By: Cyril Chang and Sandra Richardson
We were among eight health care consultants and state health officials from Tennessee
to visit China this past summer. We were invited by the Chinese Ministry of Health
under an ongoing China-Tennessee Rural Health Care Exchange Program to see their rural
health care system first-hand. We met and exchanged ideas with both frontline health
care professionals and policy makers about how we can learn from each other in reforming
our respective health care systems.
Dr. Sandra Richardson and Dr. Cyril Chang at the Big Goose Pagoda in Xi-an, China.
This year’s visit was a follow-up of last year’s exchange program that brought 43
Chinese rural health care administrators and professionals to Tennessee for three
weeks of training. The exchange was first initiated by Gov. Phil Bredesen in 2007
during Tennessee’s first trade mission to China. Both President Shirley Raines and
Dr. Chang participated in the planning for the exchange and witnessed the signing
of a letter of understanding in Beijing to establish regular exchanges of health care
professionals. This year’s visit was the third major event of this burgeoning health
care relationship between China and Tennessee.
The program this past summer took place in Xi’an June 7-22 for more than 100 Chinese
health care professionals from eight different provinces currently undergoing rural
health care reform. The World Bank and the British Department for International Development
program funded the program.
Prior to the weeklong training conference, the eight of us from Tennessee’s three
major universities, Vanderbilt, East Tennessee State University and the University
of Memphis, spent almost a week in Ankang, a mediumsized city in southern Shaan-xi
Province, and visited villages and townships in the surrounding areas.
The health care facilities we saw were not sophisticated technologically by American
standards and the quality of training needed urgent upgrade. However, we were heartily
impressed with their ambition and determination in extending insurance coverage to
everyone and their interest and earnestness in Tennessee’s expertise in the delivery
of health care and training.
We were also intrigued by the way they deliver public health services such as health
promotion and disease prevention. In the United States, basic public health services
are delivered by the public health systems at the county and state levels while medical
care is delivered by a separate and mostly private health care system. In China, public
health and medical care functions are delivered together by the same hospitals and
doctors in each village and township.
China has recently unveiled an ambitious health reform program to establish a basic
health care system that can provide “safe, effective, convenient and affordable services”
to both urban and rural residents. The United States is currently undergoing our own
health care reform to bring insurance coverage to everyone and to slow the growth
of health care spending.
It has been a rare honor and opportunity for us to play a small role in the reform
of the rural health system in China. We have been told that they find our lectures
and seminars interesting and helpful, especially in how to finance health care and
use health information technology to improve efficiency. We also know that we have
broadened our own perspective on how health care can be delivered in countries with
less resources and greater challenges.
(Dr. Cyril Chang is a Suzanne Downs Palmer Professor of Economics and director of
the Methodist Le Bonheur Center for Healthcare Economics at the Fogelman College of
Business and Economics. He is a former recipient of the U of M’s Eminent Faculty Award.
Dr. Sandra Richardson is an assistant professor of management information systems
in the Fogelman College of Business and Economics.)