cross-posted from: https://beehaw.org/post/18095407
- Doctors, medical students shun China’s rural healthcare system
- Ageing villagers will need better healthcare
- Strategy imperils economy through demographic, other risks
Although China has made significant progress in improving its health care system, experts expect rural-urban inequalities to widen as the population ages.
China’s development model is at a crossroads, say health and population experts, with a choice between much higher spending on pensions and healthcare or industrial upgrades and urbanisation, which Beijing sees as key to bolstering growth.
At a twice-a-decade meeting of the ruling Communist Party last year, Beijing promised to pursue both.
However, spending vast resources on rural healthcare was “not a good move” right now, a government adviser said.
“High-quality doctors are unwilling to live in rural areas and low-quality ones cannot provide good services. This is a structural problem,” added the adviser, speaking on condition of anonymity, as the topic is a sensitive one.
“The key is building townships, which is lagging behind.”
[…]
Critics say that for China to choose urban and industrial investment over welfare programmes for its low-income rural population would present it with long-term growth risks greater than the short-term gains.
It could exacerbate overcapacity in factories, weaken consumption, and worsen the demographic crisis by pushing people into cities, where they take on busy jobs and live in small, costly apartments, so they tend to have fewer children.
[…]
China’s biggest healthcare challenge is attracting qualified medical staff to rural areas, said Shenglan Tang, a global health professor at Duke-Kunshan University.
Doctors and medical students cite low pay and heavy workloads. A lack of good schools and other facilities deters young health workers from moving families to the countryside, Tang said.
Over the past decade, the number of urban doctors almost doubled to 4.1 million, while the figure for rural doctors dropped 42% to 622,000, more than twice the rate at which the rural population shrank, National Health Commission data show.
Large cities like Chengdu, the capital of the western province of Sichuan, “extract the good doctors from the small cities. And the hospitals in the small cities extract the good doctors from rural areas,” a Chengdu doctor said.
[…]
High local government debt will make it difficult for China to boost investment in healthcare.
[…]