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Bold, persistent reforms forge ahead under Xi’s leadership

4 min read

FUZHOU — Coronary stents, used to treat coronary heart disease, were once priced at about 13,000 yuan (1,989 U.S. dollars) each in China. Now they are expected to cost patients only 700 yuan on average.

The massive price slash ensued from the initial round of the Chinese government’s centralized procurement program for high-value medical consumables in early November.

The program, which aims to bring down the pricing by large-scale purchasing and squeezing out multiple layers of agent middlemen, owes its origin to Sanming, an industrial city with a permanent population of 2.6 million in east China’s Fujian Province.

Chinese President Xi Jinping, also general secretary of the Communist Party of China Central Committee and chairman of the Central Military Commission, has paid close attention to the country’s medical reform progress, and praised Sanming’s medical advancement at several key meetings.

At the 33rd meeting of the central leading group for deepening overall reform on March 24, 2017, Xi hailed Sanming’s experience in medical reform. He said Sanming’s medical reform is in the right direction and has produced obvious results, urging promotion of Sanming’s practice nationwide.


Chen Ruibang, a resident of Sanming who is a diabetes and high blood pressure patient, spent 9,668 yuan on medication in 2019. But he only had to pay 10 percent of the amount as his medical insurance covered the remaining cost.

“Medical reform is a real boon for ordinary people,” Chen said.

Back in 2011, the city’s social medical insurance scheme for urban employees faced a deficit of 210 million yuan, which was equivalent to about 14.4 percent of the city’s fiscal revenue.

The problem called for a fundamental change and the city decided to crack down on markups on drug prices and medical materials.

Policymakers negotiated with drug companies to push prices down. For example, the price of Acarbose tablets, an oral drug that Chen took to control blood sugar levels, plummeted from 100 yuan to 9.21 yuan per box.

The city also streamlined the supply chains to cut down on middlemen profiting. In the city’s public hospitals, revenue from drugs accounted for 34 percent of total revenues in 2019, down from 60 percent in 2012, said Zhan Jifu, head of Sanming’s leading group for medical reforms.

Reform never stops in Sanming, which has endeavored to build regional medical groups consisting of big hospitals and grassroots clinics.


Xi attaches great importance to ecological conservation and environmental protection. A sound ecological environment is a basic foundation for the sustainable development of humanity and society, he says.

When Xi worked in Fujian Province, he visited Sanming 11 times. During an inspection tour on tourism and ecological protection in Taining County, Sanming, in April 1997, Xi told local people that “lush mountains and lucid waters are priceless treasures” and demanded good environmental protection.

Deng Wenshan, 65, was proud of a reform he initiated 22 years ago. Back in the 1990s, Deng, then Party chief of Hongtian village in Sanming, was concerned about the shrinking forests due to illegal logging and unattended wildfires.

“The forests were collectively owned by all the villagers, therefore no one would consider illegal logging as stealing, or felt obliged to put out wildfires,” Deng said.

Hongtian village rolled out an audacious plan in 1998, allocating mountains and forests to individual households. Once villagers got the right to use and profit from the forest, they stopped cutting trees and took to planting. Farmers have signed long-term operating contracts with the government, while ownership of the forest land remains with the government.

Dubbed “the forest version” of the household responsibility system — a vital rural reform adopted in the late 1970s that allows the distribution of land to farmers so that they manage their own production, the practice was adopted nationwide several years later.

It echoed Xi’s instruction to develop forestry as an industry while maintaining its ecological functions when he visited Sanming’s Shaxian County in 1997.

Evolving policies were rolled out and brought benefits to farmers. Ownership certificates can be used as collateral for loans, and forest owners are encouraged to establish cooperatives for large-scale operations.

“The core of Sanming forestry reform lies in the persistent pursuit of turning ecological advantages into better lives for local people through innovative policies and institutions,” said Liu Xiaoyan, head of Sanming’s forestry bureau.

The total output value of forestry reached 114.6 billion yuan last year in Sanming. This year, the city’s forest coverage is expected to exceed 80 percent.

With its bold and persistent reforms in various sectors, Sanming’s GDP rose from 17.26 billion yuan in 1996 to 260.16 billion yuan in 2019, with an average annual growth rate of 10.8 percent.

“As long as we practice our people-centered development philosophy, have the courage to make up our minds and tackle difficulties head-on, we will be able to accomplish many big things,” said Yu Hongsheng, mayor of Sanming.



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