China's health care reform: A tentative assessment

被引:181
作者
Yip, Winnie [1 ]
Hsiao, William [2 ]
机构
[1] Univ Oxford, Dept Publ Hlth, Hlth Econ Res Ctr, Headington OX3 7LF, England
[2] Harvard Univ, Dept Hlth Policy & Management, Dept Global Hlth & Populat, Cambridge, MA 02138 USA
关键词
Health Care; Health insurance; Income distribution; Asymmetric information; Incentive compatibility; PROVIDER-PAYMENT REFORM; HOSPITAL REIMBURSEMENT; SYSTEM REFORM; CHALLENGES; PERFORMANCE; HAINAN;
D O I
10.1016/j.chieco.2009.08.003
中图分类号
F [经济];
学科分类号
02 ;
摘要
China has recently unveiled ail ambitious new health-care reform plan, entailing a doubling of government health spending as well as a number of concrete reforms. While the details of the plan have not yet been completely announced, we offer a preliminary assessment of how well the reform is likely to achieve its stated goal of assuring every citizen equal access to affordable basic health care. The reform is based on three fundamental tenets: strong role of government in health, commitment to equity, and willingness to experiment with regulated market approaches. Within this framework, the reform offers a number Of laudable changes to the health system, including an increase in public health financing, an expansion of primary health facilities and ail increase in subsidies to achieve universal insurance coverage. However, it fails to address the root causes of the wastes and inefficiencies plaguing China's healthcare system. such as a fragmented delivery system and provider incentives to over-provide expensive tests and services. We Conclude that China should consider changing the provider payment method from fee-for-service to a prospective payment method such as DRG or capitation with pay-for-performance, and to develop purchasing agencies that represent the interests of the population so as to enhance competition. (C) 2009 Elsevier Inc. All rights reserved.
引用
收藏
页码:613 / 619
页数:7
相关论文
共 31 条
[1]  
[Anonymous], 2009, STAND C STAT COUNC C
[2]  
[Anonymous], 2000, HDB HLTH EC
[3]   Privatization and its discontents - The evolving Chinese health care system [J].
Blumenthal, D ;
Hsiao, W .
NEW ENGLAND JOURNAL OF MEDICINE, 2005, 353 (11) :1165-1170
[4]   Launch of the health-care reform plan in China [J].
Chen, Zhu .
LANCET, 2009, 373 (9672) :1322-1324
[5]   China's latest health reforms: A conversation with Chinese health minister Chen Zhu [J].
Cheng, Tsung-Mei .
HEALTH AFFAIRS, 2008, 27 (04) :1103-1110
[6]  
CHOU WL, 2009, HLTH EC, V18
[7]  
Eicher R, 2006, 1 M WORK GROUP PERF
[8]  
Hsiao W.C., 2004, HARVARD CHINA REV, V5, P64
[9]  
HSIAO WC, 2008, SOCIAL EXPT RURAL CH
[10]   The political economy of Chinese health reform [J].
Hsiao, William C. .
HEALTH ECONOMICS POLICY AND LAW, 2007, 2 (03) :241-249