Health is a fundamental human right, declared by the WHO constitution of 1948, and promoting and protecting health is necessary to human welfare and sustained. WHO committed in 2005 and develop a health financing systems to ensure all people have access to health services without financial hardship, which was defined as universal coverage. Universal coverage means that everyone can use promotive, preventive, curative and rehabilitative health services when they need, of good quality and have no financial hardship.
In 2005, the 58th World Health Assembly recommended that member states guarantee access to universal coverage, thereby achieving equity in access” .
Although policy makers have implemented several measures to achieve universal coverage, there still have barriers. The 2010 World Health statistics indicated that in 2007, general government expenditure on health accounts for 60.3% of the national health account on average, whereas the private expenditure contribution averaged 39.7% . In China, the rate of the general government expenditure on health was 44.7%, which was lower than the private expenditure (55.3%). With the poor in the urban and rural areas of China at risk of being unable to afford healthcare services, there is a long way to universal coverage and equity to access.
So what can we do to achieve it? In fact, the World Health Report 2000 stated that increasing public financing for healthcare was an integral part of the efforts toward achieving universal coverage and equity . More government input to healthcare, more skilled doctors can be treated, who can support better health service to patience. If the Government invests more to healthcare, especially to poor regions, the ratio of government financing in health expenditure will increase and the ratio of out-of-pockets will decrease. Thus, with increasing government input, people can have good quality and affordable health service, which promoting the equity of universal coverage.
Therefore, to promote fairness, the Chinese government launched a three-year implementation plan in 2009. The opinions of the CPC Central Committee and the State Council on widening the medical and health system reform indicated that the government input in health services would be gradually increased, while aiming to alleviate the burden of expensive medical bills of the citizens and increase their access to healthcare services [3, 4]. The government promised to inject CNY 850 billion (US$ 124 billion) into the health care system in three years (2009–2011). Moreover, the government stated that increasing the input in primary healthcare institutions (PHIs) was one of the five top priorities this plan had explicitly set. In fact, in these three years, the government health investment amounted to about CNY 1409.9 billion (US$ 206 billion), and 44% of the funds were allocated for primary healthcare institutions according to a report from the Ministry of Finance in 2012 .
Primary healthcare institutions, including CHSCs and THs, are the essential parts of the healthcare system in China. The three-year plan pointed out that to ensure that patience to the primary healthcare institutions has good quality and affordable health service, at the same time, the health sectors can run smoothly, the government shall be responsible for its local primary healthcare institutions by taking on its national standard expenditure of basic development, procurement of equipment, and payment for medical faculty and public health care. In these three years, the primary healthcare institutions implemented the essential medicine policy. The fundamental drug zero rate differentia decreased the drug income by 36.5% to 62.9% . Without the profit from drugs, government financial support seemed more significant to those institutions. However, how to compensate for the primary healthcare institutions remains unsolved .
In our study, we describe government investment and the promoting to equity of universal coverage. Then we analyze the differences of government investment between different provinces and between urban and rural areas. We attempt to give evidence of promoting to equity of government financing and identify the existing key problems. In the last, we give some suggestions to use government financing to promoting to equity.