It's not just an AIDS problem

Hospitals In China Find Profit In AIDS Patients Pressured To Pay for Extra Tests, Treatments By Peter S. Goodman

From 1980 to 2004, the central government's share of total funding for health care dropped from 36 percent to 17 percent, according to a recent state study. Doctors and hospitals became responsible for living off their profit. The state continued regulating fees for basic services, but hospitals were freed to collect profit on sales of new drugs and high-technology tests.

That decision is now widely viewed as a disaster. Pharmacies have become profit centers for Chinese hospitals, the source of up to 90 percent of revenue, encouraging doctors to overprescribe drugs, Chinese experts said. More than half of all Chinese health care spending is devoted to pharmaceuticals, as compared with about 15 percent in most of the developed world, according to a recent World Bank study.

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Fewer than one-third of the Chinese have health insurance. From 1980 to 2004, out-of-pocket expenses tripled as a proportion of total health care spending, climbing from 20 percent to 60 percent, according to a recent Ministry of Finance study.

As costs skyrocket, many poor Chinese peasants are relying on folk remedies. Infant mortality is on the rise in some rural areas. And infectious diseases such as schistosomiasis, a chronically debilitating ailment caused by parasitic worms, are regaining traction.

In July, a report released by the Beijing-based Development and Research Center, an institute that is part of China's governing State Council, concluded that the reform of the country's health care system has been "unsuccessful."

It's not just an AIDS problem, but a number of doctors would rather prescribe expensive medicines than supply patients with free anti-retrovirals, which is what they're supposed to be doing.