PHA-Exch> The Chinese Health Care System: Structure, Problems and Challenges

[Claudio Schuftan]

From: Ruggiero, Mrs. Ana Lucia (WDC) ruglucia at paho.org
 EQUIDAD at listserv.paho.org

 *The Chinese Health Care System: Structure, Problems and Challenges *



Jens Leth Hougaard, Lars Peter Østerdal and Yi Yu

*Department of Economics - University of Copenhagen - January 2008*



Available online PDF [34p.] at:
http://www.econ.ku.dk/Research/Publications/pink/2008/0801.pdf



"…In the present paper we describe the structure of the Chinese health care
system and sketch its future development. We analyse issues of provider
incentives and the actual burden sharing between government, enterprises and
people. We further aim to identify a number of current problems and link
these to a discussion of future challenges in the form of an aging
population, increased privatization and increased inequity…"



"…..In the late 80ies the Chinese government launched a major reform of the
social insurance system, including reforms of pension- and health care
schemes. This reform has had a huge impact on the organization of the entire
public welfare system. It has been implemented using a series of local
experiments, of which particular models have been selected for national
implementation. The system is constantly changing trying to respond to
current financial problems and adapt to the need of the population.


Despite many efforts, the general impression of the population as well as
the governing authorities is that the reform has not been successful.1 Cost
inflation has been difficult to control and the huge inequality in access
seems to be further increased. On top of this, the reform process itself has
made the population confused and uncertain about their rights in the system
and when adding that the lack of regulation makes the system more exposed to
corruption this distrust only becomes worse.

China is a country with huge regional differences. It is therefore
questionable whether it makes sense to talk about one coherent system or
whether one should more likely consider the system as several co-exiting
subsystems – subsystems that seem to be related to different groups of
people as well as differences in geographic location. Moreover, any
empirical analysis of the Chinese health care system will suffer from
considerable data uncertainties and often even a crucial lack of relevant
data….."
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