The new cooperative medical scheme in China

Does China's new cooperative medical scheme promote rural elders' access to healthcare services in relation to chronic conditions?

“…Similarly, check-ups are of no value for those at high risk of developing chronic conditions without the follow-up prevention and health promotion services that should be provided through the rural primary healthcare system by a multidisciplinary team of health professionals with expertise in chronic conditions. 25,27 With the financial capacity of NCMS increasing year by year, it is possible for NCMS to cover prevention, health promotion services and disease management for chronic conditions. However, problems remain with healthcare manpower and with the service content of the rural primary healthcare system, especially in the case of public health services offered in township health centers and village clinics.…”

“…25,26 Special considerations for rural elders were encouraged, such as premiums remission and free check-ups. 16,25,27 For example, in Jiangsu, local governments have paid for rural elders to participate in NCMS, and annual check-ups paid for by NCMS will be available to participants. NCMS is proven to increase the use of healthcare services by rural elders, who have reported a significantly higher satisfaction with NCMS than other age groups.…”

“…NCMS is proven to increase the use of healthcare services by rural elders, who have reported a significantly higher satisfaction with NCMS than other age groups. 25,27,28 Chronic disease has been found to be strongly associated with a decline in household income, and having a chronic disease is one of most important factors leading to poverty in China. [29][30][31] Studies showed that NCMS participants with a high income benefited more from NCMS than those with middle and low incomes, 24 and elders in rural areas with middle and low incomes have been found to be disadvantaged in their access to healthcare services.…”

China's achievements and challenges in improving health insurance coverage

“…According to statistics, the proportion of out-of-pocket expenditures to total national health expenditures decreased dramatically from 60% in 2001 to 35% in 2011 at the national level (4). In contrast, the proportion of out-of-pocket payments as a share of average annual the most effective approaches for rapid expansion of coverage (20,21). Funds for the NRCMS are jointly provided by the central government, local governments, and rural households, with a ratio of contribution of 2:2:1 (i.e., 80% from the government and 20% from rural residents) (20,22).…”

Good and Bad News from China's New Cooperative Medical Scheme

“…Based on three simulation scenarios, Yip and Hsiao (2009) concluded that the NCMS could have only limited effectiveness in protecting the population from medical impoverishment because it ignored disease profiles and health expenditure patterns. You and Kobayashi (2009) reviewed the papers on the NCMS published between 1 January 2003 and 30 March 2008, and suggested that rigorous evaluations, based on richer and more recent micro-level data, could considerably strengthen the evidence base for the impact of the NCMS as it is rolled out to more counties. In this context, the overall goal of this article is to understand progress in implementing the NCMS, while seeking to assess its strengths and weaknesses, and in particular its effects on the incidence of catastrophic medical payment.…”