Financing Healthcare In China

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.

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.

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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.

The report recommends that China maintain the goal and direction of its healthcare reform, and continue the shift from its current hospital-centric model that rewards volume and sales, to one that is centered on primary care, focused on improving the quality of basic health services, and delivers high-quality, cost-effective health services. With 20 commissioned background studies, more than 30 case studies, visits to 21 provinces in China, the report proposes practical, concrete steps toward a value-based integrated service model of healthcare financing and delivery, including: 1) Creating a new model of people-centered quality integrated health care that strengthens primary care as the core of the health system. This new care model is organized around the health needs of individuals and families and is integrated with higher level care and social services. 2) Continuously improve health care quality, establish an effective coordination mechanism, and actively engage all stakeholders and professional bodies to oversee improvements in quality and performance. 3) Empowering patients with knowledge and understanding of health services, so that there is more trust in the system and patients are actively engaged in their healthcare decisions. 4) Reforming public hospitals, so that they focus on complicated cases and delegate routine care to primary-care providers. 5) Changing incentives for providers, so they are rewarded for good patient health outcomes instead of the number of medical procedures used or drugs sold. 6) Boosting the status of the health workforce, especially primary-care providers, so they are better paid and supported to ensure a competent health workforce aligned with the new delivery system. 7) Allowing qualified private health providers to deliver cost-effective services and compete on a level playing field with the public sector, with the right regulatory oversight, and 8) Prioritizing public investments according to the burden of disease, where people live, and the kind of care people need on a daily basis.

Most of the existing literature on health system reform in China deals with only one part of the reform process (for example, financing reform in rural areas, or the new system of purchasing pharmaceuticals), or consists of empirical case studies from particular cities or regions. This book gives a broad overview of the process of health system reform in China. It draws extensively both on the Western literature in health economics and on the experience of health care reform in a number of other countries, including the US, UK, Holland, and Japan, and compares China''s approach to health care reform with other countries. It also places the process of health system reform in the context of re-orienting China''s economic policy to place greater emphasis on equity and income distribution, and analyzes the interaction of the central and local governments in designing and implementing the reforms. This book will be of interest to policymakers, academics, students of health economics, health policy and health administration, and people who are interested in Chinese social policy. Sample Chapter(s). Chapter 1: Health Policy in China: Introduction and Background (189 KB). Contents: Introduction: Health Policy in China: Introduction and Background; Health Systems and Health Reform: International Models; Main Components of Health Reform: Strengthening China''s Social Insurance System; Providing Primary Care; The Hospital Sector and Hospital Reform; China''s National Drug Policy: A Work in Progress; Health Care and Harmonious Development in China: Health Policy and Inequality; Decentralized Government, Central-Local Fiscal Relations, and Health Reform; China''s Health System in the Future: Health Services in the Future: Social Insurance and Purchasing; China''s Future Health Care System: A Mixed Public-Private Model?. Readership: Policy makers, academics, students of health economics, health policy, and health administration, and people who are interested in Chinese social policy.

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.