海峡时报：很多中国人没有能力支付就医的费

<P>【新加坡《海峡时报》】</P>
<P>英文原文：</P>
<P>Nov 24, 2004
Many Chinese cannot afford to see a doctor </P>
<P>Fees have risen more rapidly than incomes in rural and urban areas
By Chua Chin Hon
China Correspondent
In Beijing </P>
<P>NEARLY four in 10 Chinese cannot afford to see a doctor because health-care costs have risen more rapidly than their incomes, state media reported, citing a new national survey on medical services.</P>
<P>
Fewer people are going to the doctors as the cost of treatment has risen by an annual average of 14 per cent between 1993 and last year, the official Xinhua news agency reported late on Monday.</P>
<P>Charges for outpatient treatment, for instance, rose from 21 yuan (S$4.20) in 1993 to 75 yuan last year.</P>
<P>During the same period, the average bill for those who were hospitalised rose from 933 yuan to 2,233 yuan.</P>
<P>



Mr Rao Keqin, of the Health Ministry’s statistics information centre, said 36 per cent of urban patients and 39 per cent of rural patients failed to see a doctor because they could not afford it.</P>
<P>The narrow gap between these two percentages is surprising as health-care costs are widely regarded as a more serious problem in rural rather urban centres.</P>
<P>Observers suggested that the huge influx of migrant labour into the cities and high urban unemployment might account for this development.</P>
<P>The statistics highlight the huge social task ahead for the government.</P>
<P>Figures from the latest China Statistical Yearbook show that the growth in per capita annual income for rural and urban households has lagged behind the 14 per cent increase in health-care costs since 1997.</P>
<P>In particular, the per capita income for rural households has seen only low, single-digit growth of 3 per cent to 6 per cent since 1998.</P>
<P>But Professor Zhao Liang of the China Academy of Health Policy said the situation is not as dire as the figures or newspaper headlines suggest.</P>
<P>He told The Straits Times: ’The problem is not always about not having enough money. Those in the cities may just not have the time to go to the doctor.’</P>
<P>The increase in costs could also be due to more people seeking better and more expensive treatment and facilities as well, he added.</P>
<P>’The increase in medical costs is not just due to supply-side reasons, but also rising demand,’ said Prof Zhao. ’We should put the problem into proper perspective.’</P>
<P>But Chinese doctors came in for some flak in Xinhua’s report, which said they were ’inclined’ to prescribe expensive medication as many hospitals depend on medicine sales for their income instead of the services provided.</P>
<P>Researchers conducting the survey also found that 43.3 per cent of patients had requested for voluntary discharge from hospitals. More than six in 10 cited economic reasons for doing so.</P>
<P>The survey, conducted between September and October last year, involved 193,689 residents in 92 cities and counties.</P>
<P>It followed two other nationwide surveys conducted in 1993 and 1998.</P>
<P>Media reports did not say whether the surveys indicate that the overall situation had improved or deteriorated.</P>
<P>When contacted yesterday, a Health Ministry official said the latest survey would be published in full next month, and declined to disclose further details.</P>
<P>The government has been devoting more money and resources to improving medical care in recent years as an ageing population and rapid urbanisation put increasing stress on the system.</P>
<P>Health officials announced recently that the government would invest 1.2 billion yuan in boosting rural health-care services in central and western China, and would encourage more doctors to serve in the countryside, where they are badly needed.</P>
<P>Calling for patience, Prof Zhao said: ’Reforms in China are always gradual. There will be some hiccups along the way, but we need to show some understanding of the scale of the situation.’</P>
<P>中文译文：</P>
<P>海峡时报
2004年11月24日</P>
<P>很多中国人没有能力支付就医的费用——费用增加速度大大超过城市和农村居民的收入</P>
<P>北京，通讯员，Chua Chin Hon</P>
<P>几乎 40% 的中国人没有能力支付就医的费用，因为身体保健的价格增长太过迅速，超过了他们的收入，官方媒体报道，引用了一个新的对医药行业的国家调查。</P>
<P>越来越少的人们去看医生，治疗的费用从 1993 年到去年，每年平均增长超过 14%，官方的新华社这个周一报道。</P>
<P>同期，每次去就医的平均花费从 993 元增加到 2233 元。</P>
<P>卫生部信息统计中心的 Rao Keqin 先生说，36% 的城市病人和 39% 的农村不能去就医，因为他们支付不了费用。</P>
<P>这两个百分比之间的很小的差别让人惊讶，医疗费用曾经被认为是农村的一个问题而不是城市。</P>
<P>观察人士指出，从农村进入城市的巨大人数的劳动力和城市的高失业人群，能够说明这个变化。</P>
<P>这个统计报告将巨大的社会问题摆在政府面前。</P>
<P>从最新的中国统计年鉴可以看到，每个居民的收入增加从 1997 年起低于 14%</P>
<P>特别是从 1998 年起，农村居民收入增加缓慢，只有 3% 到 6% 的增长</P>
<P>但是中国医政学院(Academy of Health Policy)的 Zhao Liang 教授说情况并没有这个报告或者报纸上所说的那么可怕</P>
<P>他告诉海峡时报，“问题不是总是没有足够的钱，那些在城市的人有些可能是没有时间去看医生。”</P>
<P>他补充到，费用的增加因素中有可能由于更多的人们寻求更好的治疗和医疗设备。</P>
<P>“医药费用的增加不知是因为供应方的原因，还有需求方的原因”，Zhao 教授说，“我们应该在一个大环境下看这个问题。”</P>
<P>但是中国的医生受到新华社报道的一些指责，报道中说，他们倾向于开更昂贵的药物，因为很多医院依靠药物的销售作为他们的收入来源而不是医疗服务的提供。</P>
<P>专家指出，这个调查报告中反映了 43.4% 的病人曾经主动要求出院，其中 60% 以上因为经济原因而这么做。</P>
<P>这个调查报告是在去年9月到10月做出的，访问了 92 个城市和乡村中的 193,689 名居民中。</P>
<P>媒体的报导没有说是否这个调查报告指出整个的情况是变好了还是恶化了</P>
<P>昨天的接触中，一名卫生部的官员说，最新的调查报告会在下一个月公布，但是他拒绝透露进一步的细节。</P>
<P>政府在近些年已经投入了更多的钱和资源以便提高医疗服务水平，同时老年化的人口和快速的城镇化带来了增加的压力。</P>
<P>卫生方面的官员最近宣称，政府将会投入 12 亿元用来提高中西部的农村医疗服务，并且鼓励更多的一生为农村服务，在那里很缺乏医生。</P>
<P>Zhao 教授号召耐心，他说:"中国的改革经常是逐渐的，中间有时候有些停顿，但是我们需要对这种情况的更多的理解."</P><P>【新加坡《海峡时报》】</P>
<P>英文原文：</P>
<P>Nov 24, 2004
Many Chinese cannot afford to see a doctor </P>
<P>Fees have risen more rapidly than incomes in rural and urban areas
By Chua Chin Hon
China Correspondent
In Beijing </P>
<P>NEARLY four in 10 Chinese cannot afford to see a doctor because health-care costs have risen more rapidly than their incomes, state media reported, citing a new national survey on medical services.</P>
<P>
Fewer people are going to the doctors as the cost of treatment has risen by an annual average of 14 per cent between 1993 and last year, the official Xinhua news agency reported late on Monday.</P>
<P>Charges for outpatient treatment, for instance, rose from 21 yuan (S$4.20) in 1993 to 75 yuan last year.</P>
<P>During the same period, the average bill for those who were hospitalised rose from 933 yuan to 2,233 yuan.</P>
<P>



Mr Rao Keqin, of the Health Ministry’s statistics information centre, said 36 per cent of urban patients and 39 per cent of rural patients failed to see a doctor because they could not afford it.</P>
<P>The narrow gap between these two percentages is surprising as health-care costs are widely regarded as a more serious problem in rural rather urban centres.</P>
<P>Observers suggested that the huge influx of migrant labour into the cities and high urban unemployment might account for this development.</P>
<P>The statistics highlight the huge social task ahead for the government.</P>
<P>Figures from the latest China Statistical Yearbook show that the growth in per capita annual income for rural and urban households has lagged behind the 14 per cent increase in health-care costs since 1997.</P>
<P>In particular, the per capita income for rural households has seen only low, single-digit growth of 3 per cent to 6 per cent since 1998.</P>
<P>But Professor Zhao Liang of the China Academy of Health Policy said the situation is not as dire as the figures or newspaper headlines suggest.</P>
<P>He told The Straits Times: ’The problem is not always about not having enough money. Those in the cities may just not have the time to go to the doctor.’</P>
<P>The increase in costs could also be due to more people seeking better and more expensive treatment and facilities as well, he added.</P>
<P>’The increase in medical costs is not just due to supply-side reasons, but also rising demand,’ said Prof Zhao. ’We should put the problem into proper perspective.’</P>
<P>But Chinese doctors came in for some flak in Xinhua’s report, which said they were ’inclined’ to prescribe expensive medication as many hospitals depend on medicine sales for their income instead of the services provided.</P>
<P>Researchers conducting the survey also found that 43.3 per cent of patients had requested for voluntary discharge from hospitals. More than six in 10 cited economic reasons for doing so.</P>
<P>The survey, conducted between September and October last year, involved 193,689 residents in 92 cities and counties.</P>
<P>It followed two other nationwide surveys conducted in 1993 and 1998.</P>
<P>Media reports did not say whether the surveys indicate that the overall situation had improved or deteriorated.</P>
<P>When contacted yesterday, a Health Ministry official said the latest survey would be published in full next month, and declined to disclose further details.</P>
<P>The government has been devoting more money and resources to improving medical care in recent years as an ageing population and rapid urbanisation put increasing stress on the system.</P>
<P>Health officials announced recently that the government would invest 1.2 billion yuan in boosting rural health-care services in central and western China, and would encourage more doctors to serve in the countryside, where they are badly needed.</P>
<P>Calling for patience, Prof Zhao said: ’Reforms in China are always gradual. There will be some hiccups along the way, but we need to show some understanding of the scale of the situation.’</P>
<P>中文译文：</P>
<P>海峡时报
2004年11月24日</P>
<P>很多中国人没有能力支付就医的费用——费用增加速度大大超过城市和农村居民的收入</P>
<P>北京，通讯员，Chua Chin Hon</P>
<P>几乎 40% 的中国人没有能力支付就医的费用，因为身体保健的价格增长太过迅速，超过了他们的收入，官方媒体报道，引用了一个新的对医药行业的国家调查。</P>
<P>越来越少的人们去看医生，治疗的费用从 1993 年到去年，每年平均增长超过 14%，官方的新华社这个周一报道。</P>
<P>同期，每次去就医的平均花费从 993 元增加到 2233 元。</P>
<P>卫生部信息统计中心的 Rao Keqin 先生说，36% 的城市病人和 39% 的农村不能去就医，因为他们支付不了费用。</P>
<P>这两个百分比之间的很小的差别让人惊讶，医疗费用曾经被认为是农村的一个问题而不是城市。</P>
<P>观察人士指出，从农村进入城市的巨大人数的劳动力和城市的高失业人群，能够说明这个变化。</P>
<P>这个统计报告将巨大的社会问题摆在政府面前。</P>
<P>从最新的中国统计年鉴可以看到，每个居民的收入增加从 1997 年起低于 14%</P>
<P>特别是从 1998 年起，农村居民收入增加缓慢，只有 3% 到 6% 的增长</P>
<P>但是中国医政学院(Academy of Health Policy)的 Zhao Liang 教授说情况并没有这个报告或者报纸上所说的那么可怕</P>
<P>他告诉海峡时报，“问题不是总是没有足够的钱，那些在城市的人有些可能是没有时间去看医生。”</P>
<P>他补充到，费用的增加因素中有可能由于更多的人们寻求更好的治疗和医疗设备。</P>
<P>“医药费用的增加不知是因为供应方的原因，还有需求方的原因”，Zhao 教授说，“我们应该在一个大环境下看这个问题。”</P>
<P>但是中国的医生受到新华社报道的一些指责，报道中说，他们倾向于开更昂贵的药物，因为很多医院依靠药物的销售作为他们的收入来源而不是医疗服务的提供。</P>
<P>专家指出，这个调查报告中反映了 43.4% 的病人曾经主动要求出院，其中 60% 以上因为经济原因而这么做。</P>
<P>这个调查报告是在去年9月到10月做出的，访问了 92 个城市和乡村中的 193,689 名居民中。</P>
<P>媒体的报导没有说是否这个调查报告指出整个的情况是变好了还是恶化了</P>
<P>昨天的接触中，一名卫生部的官员说，最新的调查报告会在下一个月公布，但是他拒绝透露进一步的细节。</P>
<P>政府在近些年已经投入了更多的钱和资源以便提高医疗服务水平，同时老年化的人口和快速的城镇化带来了增加的压力。</P>
<P>卫生方面的官员最近宣称，政府将会投入 12 亿元用来提高中西部的农村医疗服务，并且鼓励更多的一生为农村服务，在那里很缺乏医生。</P>
<P>Zhao 教授号召耐心，他说:"中国的改革经常是逐渐的，中间有时候有些停顿，但是我们需要对这种情况的更多的理解."</P>