Promoting Rural Healthcare Access: A Multi-Faceted Approach
In the recent decisions made during the Third Plenary Session of the 20th CPC Central Committee, significant emphasis was placed on the need to “deepen healthcare reform,” “promote coordinated development of medical services, health insurance, and pharmaceuticals,” and “enhance the distribution and access to quality medical resources.”
Village health clinics, as the most fundamental healthcare institutions, act as the first point of contact for rural residents seeking medical attention. These clinics play a crucial role in completing the healthcare service chain, often referred to as the “last mile” in ensuring medical access. In February 2023, the central government announced a strategy to integrate village clinics into medical insurance systems, providing support for eligible clinics to become designated healthcare providers in areas with existing conditions. This year, various government agencies have issued multiple directives aimed at better utilizing health insurance funds to strengthen grassroots healthcare services, facilitating greater inclusion of village clinics in the insurance system to improve access for rural residents.
Indeed, many regions have recently been exploring ways to enhance the medical capabilities and medication safety of village clinics through health insurance services. The result has been a notable increase in rural residents’ satisfaction with healthcare access and outcomes. Recently, I conducted interviews in regions such as Shanxi, Jilin, and Hubei to assess these developments.
**Shanxi: Enhancing Medical Conditions through Insurance Coverage**
In Baijiazhuang Village, located in Shanxi’s Shouyang County, Village Doctor Xu Zhizhong was seen providing medications to a villager. The well-organized clinic offers a variety of medical devices, including oxygen machines and nebulizers. “These are all provided by the city, enabling us to conduct over 20 types of examinations,” Xu explained. With a population of over 1,000, the clinic saw more than 2,000 treatments last year, with only about 10% requiring referral to larger hospitals.
The quantity of medications available in the clinic exceeds 500 types, and emergency services are efficiently managed with a 15-minute response time. Xu, who has been serving the community for 45 years, noted a significant reduction in the gap between the medical conditions in rural and urban areas. “It’s incredible to think how far we’ve come!” he expressed.
To strengthen the rural healthcare safety net, Shanxi has prioritized integrating village clinics into the outpatient insurance framework as part of a larger effort to link grassroots healthcare services. As Xu mentioned, the entire insurance reimbursement process has become streamlined, allowing villagers to complete transactions with just a click.
As of 2023, all 18,040 administrative village clinics in Shanxi have been integrated into the health insurance system for direct reimbursement. Ni Baozhu, a deputy director in the province’s health department, noted that improvements in the technology infrastructure have made the system effective and accessible even in remote areas.
Shanxi has also implemented zero-markup policies on essential medicines through a centralized purchasing process, significantly lowering costs. For example, a medication that previously cost over 100 yuan is now available for just 16.76 yuan. The province encourages regular training and development for village doctors, aimed at maintaining a sustainable healthcare workforce.
**Jilin: Innovative Procurement Strategies**
Meanwhile, in Tongle Village, Jilin Province, Doctor Li Xiaokai is seen advising a villager on medication management for hypertension. The integration of village clinics into the health insurance system has dramatically transformed accessibility and affordability. “Previously, patients did not consider seeking treatment early due to costs, but now it’s much more feasible,” Li affirmed.
Since establishing a comprehensive health management information system in 2019, Jilin has improved the link between healthcare and insurance reimbursement processes. The introduction of zero-margin institutional procurement has enabled village clinics to stock essential medications affordably, benefiting many patients.
In another village, villagers expressed gratitude to Doctor Qiao for assisting a family member with the insurance process, highlighting the growing awareness of the benefits of rural health insurance.
**Hubei: Merging Public Health Services with Insurance Policies**
In Hubei’s Zhiqu County, the local health services ensure that residents can conveniently access healthcare and be reimbursed through the insurance for their medical expenses. The district has fully integrated its village clinics into the basic health insurance plan, allowing for reduced treatment costs for residents. Village doctors actively engage with their communities through regular health screenings and follow-ups, improving early detection of conditions like hypertension and diabetes.
Doctors in the village, like Zhao Yalan, are not only tasked with treating illnesses but also with proactively visiting households to provide preventative health education and check-ups.
As a result of these targeted efforts, more residents are utilizing their local village health clinics for both minor and chronic health issues, thereby maintaining their health at home and reducing unnecessary strain on larger healthcare facilities.
Overall, these stories from Shanxi, Jilin, and Hubei illustrate a significant shift towards improving rural healthcare delivery through proactive measures, increased insurance integration, and community involvement, making healthcare more accessible and effective for residents in these areas.
