China S New Public Health Insurance

Especially since the 2003 SARS crisis, China’s healthcare system has become a growing source of concern, both for citizens and the Chinese government. China’s once praised public health services have deteriorated into a system driven by economic constraints, in which poor people often fail to get access, and middle-income households risk to be dragged into poverty by the rising costs of care. The New Rural Co-operative Medical System (NRCMS) was introduced to counter these tendencies and constitutes the main system of public health insurance in China today. This book outlines the nature of the system, traces the processes of its enactment and implementation, and discusses its strengths and weaknesses. It argues that the contested nature of the fields of health policy and social security has long been overlooked, and reinterprets the NRCMS as a compromise between opposing political interests. Furthermore, it argues that structural institutional misfits facilitate fiscal imbalances and a culture of non-compliance in local health policy, which distort the outcomes of the implementation and limit the effectiveness of insurance. These dynamics also raise fundamental questions regarding the effectiveness of other areas of the comprehensive New Health Reform, which China has initiated to overhaul its healthcare system.

The population of Asia is growing both larger and older. Demographically the most important continent on the world, Asia's population, currently estimated to be 4.2 billion, is expected to increase to about 5.9 billion by 2050. Rapid declines in fertility, together with rising life expectancy, are altering the age structure of the population so that in 2050, for the first time in history, there will be roughly as many people in Asia over the age of 65 as under the age of 15. It is against this backdrop that the Division of Behavioral and Social Research at the U.S. National Institute on Aging (NIA) asked the National Research Council (NRC), through the Committee on Population, to undertake a project on advancing behavioral and social research on aging in Asia. Aging in Asia: Findings from New and Emerging Data Initiatives is a peer-reviewed collection of papers from China, India, Indonesia, Japan, and Thailand that were presented at two conferences organized in conjunction with the Chinese Academy of Sciences, Indian National Science Academy, Indonesian Academy of Sciences, and Science Council of Japan; the first conference was hosted by the Chinese Academy of Social Sciences in Beijing, and the second conference was hosted by the Indian National Science Academy in New Delhi. The papers in the volume highlight the contributions from new and emerging data initiatives in the region and cover subject areas such as economic growth, labor markets, and consumption; family roles and responsibilities; and labor markets and consumption.

This study investigates the situation of Universal Health Care (UHC) in China from a health economic perspective. The first chapter introduces the historical background, analyzes the relevance of UHC and sheds light on the current health insurance status. In this chapter a new holistic health insurance theory is proposed that allows the inclusion of preventive medicine. The second chapter introduces the "Definition and concept" consisting of three dimensions: Firstly, the height dimension with the leading question "What proportion of the costs is covered?". Secondly, the depth dimension that is concerned with the question "Which benefits are covered?". This chapter puts a special focus on the important economic role of non-communicable diseases. Thirdly, the breadth dimension which investigates the question "Who is insured?". The third chapter, looking at the first dimension, found a high but shrinking amount of out-of-pocket payments and catastrophic health payments. Comparing the payment and benefit distributions, it found the ability to pay principle and insufficient separation of health service payments from its consumption. The second dimension discovered problems concerning the roles of ministries, financing and the benefit package. Reforming these areas will be necessary to provide people with appropriate health care. The third dimension showed that migrant workers are exposed to more health risks, have less access to health care and a lower health status. The de facto coverage rate for the Chinese population (including migrant workers) was calculated to be 81.19% in 2011 and 82.16% in 2020. The goals of the Chinese Communist Party (90% in 2011 and nearly 100% in 2020) are hence not reached. The study closes with a "Summary and conclusion, a "Boundaries and discussion" and an "Outlook" section.

China’s current social medical insurance system has nominally covered more than 95 per cent of 1.4 billion population in China and is moving towards the ambitious goal of universal health insurance coverage. Challenges posed by a rapidly ageing population, an inherently discriminatory design of the health insurance system, the disorder of drug distribution system and an immature legal system constrain the Chinese government from realizing its goal of universal health insurance coverage in the long run. This book uses a refined version of historical institutionalism to critically examine China's pathway to universal health insurance coverage since the mid-1980s. It pays crucial attention to the processes of transforming China's healthcare financing system into the basic social medical insurance system alongside rapid socio-economic changes. Financing Healthcare in China will interest researchers and government and think-tank officials interested in the state of healthcare reforms in China. Healthcare specialists outside of East Asia may also be interested in its general study of healthcare in developing countries. Scholars and students interested in the healthcare field will also find this useful.

Abstract: In 2003, after over 20 years of minimal health insurance coverage in rural areas, China launched a heavily subsidized voluntary health insurance program for rural residents. The authors use program and household survey data, as well as health facility census data, to analyze factors affecting enrollment into the program and to estimate its impact on households and health facilities. They obtain estimates by combining differences-in-differences with matching methods. The authors find some evidence of lower enrollment rates among poor households, holding other factors constant, and higher enrollment rates among households with chronically sick members. The household and facility data point to the scheme significantly increasing both outpatient and inpatient utilization (by 20-30 percent), but they find no impact on utilization in the poorest decile. For the sample as a whole, the authors find no statistically significant effects on average out-of-pocket spending, but they do find some-albeit weak-evidence of increased catastrophic health spending. For the poorest decile, by contrast, they find that the scheme increased average out-of-pocket spending but reduced the incidence of catastrophic health spending. They find evidence that the program has increased ownership of expensive equipment among central township health centers but had no impact on cost per case.

This book examines the financing of China’s health system, argues that present arrangements are not adequate and proposes an increased role for commercial health insurance as a way of overcoming the difficulties. Highlighting that China’s present social medical insurance system can only cover basic medical services, with the results that many Chinese people with higher income are going abroad for high-quality medical services and that doctors are not bringing in the salaries and obtaining the social status they expect, the book suggests that commercial health insurance offers a possible solution, in that it can help meet the demand of higher-income groups for better healthcare services while at the same time increasing the income of more competent medical professionals. The book goes on to consider the current state of China’s commercial insurance industry, outlining the various challenges that the industry needs to overcome if it is to fulfil an increased role, challenges such as greater specialization, increased capacity, structural reform, improved regulation and closer integration with China’s medical reform programme.

This volume provides a comprehensive review of China's healthcare system and policy reforms in the context of the global economy. Following a value-chain framework, the 16 chapters cover the payers, the providers, and the producers (manufacturers) in China's system. It also provides a detailed analysis of the historical development of China's healthcare system, the current state of its broad reforms, and the uneasy balance between China's market-driven approach and governmental regulation. Most importantly, it devotes considerable attention to the major problems confronting China, including chronic illness, public health, and long-term care and economic security for the elderly. Burns and Liu have assembled the latest research from leading health economists and political scientists, as well as senior public health officials and corporate executives, making this book an essential read for industry professionals, policymakers, researchers, and students studying comparative health systems across the world.

One way to describe the importance of social policy is to say it's about 'what is and what might be.' This ethos is the driving force behind Chack-Kie Wong, Vai Io Lo, and Kwong-leung Tang's China's Urban Health Care Reform. Based on a study of a mid-level city in China, these three scholars provide analysis and offer theory-based recommendations on health care development. Using a comparative policy framework, supported by a legal expert's knowledge of regulatory specifications, China's Urban Health Care Reform argues that a strategy with priority in economic growth, as in the case of China, does not bring forth cost efficiency and equity in health care for the whole nation. Ultimately, Wong, Lo, and Tang strive to offer direction for health care reform that will lead to better health care in China's cities. As a result, this is a work of great significance to anyone involved in public health, social work, public policy, medicine, or law.