If the government's pledges are honored to the letter, China's underfunded rural healthcare system is set to witness a major financial boost this year.

At a national health conference, which ended Tuesday in Beijing, the Ministry of Health singled out rural healthcare as one of its five major tasks of 2005.

The decision could not have come at a better time.

The public health system has been under increasing scrutiny in recent years, especially after the SARS outbreak of 2003, which exposed serious weaknesses of our existing healthcare system.

And if the situation in the cities is bad, that of rural areas is desperate. The old rural health cooperative system, which existed when China was still a planned economy, gradually crumbled as China's economy shifted towards a market-based one.

And a replacement one has yet to be brought in to fill the vacuum which has reduced medical services in the countryside to a minimum.

Currently, rural areas have just 20 percent of the country's medical resources and yet 70 percent of the country's population.

And, according to Gao Qiang, vice-minister of health, nearly 80 percent of rural people are not covered by any type of medical insurance. This means they have to pay all medical costs themselves.

The drastically rising fees of recent years have taken a heavy toll on the public, especially farmers whose income growth has stagnated in the last few years.

"Nearly 48.9 percent of Chinese people cannot afford to see doctors when they fall ill and 29.6 percent are not hospitalized when they should be," said Gao, quoting survey results released last month by the Ministry of Health.

The problem is even more acute in the countryside. With the old healthcare cooperative system fading, farmers are having to seek costly medical services in towns and cities.

In recent years, cases of farmers being thrown into poverty by high medical fees have been widely reported, a situation that has deterred many from seeking medical help when they fall ill.

A new national rural health cooperative system is urgently needed to replace the decrepit or non-existent old one.

It is encouraging that the Ministry of Health has recognized the necessity.

While practical steps and policy support are critical to establish an effective rural healthcare system, expert support is also indispensable in the drive to that end.

Recognizing this, the government is to send a 10,000-strong urban medical team to county-level hospitals over the next three years to provide medical and training services.

The government is obliged to fairly provide public services such as medical care, to all people.

As such, it is high time for the government to do more to improve rural healthcare, which has been neglected for too long.

Pledges have been made and now is the time to see them realized by concrete action.

(China Daily January 13, 2005)