China may be on the forefront of economic development, but it has a long way to go in providing health care for its hundreds of millions of workers, according to Hocking Cheng, managing director for health management solutions in China for Aetna. Such health care woes may haunt U.S. multinationals that have to contend with employee wellness issues at home and abroad.

While GDP in China has grown at 10% over past 30 years, health care expenditures have grown at 18% in past 20 years. Spending in rural and urban areas varies greatly, and most care is provided through public hospitals, which, Cheng told attendees at the Institute for Health and Productivity Management annual conference, are funded by prescription drug sales and over utilization of technology. Although the Chinese government covers 95% of its people, it contributes just 10% of operating expenses in health care.

Access to care also is an issue, he said, asserting that the average person in a rural area has only one-fourth the health care resources of a worker in an urban area. Even in urban areas, there are 2.5 general practitioners for every 1,000 people. As a result, many workers end up in hospitals to obtain general care, translating to long lines to see doctors and lost worker productivity.

The role for multinational employers, Cheng said, is to develop onsite clinics and promote behavioral change to curb the number of employees seeking general medical care at hospitals.

He also said there's room for employers to expand efforts to gather data on employee health, including biometric screenings and other wellness initiatives that are widely used in stateside wellness programs.

"Given the rapidly changing economy, [employers] have a more active role to play in starting to engage workers and play a positive role in managing health," Cheng said.

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