Health Care Systems In Developing Countries In Asia

For the last two decades, major Asian economies have successfully kept their economic growth momentum going. Now, as these economies are entering a new phase of economic growth, more attention is being paid to their respective states of social development, especially the provision and the expansion of social security and, in particular, health care. Academic study of the development of health care in developing countries has been for the most part neglected by the literature, and in-depth country case studies that are directly comparable on a one-to-one basis have not yet been conducted in a systematic manner. This book volume also proposes a new stance on health policy and the health care policy paradigm, one that focuses on "saving lives" from premature death, as well as illness, accidents, misery and poverty, based on the normative theory of developmental social policy (DSP). This groundbreaking book will therefore serve as a valuable reference volume for health policy, social policy and public policy experts, social development experts, health and development economists, health sociologists, social workers, government administrators as well as other medical and health professionals and academics.

"The health systems of Japan and the Asian Tigers--Hong Kong (China), the Republic of Korea, Singapore, and Taiwan (China)--and the recent reforms to them provide many potentially valuable lessons to East Asia's developing countries. All five systems have managed to keep a check on health spending despite their different approaches to financing and delivery. These differences are reflected in the progressivity of health finance, but the precise degree of progressivity of individual sources and the extent to which households are vulnerable to catastrophic health payments depend too on the design features of the system-the height of any ceilings on social insurance contributions, the fraction of health spending covered by the benefit package, the extent to which the poor face reduced copayments, whether there are caps on copayments, and so on. On the delivery side, too, Japan and the Tigers offer some interesting lessons. Singapore's experience with corporatizing public hospitals-rapid cost and price inflation, a race for the best technology, and so on-shows the difficulties of corporatization. Korea's experience with a narrow benefit package shows the danger of providers shifting demand from insured services with regulated prices to uninsured services with unregulated prices. Japan, in its approach to rate-setting for insured services, has managed to combine careful cost control with fine-tuning of profit margins on different types of care. Experiences with diagnosis-related groups in Korea and Taiwan (China) point to cost-savings but also to possible knock-on effects on service volume and total health spending. Korea and Taiwan (China) both offer important lessons for the separation of prescribing and dispensing, including the risks of compensation costs outweighing the cost savings caused by more "rational" prescribing, and cost-savings never being realized because of other concessions to providers, such as allowing them to have onsite pharmacists. "--World Bank web site.

This book addresses the global need for more comparative studies on health policy and health care systems, given the rise in recent decades of societal aging, modern mass diseases, economic globalization, and resulting permanent fiscal austerity of governments which have fundamentally altered the status quo of health care systems. The book examines the healthcare experiences of the most developed countries in Asia (Japan, South Korea, Taiwan and Singapore) and compares these with four of the most important health care systems in Europe (UK, France, Germany and Italy). Focusing on the public health care systems the contributors discuss the rising need for reforms in health care and health insurance administration, delivery systems, financing and overall health care policy strategies, particularly in fast-aging societies in Asia, and highly aged societies in Europe. This book will appeal to students and scholars of health care policy, health and social administration, social policy, public policy and social work. It will also provide a reference for professionals who need a view of the trajectory of public health financing in relation to changed and changing demographics and disease patterns.

During the past three decades, health care systems in the East Asian regions of China, Japan, South Korea, and Taiwan have undergone major changes. Each system has its unique achievements and challenges. Global health care policymakers are increasingly interested in understanding the changes that have taken place in these four systems. This four-volume reference set is designed to help health care professionals, academics, policymakers, and general readers gain a good grasp of the background and latest developments in the health care systems of China, Japan, South Korea, and Taiwan. This reference set provides an in-depth comparative health policy analysis and discussion of health care reform strategies in each of these systems. One unique feature of this set is that each volume has been edited by a leading scholar who has been deeply involved in the development of the health care system in that particular region. Each of these editors also has invited both scholars and practitioners to provide a first-hand description and analysis of key health care reform issues in that system. The many examples provided in each volume demonstrate how findings of evidence-based policy research can be implemented into policy practice.Volume 1 describes and discusses China's ambitious and complex journey of health care reform since 2009. The Chinese government has achieved universal health insurance coverage and has embarked on reforms of the service delivery system and provider payment methods that are aimed at controlling health expenditure growth and improving efficiency. This volume includes pilot and social experiments initiated by the government and researchers and their evaluations that have guided the formulation of health reform policies. It provides information on how to make reforms work at the local and provincial levels. The findings detailed in this volume will contribute to a global knowledge base in health care reforms.Volume 2 provides a comprehensive review and evaluation of the Japanese health care system. Japan has a long history of health care system development and provision of universal health coverage, with a mature and well-developed health care system among East Asian countries. However, due to increases in health care costs, economic stagnation and the country's rapidly aging population, Japan has undergone significant health care reform during the last two decades, both in the delivery as well as financing of health services in its hospital sector, medical technology sector and long-term care insurance. Despite these challenges and reforms, health outcomes among the Japanese population have been progressively among the best in the world. This volume shows how policy research can lead to policy analysis, implementation and assessment. It also provides valuable lessons learnt for mutual learning among other health care systems.Volume 3 offers a comprehensive review of the developments in South Korea's national health insurance system since 1989 in terms of financing, delivery systems, and outcomes. The volume analyzes the efficiency of cost and service delivery by public sectors versus private sectors. It points out areas of challenge to future Korean health care reform. Chapter authors in this volume are leading experts involved in Korean health care policy implementation.Volume 4 reviews the development and achievements of Taiwan Health Insurance since 1995. Because of its continuous reform in payment, services delivery, and pharmaceutical technology, Taiwan has been considered a model example of universal health insurance among global health systems. This volume shows the processes used to translate policy research findings into policy changes. While the health care reform in Taiwan is ongoing, the Taiwan example provides a real-world and practical understanding of health care system changes.In summary, this four-volume set makes an outstanding contribution to health care system reform and policy research, based on solid scholarly work. It also introduces policy researchers and academic communities to current debates about health systems, health financing, and universal health coverage. This reference volume is a must for anyone keen on East Asia's health care system reform dynamics and changing scene.

There has been a dramatic spread of health markets in much of Asia and Africa over the past couple of decades. This has substantially increased the availability of health-related goods and services in all but the most remote localities, but it has created problems with safety, efficiency and cost. This book documents the problems associated with unregulated health markets and presents innovative approaches that have emerged to address them.

The Asia-Pacific region has not only the greatest concentration of population but is, arguably, the future economic centre of the world. Epidemiological transition in the region is occurring much faster than it did in the West and many countries face the emerging problem of chronic diseases at the same time as they continue to grapple with communicable diseases. This book explores how disease patterns and health problems in Asia and the Pacific, and collective responses to them, have been shaped over time by cultural, economic, social, demographic, environmental and political factors. With fourteen chapters, each devoted to a country in the region, the authors take a comparative and historical approach to the evolution of public health and preventive medicine, and offer a broader understanding of the links in a globalizing world between health on the one hand and culture, economy, polity and society on the other. Public Health in Asia and the Pacific presents the importance of the non-medical context in the history of human disease, as well as the significance of disease in the larger histories of the region. It will appeal to scholars and policy makers in the fields of public health, the history of medicine, and those with a wider interest in the Asia-Pacific region.

The health systems of Japan and the Asian Tigers--Hong Kong (China), the Republic of Korea, Singapore, and Taiwan (China)--and the recent reforms to them provide many potentially valuable lessons to East Asia's developing countries. All five systems have managed to keep a check on health spending despite their different approaches to financing and delivery. These differences are reflected in the progressivity of health finance, but the precise degree of progressivity of individual sources and the extent to which households are vulnerable to catastrophic health payments depend too on the design features of the system-the height of any ceilings on social insurance contributions, the fraction of health spending covered by the benefit package, the extent to which the poor face reduced copayments, whether there are caps on copayments, and so on. On the delivery side, too, Japan and the Tigers offer some interesting lessons. Singapore's experience with corporatizing public hospitals-rapid cost and price inflation, a race for the best technology, and so on-shows the difficulties of corporatization. Korea's experience with a narrow benefit package shows the danger of providers shifting demand from insured services with regulated prices to uninsured services with unregulated prices. Japan, in its approach to rate-setting for insured services, has managed to combine careful cost control with fine-tuning of profit margins on different types of care. Experiences with diagnosis-related groups in Korea and Taiwan (China) point to cost-savings but also to possible knock-on effects on service volume and total health spending. Korea and Taiwan (China) both offer important lessons for the separation of prescribing and dispensing, including the risks of compensation costs outweighing the cost savings caused by more "rational" prescribing, and cost-savings never being realized because of other concessions to providers, such as allowing them to have onsite pharmacists.