Beijing will have to learn from the crisis and rethink the organization of its hospital system.
by Frédéric Lemaître (Beijing, correspondent)
Analysis. The end of the zero covid policy puts the Chinese hospital system to the test. In a good part of the country, hospitals were overwhelmed at the end of December 2022, forcing people – often very elderly – with COVID -19 to stay long, sitting in simple armchairs or in crowded corridors. Still was only the tip of the iceberg. Even in Beijing, it was sometimes necessary to wait several days for patients, even seriously affected, were admitted to the hospital. For this reason, the announcement by China that 60,000 people died from COVID-19 to the hospital between December 8 and January 12 is only a very imperfect indicator since the people who died at their home are without much more doubt.
China will therefore have to, like many other countries, learn from this crisis and rethink the organization of its hospital system. She may take the way. Zhang Wenhong, the epidemiologist of Shanghai who for months courageously pleaded to increase vaccination and learn to live with the virus, has just been appointed member of the political advisory committee of the Chinese people. A body that brings together loyal experts in the Chinese Communist Party without being subservient to it and issues proposals intended to light it.
Already, in 2003, the crisis due to the SRAS had prompted the government to redefine the qualifications of rural doctors, but above all to rethink the financing of social protection. Free until the end of the 1970s, medical insurance collapsed with privatizations of the end of the 20th e century. From 2003 to 2009, China restored a health insurance system which varies according to the cities and the status of the insured (migrants, residents), but which still covers more than 95 % of the population.
Hospital, keystone of the system
Thanks to public investments, the share of health expenses payable by insured persons significantly decreased as a percentage, from 64 % in 2000 to 35 % in 2019, according to the World Bank. But as, at the same time, the cost of expenses explodes due to the aging of the population and the increasingly pointed care offer, households must still pay more to access it. In 2019, each Chinese spent an average of 300 dollars (276 euros) in his pocket to be treated, compared to 100 dollars twenty years earlier. A figure that hides important disparities. The State does not necessarily reimburse 100 % of expenses in the event of serious illness, cancer can, for example, lead to a financial disaster for an entire family. Despite everything, life expectancy at birth which was only 40 years old in 1950 went to 70 years in 2000 and 78 years in 2021: an undeniable success of the regime.
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