Public Medical Insurance Reforms In China

This book investigates public medical insurance reform in China and studies its effects from both institutional and empirical study perspectives. It provides the reader with academic evidence for understanding the transformation of public medical insurance and its effect on the utilization of healthcare services, expenditure for medical care, individuals' financial portfolio allocation, and well-being. The main content of the book comprises two parts. First, institutional transformations of public medical insurance are considered: medical insurance reform in rural and urban China, and problems of medical insurance reform in the country. Second, it looks at the impact of public medical insurance reforms in China: evidence-based on empirical studies, including determinants of participation in medical insurance, the New Rural Cooperative Medical Scheme and its effects on the utilization of healthcare services, medical insurance and its effects on out-of-pocket expenditure, risky financial market participation, and well-being in China. This study provides academic evidence about these issues based on economic theories and econometric methods using many kinds of nationwide Chinese representative survey data. The book is highly recommended to readers who are interested in up-to-date and in-depth empirical studies on the mechanisms of participation in medical insurance and the impact of public medical insurance reforms on individuals and household behaviors in China. This volume will be of interest to those who are interested in the Chinese economy, social security policymakers, and scholars with an econometric analysis background.

This book investigates public medical insurance reform in China and studies its effects from both institutional and empirical study perspectives. It provides the reader with academic evidence for understanding the transformation of public medical insurance and its effect on the utilization of healthcare services, expenditure for medical care, individuals’ financial portfolio allocation, and well-being. The main content of the book comprises two parts. First, institutional transformations of public medical insurance are considered: medical insurance reform in rural and urban China, and problems of medical insurance reform in the country. Second, it looks at the impact of public medical insurance reforms in China: evidence-based on empirical studies, including determinants of participation in medical insurance, the New Rural Cooperative Medical Scheme and its effects on the utilization of healthcare services, medical insurance and its effects on out-of-pocket expenditure, risky financial market participation, and well-being in China. This study provides academic evidence about these issues based on economic theories and econometric methods using many kinds of nationwide Chinese representative survey data. The book is highly recommended to readers who are interested in up-to-date and in-depth empirical studies on the mechanisms of participation in medical insurance and the impact of public medical insurance reforms on individuals and household behaviors in China. This volume will be of interest to those who are interested in the Chinese economy, social security policymakers, and scholars with an econometric analysis background.

The authors find that economic growth does not automatically improve health care, and that prioritizing health care as China has done does not necessarily lead to cost efficiency and equity in health care for the whole nation.

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.

How efficient is the Chinese healthcare system? Milcent examines the medication market in China against the global picture of healthcare organization, and how public healthcare insurance plans have been implemented in recent years, as well as reforms to tackle hospital inefficiency. Healthcare reforms, demographic changes and an increase in wealth inequity have altered healthcare preferences, which need to be addressed. Significantly, the patient–medical staff relationship is analysed, with new proposals for different lines of communication. Milcent puts forward digital healthcare in China as a tool to solve inefficiency and rising tensions, and generate profit. Where China is leading in the digitalization of healthcare, other countries can learn important lessons. Chinese social models are also put into context with respect to current reforms and experimentation.

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 introduction and ongoing development of public medical care insurance in contemporary China. Based on extensive field investigations, residents’ surveys and analyses by local policy experts and practitioners it provides a comparative analysis of the marketization of public policy in China in contrast to those in other countries, such as the United Kingdom and Germany. The book highlights system-specific issues of the centrally planned economy (CPE) during economic reform, such as alienation of entitlements from funding and historically rooted obligations in the realm of public policy, and as such fills the gap in research on the Chinese government’s public financial management. Public Policy and Health Care in China will appeal to students, academics and researchers interested in public policy and health care in China, as well as Chinese society and economics more broadly.

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.