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Health care ailments easy to diagnose, tough to cure

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[By Jiao Haiyang/China.org.cn]

4-2-1 problem

China's aging population presents the health care system with another challenge, and one that is likely to get worse, as it will in many other countries facing a similar demographic shift.

According to figures from the United Nations, almost one third of China's population, or 438 million, will be over 60 by 2050, more than double the current number of 178 million.

Often referred to as "the 4-2-1 problem," the policy has meant that one child has to support two parents and four grandparents.

Meanwhile, few organized long-term care or home health care systems exist despite the increasing number of people who will need these kinds of services.

While China's aging problem is significant, France and Japan face an even bigger problem in this area because they have more restrictive immigration policies, according to Burns. "In the US, what keeps our aging problem under control is the fact that we allow in immigrants who work, pay taxes and support the elderly, thereby keeping our age-dependent ratio lower than that in more restrictive countries."

While the US has a positive and fairly high rate of immigration, China has a negative rate - meaning that more people leave the country than enter.

Another "ticking time bomb" in China is the middle-aged Chinese male who works long hours in often stressful conditions, says Burns. "Many suffer from hypertension and diabetes, and 30 percent to 50 percent of them smoke.

"All the Western diseases are showing up in China - the most popular Western restaurant now is Kentucky Fried Chicken- which means the country will have a growing problem with early onsets of chronic illnesses, comparable to the US."

Health care reform in China is further impeded by the fact that the heads of many Chinese medical centers tend to be appointees rather than professionally trained managers, Burns says, which results in serious performance and governance issues. Nor does the country's medical education system offer hospital administration programs.

Add to that the existence of kickbacks at various junctures in the delivery process: Hospitals, for example, get kickbacks from drug and device companies, and hospital executives give a portion of these kickbacks to their doctors.

All these challenges will cause problems for the provincial and central governments in China that must foot the health care bill, Burns adds.

Adapted from China Knowledge@Wharton, http://www.knowledgeatwharton.com.cn. To read the original, please visit: http://www.knowledgeatwharton.com.cn/index.cfm?fa=article&articleid=2814

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