Expansion of Chinese Social Health Insurance: who gets what, when and how?

Huang, Xian Feng

doi:10.1080/10670564.2014.882617

Cited by 30 publications

(33 citation statements)

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“…There are significantly fewer studies on inpatient treatment, but insurance coverage has generally increased inpatient visits (89), with significant geographic variation because the magnitude of the impact of insurance is dependent on province (34). Health ministries and governments below the national level have control over policy specifics, such as reimbursement rates and coverage depth, driving significant variation across provinces (28). This overall increase in utilization also drives the increase in overall costs because individuals increase their use of services in reaction to the lower costs.…”

Section: Access and Utilizationmentioning

confidence: 99%

“…Given that Urban Employee Insurance is more likely to cover outpatient services than Rural Resident Insurance is (28) (9,88), urban areas and wealthier families continue to benefit disproportionately from insurance subsidies because urban insurance plans provide substantively more coverage (10,28,54).…”

Section: Impact Of Insurance On Patientsmentioning

confidence: 99%

“…Currently, policies related to the Urban Employee, Urban Resident, and Rural Resident Insurance programs operate in isolation of each other, creating inequalities in the system across insurance programs. Institutional barriers, such as the household registration system, sort individuals into different insurance types with varying levels of coverage, reducing the equity of the system, and migrant workers, defined as individuals outside of their place of registration, continue to face barriers to using their existing coverage (28,30,81,89,94,96,97). First, recently announced reforms (48) will begin the process of minimizing the differences in funding and functioning of the various insurance schemes, integrating the residence programs, and diminishing urban and rural differences.…”

Section: Access and Utilizationmentioning

confidence: 99%

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China's Health Reform Update

Liu

Vortherms

Hong

2017

Annu. Rev. Public Health

214

215

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China experienced both economic and epistemological transitions within the past few decades, greatly increasing demand for accessible and affordable health care. These shifts put significant pressure on the existing outdated, highly centralized bureaucratic system. Adjusting to growing demands, the government has pursued a new round of health reforms since the late 2000s; the main goals are to reform health care financing, essential drug policies, and public hospitals. Health care financing reform led to universal basic medical insurance, whereas the public hospital reform required more complex measures ranging from changes in regulatory, operational, and service delivery settings to personnel management. This article reviews these major policy changes and the literature-based evidence of the effects of reforms on cost, access, and quality of care. It then highlights the outlook for future reforms. We argue that a better understanding of the unintended consequences of reform policies and of how practitioners' and patients' interests can be better aligned is essential for reforms to succeed.

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Section: Access and Utilizationmentioning

confidence: 99%

Section: Impact Of Insurance On Patientsmentioning

confidence: 99%

Section: Access and Utilizationmentioning

confidence: 99%

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China's Health Reform Update

Liu

Vortherms

Hong

2017

Annu. Rev. Public Health

214

215

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“…The decentralization literature mentioned in the introduction offers an important amendment because it studies the impact of these exogenous factors on the decisions of a greater variety of actors within the state apparatus. Recent empirical studies on the expansion of welfare in the health‐care and pension sectors are paying increasing attention to the impact of institutional factors, which are defined as “decentralized authoritarianism” by Landry (), on the social policymaking process (Huang, ; Meng, ; Shi, ).…”

Section: Theoretical Approachmentioning

confidence: 99%

“Promotion tournament 2.0”: Why local cadres expand health‐care provision in China

Zhang

2020

Governance

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Previous research has attributed the delayed welfare development in China to the government's traditional obsession with GDP growth target as the principal criteria for cadre promotion. Yet why has health‐care provision significantly expanded since the 2000s? This article argues that as central policies adjusted to incorporate health care as a priority, the cadre assessment system subsequently made it a “hard target,” and thus the competition for office has compelled local cadres to implement health‐care expansion. Apart from the importance of local leaders in policy change as the literature suggests, this article elaborates on the pivotal role of technical bureaucrats by innovatively introducing the “promotion tournament 2.0” model, which emphasizes the knowledge–power coalition between these political actors. By investigating the case of health‐care expansion, this article illustrates the local politics of policy change with various forms of data collected from semi‐structured interviews, newspaper archives, political documents, and official statistics.

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“…este artículo muestra que, aunque la reforma haya tenido como resultado la expansión de la cobertura, dado que en 2011 china alcanzó la universalización de la cobertura del sistema social de salud (3) , el modelo configurado profundizó las desigualdades y consolidó la estratificación de la sociedad china, respondiendo a la estrategia de "divide y reinarás" de los gobiernos autoritarios. Así, al mismo tiempo que el acceso a la atención de la salud apacigua el descontento social, la concesión de beneficios diferenciados para distintas clases de la población china mantiene satisfecha a la base de apoyo del gobierno y dificulta la unión de las demás clases, reduciendo las amenazas potenciales a la estabilidad del régimen (5) .…”

Section: Introductionunclassified

Seguro social de salud en China: principales reformas y desequilibrios

Ferreira

2017

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This article analyzes the social health insurance system in China, its reforms and the principal social inequalities uncovered. Based in the work of a number of authors of reference, it is possible to observe that rural and urban reforms follow the same pattern: large systems that were gradually reduced and then again expanded relatively quickly. Improvements notwithstanding, some of China's historical problems persist, especially the rural-urban gap and regional disparities. The lack of integration of workers that migrate from the country to the city is reproduced in the current Chinese public health system, constituting one of the primary challenges to be faced at present.

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Expansion of Chinese Social Health Insurance: who gets what, when and how?

Cited by 30 publications

References 0 publications

China's Health Reform Update

China's Health Reform Update

“Promotion tournament 2.0”: Why local cadres expand health‐care provision in China

Seguro social de salud en China: principales reformas y desequilibrios

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