The health status of residents of China and India lags behind relative to other populations, and health gains in each country have been uneven across subpopulations. Each health system provides little protection against financial risk, and patient satisfaction is a lower priority than it should be. This paper compares the Chinese and Indian health systems to determine what approaches to improving health in these two countries do and do not work.
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 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.
Health policy makers in developing, low income countries are often faced with difficult choices and tradeoffs in allocating the rather limited resources at their disposal. This paper analyzes the varied approaches taken by the Governments of China and India which resulted in differential levels of gain in health indicators. An attempt has been made to synthesize policy implications for health policy analysts in developing countries that would optimize the health outcomes for a given budgetary allocation.
From earlier times, developed nations had come to the understanding that regular public health efforts will lead to an increase in the labor productivity and life expectancy thus contributing to the GDP in a positive manner. This understanding came about before there existed the spread of modern curative technologies. On the other hand, developing nations when hit by a wave globalization brought in modern technological services in the private sector, before a strong public sector could be established, thus neglecting the importance of a public health services.The development of Government and public healthcare centers across the nation is crucial to India's healthcare system. There exists a three-tier system in the Indian public healthcare system. The public funds in India have been directed towards tertiary rather than primary levels. World health statistics have indicated that India has the highest out of pocket private healthcare costs for families, among developing nations. Penetration of health insurance in India is low by international standards. Reserve Bank of India data for 2009-10 to 2016-17, shows that the Government has been spending around 7% of its GDP on Social Services. Education and health sectors accounted for 2.9% and 1.4% respectively in the year 2016-17. The Government as a policy measure should give top priority to increasing investment in the traditional healthcare sector. For secondary care, there should be a concentrated effort to achieve the Rashtriya Swathya BimaYojana(RSBY) target of insuring all individuals below poverty line. For primary care, government should not replace the private sector, but help make it better by enabling programmes of training unqualified doctors and keeping that training as a prerequisite to practice medicine. The research undertaken is a descriptive and diagnostic study to understand and explain the reasons underlying the nature of Public Healthcare system in India. An in-depth comparison has been made to highlight the strengths of the Indian Public Healthcare system and the areas Indian Public Healthcare system needs to develop to cater to the demands of a growing and developing democratic economy. The stratified sample includes the 2 leading economic powers-USA and China, to understand and contrast the private sector and public sector dominated progress of the two nations respectively.
In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.
From the small beginning they made in China's eight lakh villages, China built an elaborate health system in the next two decades. The health system model built by China served as a shining lighthouse for developing countries, though it has its dark spots that I will describe in the concluding part. After 1978, the CMS collapsed and the work-points collective system gave way to user-fees. These widely welcome reforms had knocked off some of the good things from the health system, -- Its universal accessibility and equity. However, it added a burden of paying user-fees for the services. This has been difficult for the poor of China.. Even at the beginning of a 'millenium', India has no worthwhile system of healthcare in its half million villages. I have written this small travelogue for simply jolting the Indian health policy community out of its slumber and point out the lost perspective.
This publication is a comprehensive assessment of leading risks to global health. It provides detailed global and regional estimates of premature mortality, disability and loss of health attributable to 24 global risk factors.--Publisher's description.
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.
