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China's Health Care Reform Looks to Science

SHANGHAI—No matter where you stand on "Obamacare," the derisive term given to President Barack Obama's attempt to mandate health care for Americans, you'll be blown away by the sheer scale of "Chinacare." In just 2 years, China's health care reform effort has put 1.27 billion Chinese—95% of the country's population—on basic health insurance, creating "the largest medical insurance system in the world," Health Minister Chen Zhu announced here on 24 June at the opening session of the 2011 Sino-American Symposium on Clinical and Translational Medicine. And for scientists inside China and abroad, the ambitious reform effort is about to get a whole lot more interesting. Chen invited researchers to become involved in the planned 12-year, $130 billion health care revamp. "Science and technology must play a major role in health care reform," he said.

Before the Chinese government launched the reform effort in 2009, a common complaint, Chen noted, was that it was "too difficult and too expensive to see a doctor in the so-called public hospitals." One problem was that doctors had a vested interest in over-prescribing medications: for most drugs, Chen said, doctors would receive a 15% commission on the prescription cost. "We stopped that practice," the minister said. Doctors no longer get a commission on 307 widely used prescription drugs. And in the past 2 years, Chen said, thousands of county hospitals and village clinics have been refurbished. The rapid strides wowed the audience, including John Gallin, director of the U.S. National Institutes of Health's Clinical Center in Bethesda, Maryland. "It's a very impressive achievement," he told ScienceInsider.

Among priorities in 2011, the government intends to make headway against two diseases that hit China hard: hepatitis B and skeletal fluorosis, which is caused by inhalation of fluorine given off by home coal stoves. In 2011, China plans to have completed vaccinating 66 million children under the age of 15 against hepatitis B, and have finished replacing stoves in 1.63 million homes, mostly in southwest China.

Opportunities abound for biomedical research initiatives, the health minister noted. "The disease spectrum is so diverse. We have everything in China," said Chen, who welcomes cooperation with foreign researchers. He also cited the need to "strengthen China's biobanks." "I hope health care reform goes better here than it did for us," Harry Selker, dean of Tufts University's Clinical and Translational Science Institute in Boston, quipped after Chen's talk. By all measures, Chinacare is off to a flying start.