Political Interests and the Implementation of China’s Urban Health Insurance Reform

Abstract

During the s and s China has been experimenting with reform of its health insurance system. Based on a study of experimental schemes in several cities in eastern China in the late s, this paper shows that the schemes' main problems are due to the vested interests of enterprises, hospitals, officials, and other beneficiaries of the pre-reform system. Reform policy has been implemented slowly, and local health insurance schemes have () suffered from poor participation rates, and () had difficulties balancing contributions into local government-run pooled funds with expenditures needed for medical treatment. These problems threaten the viability of the national programme announced in late . The solution lies in improving local government capacity through effective legislation and training, but this will be difficult to achieve.

Absence of appropriate hospitalization cost control for patients with medical insurance: a comparative analysis study

“…Furthermore, there is a possibility that unbundling prices as well as over-use of hi-tech medical equipments are still adopted in the 10 chosen hospitals from the 7 cities in our study, which might have contributed to the increase in hospitalization cost among insured patients (Liu et al, 2000;Liu and Mills, 2005). As mentioned previously, overcoming the payment method fees for services per case might have encouraged hospitals to prolong the hospitalization LOS in order to increase hospitals' revenues from each inpatient case (Liu et al, 2000;Duckett, 2001;Meng et al, 2004). Three direct and/or indirect factors that might have contributed to the increase of LOS among insured than uninsured patients are user's income, one child policy, and the demand for better service quality and assurance of treatment.…”

Towards Universal Health Coverage via Social Health Insurance in China: Systemic Fragmentation, Reform Imperatives, and Policy Alternatives

“…Concerned with their cities' attractiveness to investment and GDP growth, local governments often turn a blind eye to investors, tolerating vast informal employment, exacerbating the poor inclusion of the migrant population in urban SHI [31,33].…”

China's ongoing public hospital reform: initiatives, constraints and prospect

“…It was said that the inability of reaching a consensus among ministries was responsible for this protracted policymaking process. 2 Public hospitals are the principal constituencies for the Chinese health bureaucracy, and the latter has been long criticized for protecting public hospitals and tolerating their inefficiencies as well as various malpractices (Aitchison 1997, World Bank 1997, Duckett 2001, Hsiao 2007, Yip and Hsiao 2008. Thus, it was unsurprising to see the MOH's efforts in trying to bargain for more budgetary allocation in the then upcoming hospital sector reforms, which were to some extent justifiable given the remarkably low contribution of government subsidies in hospital incomes (less than 10% on national average).…”