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.
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.
Although China’s new healthcare reform, launched in 2009, has achieved remarkable results in improving China’s medical and healthcare system, it is recognised that there is still room for further improvement. This is especially important as China’s population ages, the prevalence of chronic diseases increases and environment-related health risks worsen. This book reports on a major international research project which examined health trends, modes of health promotion, health finance systems, medical and healthcare innovations and environment-related health risks in China. For each of these key areas, the book considers the current situation in China and likely future trends, explores best practice from a wide range of foreign countries and puts forward proposals for improvements. Overall, the book provides a major assessment of China’s medical and healthcare system and how it should be reformed.
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.
This book considers the key sectors of China's health care system after its entrance into the WTO, including the pharmaceutical industry, health insurance services, and hospitals in terms of policies, legal framework and market potential. It offers a critical analysis of the impact of the WTO and globalization on China's health care.
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.
This multifaceted book examines the free market reform of the Chinese healthcare system in the 1980s and the more collectivist or socialist counter-reforms that have been implemented since 2009 to remedy some of the problems introduced by marketization. The book is based on an ethnographical study in a Chinese county from 2011 to 2012, which investigated local people’s experience of healthcare reforms and the various ways in which they have adapted their own behavior to the constraints and opportunities introduced by these reforms. It provides a vivid depiction of the morality and emotionality of people’s experiences of the Chinese healthcare system and the myriad frustrations and sometimes desperation it induces not only among patients with significant health problems and their families, but also healthcare practitioners caught between their desire to do right by their patients and the penalties they personally incur if they do not adhere to institutionalized cost-saving measures. The people’s experiences within China’s health sector presented reflect many similar experiences in the wider Chinese society. The book is thus a valuable resource for researchers and graduate students interested in China’s healthcare reforms and scholars concerned with issues of contemporary Chinese society.
This book provides an overview of the ongoing transition in China’s health system, especially focusing on the new healthcare reform initiated in 2009. First, it reviews the changes in China’s healthcare system from the 1950s to 2008, establishing the situation when the reform was introduced. The book subsequently analyzes the social and economic context in which the health system is embedded. Since the primary focus is on the new healthcare reform, the book introduces the blueprint and the year-for-year development of the new healthcare reform, as well as the specific reforms in health financing, public hospitals, and primary care. Given its central importance in the health system, the book also described major trends in long-term care in the past several years. In addition, it examines the health policy-making process with a case study of the New Cooperative Medical Scheme of China. Lastly, the book assesses the performance of China’s health system and predicts future developmental trends.
This text addresses the key issue of informal payments, or ‘red packets’, in the Chinese Healthcare system. It considers how transactions take place at the clinical level as well as their regulation. Analysing the practice from the perspectives of institutions and power structure, it examines how institutional changes in the pre-reform and reform era have changed the power structure between medical professions, patients and the Party-state, and how these changes have given rise and perpetuate the practice. Drawing from qualitative data from interviews of medical professionals, the author recognises the medical profession as a major player in the health care system and presents their perception of the practice as the taker of ‘red packets’ and their interactions with the patient and the state surrounding the illegal practice in an authoritarian power structure. The books considers the institutional reasons that motivate doctors to take, patients to give, and the government to "tolerate" red packets, arguing that the bureaucratization of the medical profession, society of acquaintances and shortage of quality of medical services jointly create an institutional setting that has given rise to these informal payments. Contributing to a rounded understanding of the problems of healthcare reform in China, this book is a key read for all scholars interested in the issue of informal payments and healthcare politics in transition economies.
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.
