental utilities and preventive
health care are relatively weak, the investment by the government is apparent not enough, the
number of personnel in the health care service is low together with low technical level, the health
care service is obsolete with low technical content. All of above can not satisfy the basic medical
and preventive health care demand by the resident in the countries.
Among the investment in health care service, the total investment in health care service is 5.1%
of GDP on national level, but it is only 3.87% in our province, which is obviously lower than on
national level. Meanwhile, in the total expense on the health care by the three major sources like
government, society and individual, the budget of the government increases with the lowest rate.
Its ratio in the total expense on the health care has been decreased continuously; it is only 14.02%
in 1999.
7.The investment environment of the development of health care for the private companies
should be improved
Although the dramatically development of the private companies provide good opportunities
for enlarging the fund of health care service, which also improve the optimal configuration of the
health care resources by the market competitive system, this kind of positive factor does not make
full effect because of some reasons as related policies and thinking.
There are some reasons for the restriction of the private hospital: a). The related policies on this
kind of hospitals from the government are not clear, social investors doubt about the future
development of those hospitals, some factor like mentioned above affect the investing scale and
strength for those hospitals. b). There are some miscomprehensions of those hospitals among the
masses, which do not trust those hospitals very well. Higher quality skilled persons and new-
graduated students are not willing to seek a position in those hospitals. Both affect the
competition of those hospitals. c). Those hospitals lack of persons who have management
knowledge; the administrative and technical management are relatively poor. d). They lack
necessary directing policies and atmosphere for their development. Private capital will pursue a
54
non-profitable name although they want to invest a profitable sect. On the other hand, there are
very few private investors who are willing to invest for a non-profitable sect by themselves.
Besides above mentioned, some private hospitals did not conduct enough investigation before the
establishment, which causes the non-competitive after set up.
8.The internal reformation of the medical service lags behind and cannot match the change
in the development of the market-oriented economy and the masses’ health care demand
Because of the long-term effect of the planned economy and thinking, both the administrative
and executive systems of the health care service still are short of vitality. Although the
reformation till now make some progress, but it does not involve the fundamental aspect in the
system and mechanism, which cause the some health care service sects lack the initiation and
awareness to reform by the development of the market-oriented economy and the demand by the
society. Such sects pursue for the profit blindly, focus on the external expand but not the internal
development, lack of awareness of the competition with low quality of service and low
productive efficiency, overstaffed. The masses cannot feel the benefit by the reformation of the
hospitals. Especially after our country acceded the WTO, neither administrative department nor
the executive department both lack the investigation on the effect and related reply policies on
current health care system and mechanism by our country’s promise to open the medical and
dental service, both of them lack the feeling of crisis and urgency. Besides, health care executive
department is still in the role of “runner” but not a “manger” of the health care service. The right
of the owner and runner of the hospital is not clear, and the responsibility. Hospitals also lack
talents with professional management ability. The administration system by the corporation for
current state-owned hospital couldn’t be established now is another reason for the behind of the
reformation.
9.The problems in the health care insurance for residents in the countries are prominent
The medical insurance for the worker in towns is under promotion step by step, and about a
quarter population of the residents in the countries participate some kind of medical insurance
like cooperative health care service. But the total coverage of the medical insurance is still low,
and the level of guarantee is low also. A considerable number of the workers in towns do not have
basic medical insurance. Especially, the establishment of the medical guarantee system in most
countries makes slow progress. Besides a small number of civil servants like teachers,
government office workers and medical service personnel have the basic towns-works’ medical
insurance; almost all of the residents in the countries do not enjoy the basic medical service
55
organized by the government. They need to pay the entire medical service fee by themselves. The
current organization and investment level of the cooperative medical service in our province and
so on cannot match the market-oriented economy and the development of the economy. We need
to explore actively for the new systems and ways, which are suitable for the reality.
10.The formulation and execution of the health care related policies and reformation
measure lags behind
Although the absolute investment in the health care service by the government increases every
year, but compared with the demand by the nation “the rate of the accruement of the
appropriations on the health care service by the government cannot lower than the rate of the
accruement of the total expenditure”, together compared with the development of the economy in
Zhejiang province, the appropriation on the health care service by all levels of governments is
definitely insufficient. The percentage of the appropriation on the health care service in 6.6% in
1980, it decreased to 4.59% in 1992, and even 3.78% in 1999.
Nowadays, not only the increasing rate of the appropriation on the health care service is low,
but also the distribution of the appropriation is not reasonable, which do not fundamentally
change the distribution focused on the towns and medical service but not the countries and
prevention. In 2000, the total expenditure on prevention is only 3.32% of the total appropriation
on health care service, which cause the impossibility to execute the prevention and to improve the
standard, make the whole system be tired out by too much running around. All of above cause the
low efficiency in the medical and health care service and the low benefit.
The lag of the reformation cause the distortion of the policies of the health care, which cause
the insufficient appropriation by the government where need to be sufficient funded, and
shortness and waste by the unfair distribution among the limited appropriation. It also causes the
medical service sect to execute the policies like “paid service,” allowed by the government in
order to make up the insufficiency of appropriation. Although these kind of policies apparently
improve the ability and standard of the service, resolve the shortness of the public health care
service, but it does not make reasonable change according to the reformation in the economy
system, incapable to make up the cost, cannot reflect the value of the technical service, all cause
the rapid increase in the medical burden of the society and the masses.
District health care planning is an important means to execute the macro-administration of the
health care. But now, its significance and value does not get enough attention for all respects. The
already formulated planning lack stability, and they are influenced by many interfere during
execution, weak in authority, so they cannot bring the function into full play.
56
Under the new situation as we entered the WTO, the fact that the stated-owned hospital occupy
a dominant position will change with the influx of foreign capital into the medical market of the
large and middle towns, as the foreign invested hospitals into service. The competition in the
medical service will be more vigorous with the entering of foreign advanced techniques, utilities
and management into our province. With the opening of the insurance service market, the medical
insurance service will be varied again the unitary nowadays. It is possible to open a hospital by
the medical insurance sect; the diversification of the hospital host and the management will make
the stated-owned hospitals feel the pressure to survive. Intellectual property rights related policies
will be more perfect, which cause the intellect-concentrated health care service to face the more
comprehensive legal standard, bring many new challenge like the macro planning and
configuration in health care resources, health care supervision and execution, establishment of the
fair competitive market to the health care administration sect.
The health care job of our province really face a great challenge, but it also face the rare
opportunity for development.
First, the continuous fast development of the economy in our province, not only provide more
financial support for the social public utilities like health care service, but also improve the
expense on health care service by the increase in the income. The diversification of the need of
health care service will be appeared. The health care service will be developed. Especially, as our
province first advance and promote to fulfill the goal of socialist modernization in advance, it will
promote the health care service’s development greatly.
Second, our province is one of the provinces, which have relatively early developed and fast
developing private economy. Private capital is already set foot in the health care service. The
appearance of the private hospitals not only expand the investment channels for the development
of health care service, but also bring the competitive market situation with the stated-owned
hospitals. All of them optimize the configuration of the health care resources and improve the
standard and efficiency of the health care service by the order market competition.
Third, from last year, the central government and all level of governments in our province
announced several series of policies to promote the reformation and development of the health
care service in both towns and countries. These policies define the goal, mission and concrete
steps to deepen the comprehensive reformation on the aspects like residents’ medical insurance
system, the health care administration systems in urban and rural areas, the manufacture and
distribution management system for the medicines, the price policies on medical service and
medicines, the model of health care service. The province government and related departments
also announced several related and completed policies, which provide a relatively complete frame
57
for the reformation and development of the health care service.
Fourth, China’s entering into WTO brings up new opportunities for the reformation and
development of the health care service. According to market and international goal, we will refer
to the useful experiences from the already matured reformation in the state-owned companies,
combine that with the attribution and characters in the health care services, fully utilize the
domestic and international resources, build more fair and formulated market competition and
order, develop the health care service in our province and serve the residents in our province.
The suggestion on the main health care policy
Whereas the fast development of Zhejiang’s economy, and the lag of the development of health
care service, we formulated the Modernization of Zhejiang’s Health Care Service, 2001-2002 in
order to promote the development of the health care service and ensure the realization of strategy
as basically realizing the modernization in Zhejiang in thirty years advance by the provincial
party committee. We raise the whole goal of the development of Zhejiang’s health care service as
following: up to 2020, we will establish the comprehensive and suitable health care system for
the socialist market-oriented economy and the need by the masses, which include health care
supervision and execution, the prevention and control of the diseases, the health care service in
community relating with comprehensive hospital and specialist hospitals. These will let the
masses enjoy the good health care service according to the modern life, and satisfy the need at
multi-level and desire by the society, decrease the health difference between the areas and
populations, extend the life span expected by the masses, make the main national health index
close to the middle developed countries, fulfill the goal as “powerful province in health care
service”.
In order to reach the above mentioned goal, based on the retrospection, analysis and
investigation on the year 2000’s situation, policies and so on, we raise following countermove
and suggestion of the next step in the reformation and development in Zhejiang’s health care
service.
1.Reinforce the government’s function, support by the policies and macro management
The direction on the health care service by the government firstly is the guide and support by
the right policies. With the Retrospection to the reformation and development on the health care
service in Zhejiang, the most profitable are policies. In the future, government will keep
formulating and perfect the new policies for the development of the health care service, and
58
supervise the implement. The guide and regulation on following aspects need to be reinforced
especially:
1). Enlarge the input to the social development facilities including health care service, and
improve the distribution of the input.
The function of the government under market-oriented economy ought to focus on the
development of public facilities, organize public service and provide public products. In the
health care field, government should regard the resolve of the need in the basic health care by the
masses as its duty, pay attention on the input to the construction of fundamental health care
infrastructure, which satisfy the basic health care service by the grass-rooted level population.
Recent years, the government of Zhejiang province enlarged the support to the health care
service. For instance, between the years 1997 and 1999, the project “Do not leave the unsafe
building of the commune hospital in countries to the 21st century”, issued by the government was
fulfilled in 2000 by enlarging the transferal payment of provincial finance and the strive of the
government of all levels and the society. The total raise of the fund is 100 million Yuan, the
number of hospitals rebuilt is 1220; remove 330 thousand square meters unsafe building. At the
same time, a total number of 33 billion and 880 thousand Yuan fund is invested to add medical
utilities for the commune hospitals in twenty-eight relatively poor countries, which brought the
change from the “five old items” into “five new items”, and improved the grass-rooted service
condition. This year, in the related policies on the system reformation of the health care system in
the towns and rural areas announced by the provincial government, it is clearly defined that the
input to the health care service by the government should match the development of the economy;
the rate of increase of the appropriation on the health care service can not be lower than the total
rate of increase pf the appropriation by the local government that year; the portion of input to the
health care service in the total financial appropriation should increase every year, in some
qualified towns and countries this should be over 5% step by step. In order to set as an example,
the fiscal year 2001 of Zhejiang province expand the input to health care service at its level, the
increase of the appropriation on the health care service is apparently higher than last year, as that
of education and technology. It extends the transferal payment, appropriate a special fund to
support the health care service in relatively poor towns and countries. It establishes a special fund
for the prevention of key diseases in our province like tuberculosis, AIDS, schistosomiasis.
We hope and trust that with the further development of Zhejiang’s economy and society, the
government of all in Zhejiang will expand the direction and support on the reformation and
development of health care service further.
59
In addition, our province also should to absorb, direct and utilize the private capital as fully as
possible, raise the fund for the development of the health care service via multiple channels. And
we should formulate the favorable policies to attract social fund for the development of health
care service, perfect the market regulation for the social fund, direct and encourage the
investment by the social fund to non-government conducted non-profitable health care service
and community health care service
2). Expand the regulation on the development by the government and configure the health care
resources reasonably.
Regulation the configuration of the health care resources is an important function of
government. According to present situation including the structural irrational on the configuration
of the health care resources, low efficiency of usage, the relative lag of the development in rural
area and preventive health care service, lack of funding for the intervene of the key diseases and
health care supervision, and in order to reinforce the macro regulation of the development of
health care service, based on the principle of the plan of the district health care service issued by
the central government, Zhejiang province already announced the standard principle of the
configuration of the health care resources. The eleven cities in Zhejiang province also formulated
local health care service configuration based on this principle. The next step of the development
of the health care service is under the direction of such principle to control the expand of the
health care service sect in the towns, focus on the construction of health care net-work service
both in towns and countries, execute prevention on the key diseases which can harm health of the
masses seriously. Practically focus the configuration of the health care resources on the
communities both in towns and rural areas and the preventions, resolve the acquirement of the
basic health care service.
Based on the rules of the classification management of the hospitals formulated by the central
government, in order to ensure the basic health care service, our government need to put fund and
energy together to run several non-profitable medical service sects well, which can represent the
local development level. After ensuring prerequisite that the non-profitable medical service sects
play a major and directive role, the government can organize and direct the reformation of the
property right and operation system in several state-owned medical service sects, which will
bring the formation of competitive system.
3). Change the government function of the health care service executive sects, enhance the
management on the whole field and macro management directed by law.
60
The health care service executive sects of the government ought to accelerate to match the need
of the socialist market-oriented economy system, change the function, reinforce the management
on the whole field by the means like law, administration and economy. Enhance the supervision
on the action, quality, efficiency and benefit of the health care service, uphold the competition,
and ensure to provide health care service with reasonable price and good quality to the masses.
2.In accordance with the new challenge by the fast development of the economy in Zhejiang
province, adopt suitable policy and strategy for the development of health care service
Zhejiang province is one of the provinces with greatest energy in the economical development
in China. From twenty years ago, the natives of Zhejiang make the economical development rate
among the highest in China, with the spirit as“ constantly strive to become stronger, persistent
and dauntless, bold in making innovations and lay stress on practical results”. The next step of the
reformation and development on health care service should formulate and execute suitable policy
and strategy according to the reality in Zhejiang and carry forward such spirit.
1). The ability to afford to health care service by the masses increases with the general
accruement of the income; the total amount of the health care demand also increases. Meanwhile,
the income difference between different populations increases. Based on the statistics in year
2000, the ratio of the income between the populations in towns and rural areas was up to 2.8:1.
The difference in income causes the different level of the demand on health care service.
Therefore, the development of health care service should not only match the need by the average
income population but also the special need by the population with high income.
2). The formation of the companies and markets around Zhejiang province absorbs a large
amount of social labor force, these not only alleviate the employment pressure on the government
but also bring new problems in the health care service and management in the large amount of
transient population. These should lead to the attention by the government of all levels and other
aspects of the society: first, we should adopt series of policies on the aspects such as salary,
welfare and labor safety for the workers, ensure their safety in the aspects such as labor, food and
water, based on the policy “who recruit that is responsible”, establish and implement the social
laid-off insurance, medical insurance and other guarantee remuneration by steps. Second, related
with the activities of the establishment of civilized towns and communities, depended on the
communities and grass-rooted organization, set up safe, health and economical apartments for
external labor force in the areas with high external labor force density. And provide basic health
61
care service for them like that of local residents. Third, in accordance to some particular health
problems in the transient population, launch health care promotion activities according to their
knowledge; the health care department should bring these activities into the key activities of the
communities. The community doctors and health care specialists should go down to the
communities and the areas with high transient population density to comprehend their demand for
medical service, adopt the doorstep medical service, timely provide women health care service
and planning immunity service for the women and children in the transient population.
3). Fully utilize the advantages in Zhejiang province such as the abundant fund from the private
and their fervencies to anticipate into the health care service development, expand the channels
for funding, promote the fair competition among the medical service sects, satisfy the medical
demand on different levels.
In the course of the guiding the development of the private hospitals, the health care
administrative departments at different levels and related department in the government should
treat private and public hospitals equally without discrimination, support and direct the
development of the private hospitals ardently; allow, appraise and decide the application for non-
profitable medical service by the qualified private hospitals, and compensate for the public health
care duty by them at a reasonable amount. Qualified private hospital can be listed on the key
hospitals of medical insurance. In addition, the health care administrative department can put the
private hospitals into the configuration of the district health care planning, reinforce both the
allowance of the organization, personnel, utilities and techniques of the hospitals and the
supervision of the charge, conduct standard and service quality. For such private hospitals
decided as profitable hospitals, the related department of the government should clarify the time,
range and specific rate for the tax.
In the transformation of the administrative system of the medical service, we should allow and
direct the private capital to set up some market competitive and specialized private hospitals by
the reformation, purchase and recombination of some public hospitals.
3.Highlight three important strategic points; promote the harmonious development of the
health care service
Whether the transformation of the medical model from the biomedicine to the biopsychological
social medicine, or the change in the charts of population, diseases and courses of death of
Zhejiang province, indicates that the development of the health care service is already into a new
phase, in which the development of the health care service must base on the human beings, regard
62
the improvement of health of the crowds as its goal, and the satisfaction of the crowds’ need as
the start point, highlight three important strategic points as health care in rural area, prevention
health care and development of Chinese traditional medicine, fulfill the unification between the
equity and efficiency, quality and profit, transformation and development.
1). Rural area, agriculture and peasants are the corner stone and starting point for all problems in
China, which relate with the overall economical development situation and the stabilization of
Chinese society. 80% of the populations in Zhejiang province live in rural area, which are the key
population for health care service in Zhejiang province. In addition, only two third of rural
residents go to seek medical advice after they fall ill. The condition in the rural grass-rooted level
should be improved. To reinforce the health care service in rural area, we should regard the fulfill
of the fundamental health care service as the key point, further clarify the role, nature and
function in the fundamental health care service of the rural area by the local government and
commune hospitals. We also need to implement related economical policies, constant deepen the
transformation of the administrative and operative systems of the commune hospitals in rural
area, improve the vitality of such hospitals; the transformation of the commune hospitals in rural
area should avoid the direction as “comprehensive hospital”, and they will change to community
health care service step by step, provide comprehensive, convenient and good service to the rural
residents. We should promote the development of medical technical intellectuals for the rural
area, especially the formal development and transforming training of the general physicians, and
actively promote the communities’ health care service. We also need to improve the unified
arrangement of the rural environment, stress the transformation of the water-supply system and
lavatory closely related with the life of rural residents, reinforce the health care education to the
rural residents in order to guide them to good health habits and soundly civil life style and ensure
their physical health thoroughly.
2). “Rely mainly on prevention” is a long-term guiding principle for China’s health care service,
which has such advantages as low input, wide coverage and good cost profit. Facing with the
serious situation of prevention health care, in order to improve the prevention health care, we
must establish and perfect the system as “ district coverage, service without having go to far,
comprehensive function”, recombine the preventive departments and adjust the function by the
district health care planning, reasonable simplify the preventive departments which are
configured scattered by strips currently, set up comprehensive preventive department. Develop
the total profit of the preventive recourses; constantly explore the field of preventive health care
63
service, improve the efficiency and coverage of the service. The government also will increase
the input in preventive health care service, prefect the compensation system. The government
needs to increase the input of the funding such as houses, facilities and personnel and
fundamental preventive health care and enough fund for the prevention and control of some
serious diseases.
According to the prevention of infectious diseases, we should summarize and use long-term
accumulated experience in prevention practice, continue to develop the patriotic health campaign
of a mass character, develop function of three levels preventive health care network both in urban
and rural area. Concerning to the fast spread venereal diseases in recent years, we should
implement comprehensive measures, improve the health promotion.
With regard to the prevention and control of non-infectious chronic diseases, we should
implement related countermoves according to the infectious courses. Such as implementing
screening, determining and behavior intervening for the tumor, cardiovascular diseases, in order
to determine, and diagnosis and treat in the early stage.
3). Chinese traditional medicine is profound and lasting in Zhejiang province and rich in natural
resources together with many famous doctors. Eight medicinal herbs of Zhejiang are worldwide
known. Nowadays, the increase of some chronic diseases as cardiovascular diseases and tumors
in Zhejiang and the increasingly demand for a good and health physique by the masses provide a
wide market for the development of Chinese traditional medicine. China’s entering WTO also
brings a good opportunity for traditional medicine to foreign countries. We will continue to
reinforce the intension development of the traditional medicines departments, improve the
development of technical personnel of the traditional medicines departments, and try our best to
inherit the knowledge and experience from experts, develop high-tech research in traditional
medicine by using modern advanced techniques, promote and popularize Chinese traditional
medicine techniques and modern technical achievements, further expand the communication and
collaboration between the traditional medicine and foreign resources.
4). Regard the satisfying the basic medical care demand by the masses as the goal, energetic
develop commune health care services both in urban and rural areas. Regardless in urban or rural
areas, commune health care service should press close to residents and families, provide
convenient, good and cheap basic health care service, which combine the education of medical
aid, prevention, health care, recover and physique and the guide of birth control to the masses. In
addition, develop specific services of different content and standard service and facilities for the
64
well-off population in order to satisfy the health care demand by different population.
Commune health care service is a major part in the grass-rooted community operation, which is
needed the support and cooperation by the government and grass-rooted organization at all levels.
Now, most projects of the commune health care services in Zhejiang such as the establishment of
health document, doorstep service and health consultation are all free, related departments in the
government did not set up the standard for price et, which make them uneasy to run in the future.
Therefore, related departments in the government should run their own function and cooperate
closely, and give enough financial input. Social insurance handling institutions should be allowed
to be a part of official medical insurance units; prices in such institutions should be formulated as
soon as possible according to the service prices standard. Health care administrative departments
should develop a group of skilled general physician intensively, and make great effect to
supervise the quality of service.
4.Continue to reform and renovate, improve the quality and efficiency and the health care
service
During the process to establish and perfect the socialist market-oriented economy system, the
particular laws of value, supply and demand, and competition of the market-oriented economy,
affect the development of the health care service more and more widespread and profound.
Therefore, we must consider according to the long-term development, continuously prefect the
service, management and operation systems of the health care service, suitable for the socialist
market-oriented economy system.
The reformation of the management system in medical institutions should highlight to expand
the decision-making power of the state-owned hospitals, implement the independent management
in such hospitals, and intensify the artificial person administrative system, practice the separation
of the ownership, managerial authority and domination of the property; establish and perfect the
internal encouragement and restrain system. The hospitals’ heads should compete publicly, and be
appointed on the basis of competitive selection according to the engagement standard, and
implement the system of job term responsibility. We should further investigate the
professionalization of hospitals heads, develop a group of skilled person step by step.
We also should develop the reformation of the hospitals’ ownership system positively and
reliably. Such hospitals with solid strength can establish groups by combining, annexing other
hospitals; develop the establishment of hospitals management companies promote the
professional and standard management and linked operation. The Non-profitable hospitals
defined by the government are the major part in all hospitals is not to say that the non-profitable
65
hospitals managed by the government should also be the major part. We can encourage the
private investment into the recombination, merge and coalition of some current state-owned
hospitals, which will cause the fair competitive pattern between non-profitable hospitals of
different system of ownership.
Deepening the reformation of the management system in the medical service should make a
breakthrough in the personnel and distribution system, the key point is to fulfill the
transformation from the “unit person” to the “social person” of the staffs in hospitals, especially
for the doctors, and implement the two-way selection between the hospitals and staffs, positions
and employees. According to the planning by the Zhejiang provincial government, we launch a
pilot project as “professional free system” for advanced titled doctors in Hangzhou, Ningbo and
Wenzhou. We also will establish all sorts of rules and regulations in which the position
responsibility system is the core, implement the service standard for medical techniques seriously,
formulate the medical conducts and ensure the quality of medical service; the staffs’ salary should
be related with skill, attitude and achievement, actively form the running system with
responsibility, encouragement, constrain, competition and vigor.
The reformation of the medical service departments in rural areas should seriously based on the
<the guide and advice to the reformation and development of the medical service departments in
rural areas> instructed and commented by the State Council. The commune hospitals in the rural
areas are the key positions in health care service in the rural areas, it has particular concepts, and
it is government’s responsibility to manage them well. The commune hospitals’ brands cannot be
sold, their non-profitable characteristics cannot change also, state-owned property in such
hospitals cannot be sold and the service function cannot change in such hospitals. If all of above
are kept, they can provide better basic health care service to the masses by deepening the
reformation in management and operation system in order to arouse the activity.
5.Quicken the implement of the modernization in health care technology
Zhejiang province is among the provinces, which advance and promote to fulfill the goal of
socialist modernization in advance.
In order to serve the masses’ health and socialist modernization better, the health care cause
should realize self-modernization by system renovation and technical creation.
The health care modernization includes the modernization of management ideas and standard,
the modernization of service system and model, the modernization of knowledge and technique
and the modernization of insurance system. That is to say: based on the human beings, regarding
the health as the core, managed by law and improve the supervision to enhance the health care
66
achievement and level of information; strengthen health care service system, implement the
optimization configuration of the resources, perfect the commune health care service and make
the health care service fair, high efficient, convenient and easy reachable; make the composition
of the health care personnel reasonable and high quality, the rudimental facilities and technical
equipment suitably advanced, health care service can match the demand by different population;
the investment into health care service can meet the development of itself, the share of the health
care expense reasonable, the operation system suitable for the socialist market-oriented economy
and the development of health care service itself. The modernization of the health care service is
in such aspects as: enhancement of the health standard of the residents, improvement of living
quality (expected life time, the death rate of infants, the death rate of pregnant woman); increase
the input into the health care service, optimize the configuration of resources (the increasing rate
of government’s health care service fund, number of doctors per thousand persons, the index of
comprehensive modernization of medical facilities); expand the health care service satisfy the
basic health care demand by the masses (the coverage rate of the general medical service for
commune residents, coverage of basic medical insurance of the residents both in urban and rural
areas, the rate of qualification of food sanitation); provide good living environment, develop
health life style (the quality of drinking water in rural area according to national standard, the
popularization rate of restroom in rural areas, adult physique index); advance the education
standard for health care technology, fulfill the information of health care (contribution rate of
medical science, health care information index).
6.Establish the system to share the risk of diseases, alleviate the diseases’ burden of the
masses
Based on the guide and advice to the reformation and development of the medical service
departments in rural areas issued by the central government recently, and related with the reality
in Zhejiang province, the medical insurance system for rural residents is to reinforce the
organizing and mobilizing function by the government, continue to practice cooperative medical
system in rural areas, positive investigate medical insurance suitable for the rural residents in
Zhejiang province. And this system is more suitable for rural economy and rural residents’
consciousness in some aspects as funding accumulation, management model and democratic
supervision. We will keep summarizing such methods as serious diseases insurance carried out in
some areas in Zhejiang province, perfect and promote them step-by-step. In some rural areas,
which are highly developed in economy, we can accord to the basic medical insurance for
residents in the towns, try out basic medical insurance system for rural residents. After the
67
transformation from “charge” to “tax” in rural areas, the central government will return parts of it
to establish the medical insurance for rural residents.
The government is the major executive department, which is responsible for the medical
insurance system for rural residents according to the demand of comprehensively establish and
amplify social insurance system for the whole society. Related departments should cooperate
positively.
We should pay close attention to the population in towns, which is not covered by the basic
medical insurance system, and implement sorts of measures to ensure them to acquire the basic
health care service. Commercial insurance companies should provide much more and more
different level medical insurance programs for the masses; we will encourage the masses to buy
commercial insurance to improve the standard of medical insurance.
Government should increase the funding for public health care related projects and health care
service funding for weak population like olds and disables by enhancing the budget ratio of
public finance; and investigate to establish the emergency funding for poor population both in
urban and rural areas.
Trying to alleviate the disease’ burden is another responsibility for medical service department
at all levels. We should the diagnose, prescript and charge reasonably together with the
improvement of medical service standard; we also need to reinforce the scientific management,
implement cost assess, develop socialized logistic services, improve the efficiency and lower the
operative cost.
68
69
