China's new healthcare reform plan, which aims to provide universal medical service to 1.3 billion people, has triggered nationwide debate since it was publicized on Tuesday morning.

News articles on healthcare reform showed up in major newspapers and online forums were swarmed with netizens eager to express their opinion.

More than 900 comments were left on the National Development and Reform Commission (NDRC) website in less than two days.

Suggestions, complaints and criticisms kept pouring into the site, which the Chinese authorities set up to solicit opinions on the long-awaited reform plan.

"I suggest leaders pay more attention to medical services in rural areas," Cao Pengfei wrote. "It would cost more than a 1,000 yuan (US$146) for a minor illness in my county," added the Shandong Province resident.

"I have no stable job and travel from place to place for work. I was wondering how people like me could be covered by medical insurance?" Ma Shengcheng asked.

Many proposed long lists of suggestions. Xia Shaochun wrote thousands of words, analyzing the problems of the current insurance system and government funding.

Opinions of health experts were seen in newspapers and magazines. Besides commenting on the plan itself, many agreed the government had taken an unprecedented open attitude towards the reform.

Healthcare reform expert Gu Xin told the China Youth Daily that scholars in the past were often asked to prove the validity and thinking behind a government decision after it was made.

"But as for the healthcare reform plan, scholars really participated in it," he said. "The government asked for our opinions and paid great attention before the plan was drafted."

Growing public criticism of soaring medical fees, a lack of access to affordable medical services, poor doctor-patient relationships and low medical insurance coverage compelled the government to launch the new round of reforms.

China first started reforming healthcare in 1992 to abolish a system under which the government covered more than 90 percent of expenses.

The country then gradually switched to a market-oriented medical system. However, soaring medical costs plunged many rural and urban Chinese into poverty.

In the new plan, the government promised to set up a "safe, effective, convenient and affordable" healthcare system that would cover all urban and rural residents by 2020.

The draft lists five priorities: speeding up the establishment of a universal healthcare system, setting up a basic drug system, improving the grassroots health service network, providing equal public health service to rural and urban residents and pushing forward reform trials in state-run hospitals.

Healthcare reform debates have been going on in China for years. In 2006, the State Council, the country's Cabinet, set up a joint-working team consisting of experts from 16 departments to create a reform plan.

An official with the team told Xinhua the group had conducted numerous seminars and undertook field investigations in more than 20 provinces, municipalities and autonomous regions over the past two years.

It also entrusted nine domestic and overseas organizations, including the World Health Organization, to conduct independent research. The submitted opinions were included in the draft.

In early 2007, the National Development and Reform Commission started a website, inviting public opinion on medical reform. The commission received 1,500 suggestions and 600 letters in less than six months.

In April, Premier Wen Jiabao held two symposiums in Zhongnanhai, the government headquarters in downtown Beijing, to discuss the issue with representatives from the medical field, companies, migrants and farm workers, among others.

"Healthcare reform is a tough problem worldwide," Peking University professor Li Ling said. "To mobilize the whole nation to join the debate is an unprecedented move of the Chinese government, which ensures that the decision could be made in a prudent, scientific and democratic way."

(Xinhua News Agency October 16, 2008)