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To the Editor: The 2009-2011 China health system reform¹ is intended to put health care accessibility for all citizens as its top priority. In their Commentary,² Ms Ho and Mr Gostin outlined the government's spending decrease in the past decades as the main cause of China's health care system inequity. While we agree with their analysis on urban-rural and quality disparities, we would also like to highlight issues of human resources and the education of health workers as points that could significantly affect the success of the reform.

According to a 2005 survey, 87.1% of rural physicians and 57.2% of urban physicians in China do not have a bachelor's education.³ Furthermore, there are major differences in medical curriculum around the country, and only 25% of China's medical colleges have a training program of 7 years or longer.³ This situation has led to patient mistrust.⁴ A 2003 national household survey found . . . [Full Text of this Article]

Maxime Maignan, MD, MSc
maxime.maignan@free.fr
Sino-French Emergency and Disaster Medicine Training Center
Beijing, China

Xue Xiaoyan, MD
Emergency Department
People's Hospital of Beijing University
Beijing

Emmanuel Fiere, MD
Associated Emergency Medical Centers
Rueil-Malmaison, France

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