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Medical expenditure has become a heavy burden on the public sector and the family system in many countries. Expanding the coverage and reimbursement of medical insurance has become a common way to reduce the burden. This book will elaborate on how medical insurance may increase the burden instead.It explains why the existing medical insurance system results in increased medical costs, where higher costs may offset the benefits of certainty brought by medical insurance, forming the 'paradox of medical care insurance'. This assumption is verified by empirical evidence in China, through a new method developed to find out the actual medical costs, using two parameters: ratio of self-payment of medical insurance and the level of monopoly in the supply of medical services. The book also describes the history, the current situation, and the reform of the health care system in China.
This book constructs a new theoretical framework for understanding contemporary Chinese agricultural production organizations from the perspective of promoting farmers' realization of 'substantial freedom' and 'feasible ability'. The new theoretical framework deepens and expands the theory of agricultural modernization and production organizations. The book discusses the 'multi-symbiosis' pattern of agricultural production organizations in contemporary China from macro and micro economics perspectives. Based on the peasant household economy, this multi-symbiosis organizational structure co-exists and interweaves with various forms of economic organizations. The book points out that this multi-symbiosis organizational structure is the result of free choice of the majority of farmers since the 'reform' and 'opening-up'; in turn, it also provides a broader organizational and institutional space for farmers' diversified choices. The book predicts that China's agricultural production organization networking will gradually move towards networking based on diversification and also form networked organization groups.
Five years have elapsed since the Chinese government announced its ambitious health care reform programme. The fact that both the United States and China unfolded their gigantic national health care reforms almost simultaneously is reflective of the daunting health policy challenges that most national governments are grappling with. While Obamacare has barely survived the obstruction from Congress and remains controversial, its Chinese counterpart has concluded its first phase at a fairly smooth pace. Having had three trillion RMB invested into it within five years, this landmark reform stands out as one of the biggest health policy interventions in modern history in terms of both scale and scope. A critical juncture in the reform process has been reached and it is time to assess its performance to date. This book provides an interim evaluation of China’s ongoing national health care reform from interdisciplinary perspective. Insights generated are not only valuable to inform next phase of the reform, but also relevant to health policy reformers in other developing and transitional countries. This book was published as a special issue of the Journal of Asian Public Policy.
Presenting a comprehensive examination of China’s medical care system, this book tackles issues of policymaking, organization, management and financing in the context of the provision of affordable care in China. Making use of extensive field investigations, interviews and a thorough analysis of documents, this book examines the re-structuring of the medical care system, spanning more than three and half decades from 1979 to the present day. Assessing the difficulties of regulatory control in the health care sector, it also explores theoretical alternatives, including post-Weberian constructs of uncertainty and control, as well as franchise and asymmetric information in market transactions. Ultimately, it argues that patient medical care has become less and less affordable amid shrinking government subsidies, breakdowns of public insurances and increases in user charges, especially between the mid-1990s and mid-2000s. Whilst the government took decades to re-organize the public hospital system and rebuild public insurances, it faced a dilemma of enforcing both low-cost medical care and maintaining revenue flow to public hospitals through marketization. Re-engineering Affordable Care Policy in China provides extensive discussion of the policymaking process as well as detailed analysis of policy contents. As such, it will be invaluable to students and scholars of Chinese social policy and public administration, as well as Chinese Studies more generally.
This book explores how far the concept of fragmented authoritarianism remains valid as the key concept for understanding how the Chinese political process works. It contrasts fragmented authoritarianism, which places bureaucratic bargaining at the centre of policy-making, arguing that the goals and interests of the implementing agencies have to be incorporated into a policy if implementation is to be secured, with other characterisations of China’s political process. Individual chapters consider fragmented authoritarianism at work in a range of key policy areas, including energy issues, climate change and environmental management, financial reform, and civil-military relations. The book also explores policy making at the national, provincial, city and local levels; debates how far the model of fragmented authoritarianism is valid in its current form or whether modifications are needed; and discusses whether the system of policy making and implementation is overcomplicated, unwieldy and ineffective or whether it is constructive in enabling widespread consultation and scope for imagination, flexibility and variation.
This book provides a multi-disciplinary framework for developing and analyzing health sector reforms, based on the authors' extensive international experience. It offers practical guidance - useful to policymakers, consultants, academics, and students alike - and stresses the need to take account of each country's economic, administrative, and political circumstances. The authors explain how to design effective government interventions in five areas - financing, payment, organization, regulation, and behavior - to improve the performance and equity of health systems around the world.
Abstract: The author applies a systems-oriented "holistic" approach to China's radical economic reforms during the past quarter of a century. He characterizes China's economic reforms in terms of a multidimensional classification of economic systems. When looking at the economic consequences of China's change of economic system, he deals with both the impressive growth performance and its economic costs. The author also studies the consequences of the economic reforms for the previous social arrangements in the country, which were tied to individual work units-agriculture communes, collective firms, and state-owned enterprises. He continues with the social development during the reform period, reflecting a complex mix of social advances, mainly in terms of poverty reduction, and regresses for large population groups in terms of income security and human services, such as education and, in particular, health care. Next, the author discusses China's future policy options in the social field, whereby he draws heavily on relevant experiences in industrial countries over the years. The future options are classified into three broad categories: policies influencing the level and distribution of factor income, income transfers including social insurance, and the provision of human services.
The objectives of this study are to describe experiences in price setting and how pricing has been used to attain better coverage, quality, financial protection, and health outcomes. It builds on newly commissioned case studies and lessons learned in calculating prices, negotiating with providers, and monitoring changes. Recognising that no single model is applicable to all settings, the study aimed to generate best practices and identify areas for future research, particularly in low- and middle-income settings. The report and the case studies were jointly developed by the OECD and the WHO Centre for Health Development in Kobe (Japan).
"Today Singapore ranks sixth in the world in healthcare outcomes well ahead of many developed countries, including the United States. The results are all the more significant as Singapore spends less on healthcare than any other high-income country, both as measured by fraction of the Gross Domestic Product spent on health and by costs per person. Singapore achieves these results at less than one-fourth the cost of healthcare in the United States and about half that of Western European countries. Government leaders, presidents and prime ministers, finance ministers and ministers of health, policymakers in congress and parliament, public health officials responsible for healthcare systems planning, finance and operations, as well as those working on healthcare issues in universities and think-tanks should know how this system works to achieve affordable excellence."--Publisher's website.
The Second Edition of Comparative Health Systems: A Global Perspective offers new perspectives in health administration, public health, and public policy that address evidence-based approaches to health system improvement; systems thinking at the policy level; integrated information management; macro and micro innovation, and systems sustainability. Part I offers introduces foundational concepts including health and disease; and policy and economics. Two new chapters explore innovation and sustainability; and the role and contributions of non-governmental organizations. In Part II, the health systems of 19 countries are each examined in their own chapter, that carefully explores the country’s geography and culture, the history of its health system, followed by a detailed evaluation of cost, quality, access and innovation.