China Endeavors to Guarantee the Implementation of the Healthy China Initiative through Legislation.

The proposal of the Healthy China Initiative is a milestone in China's health policy and health reform. Despite upgrading Healthy China to a national strategy, there are still daunting challenges to realize this strategy.[1] Among them, one is the lack of compatible legal mechanisms due to the practice of policy-oriented health reform in the past.

As China is determined to promote the rule of law and vowed to make every major reform based on law, China's top legislature has been trying for the past 3 years to provide legal grounds to the health reform[2] and the implementation of the Healthy China Initiative by drafting China's Law on Basic Health Service and Health Promotion. This draft was submitted to the Standing Committee of the National People's Congress (NPC) for the first reading by the end of 2017, which is the last chance to put it into the legislative agenda before the term of the current Congress expires in March, 2018. The draft is publicized on the website of the NPC for public comments.

Unlike the first stage of reform, in which the cautious and piecemeal fashion of reform was adopted, the current health reform and implementation of the Healthy China Initiative demands a top design by answering many fundamental and key issues. As the result, a basic health law becomes a prerequisite.[3] At present, there are 11 laws and more than 30 regulations in the health sector,[4] but there is not yet a basic health law that provides a general legal structure for the health system. In the Legislative Plans of the previous 9th, 10th, 11th, and 12th NPC, there were proposals of Health Law, Primary Health Care Law, and Basic Health Service Law, but all failed to be fulfilled. Even though this Draft was submitted to the Standing Committee of the NPC, it will evoke tremendous debates not only in the Congress but also among various governmental branches and different interest groups and stakeholder in the society.

There are three main legislative purposes of this law: first, to substantiate the provisions of the constitutional commitments of developing the national health undertakings and protecting of people's health; second, to provide legal ground for ongoing health system reform; and third, to promote and ensure the implementation of the Healthy China Initiative.[5]

The Draft of China's Basic Health Service and Health Promotion comprises 10 Chapters and 102 articles.[6] For the first time, the draft law unequivocally states that the right to health is a fundamental human right at the legal level and the country will implement the Healthy China Initiative. It defines the health service as a social undertaking of public goods, prescribes its working principles of focusing and strengthening the health service at the grass-roots levels, putting disease prevention first, supporting both traditional Chinese medicine and Western medicine, integrating health in all policies, coparticipating and sharing by the whole people, etc. It states the major health-care policies as follows: free provision of basic public health services to all citizens by the state, integration of health education into the national education system, promotion of nationwide fitness by setting up a national fitness public service system in both urban and rural areas, establishment of a system for monitoring the nutritional status of residents, provision of dietary guide, implementation of nutrition intervention programs for poor areas and key populations, and adoption of nutrition improvement measures for students and elderly people. The draft also clears that public medical and health institutions are nonprofit institutions organized by the governments at all levels for ensuring fair access to basic health services. It strictly prohibits public health institutions to cooperate with social capitals to organize profit-making institutions. All revenue and expenditure in public hospitals will be brought into governmental budget management for regulating properly their sizes and adhering to the nature of public goods.

In the first reading, a number of the Standing Committee members as well as others expressed different opinions to the title,[7] and in many other articles, the defects do not outweigh the merits since the submission of it to the Standing Committee of the NPC highlights a major achievement in promoting the rule of law in the health sector. The prologue is put on the stage; the next performance will be expecting.