The Long March to Universal Coverage : Lessons from China

The march to Universal Health Coverage (UHC) in China is unparalleled. Since the establishment of the State Council Medical Reform team in 2006,4 the basic objective of China's health reforms has been to provide the whole nation with basic medical and health care, while ensuring equal access to, and affordability of, health services. The Chinese government announced the national three-year reform plan in 2009, after which the country has made remarkable progress toward achieving nearly universal health coverage. The recent health reform initiatives under the 12th Five-Year Plan (2011-2015) continue to center on five areas. Building on recent experience, more effort is directed toward a structural change of the health system and building an environment that will facilitate policy implementation. This includes optimizing resource distribution, encouraging hospital competition, strengthening regulation and accountability, and enhancing human resources and information technology. While China has successfully extended the breadth of Health Coverage to the Poor (HCP), its scope (the comprehensiveness of services covered) and depth (the degree of financial risk protection) appear to be insufficient. Hospital admissions have increased significantly; suggesting improved access, up to 50 percent of current admissions may be amenable to more cost-effective outpatient care. Thus, it is critical to look into problems beyond the HCP program design, such as institutional arrangements, intergovernmental transfers, and supply constraints. This case study concludes with a discussion of the impacts of HCP and the needed next steps to advance HCP as an intermediate objective to the country's longer-term goals of equitable access and high quality of services.

Bibliographic Details

Main Authors:	Liang, Lilin, Langenbrunner, John C.
Format:	Working Paper biblioteca
Language:	en_US
Published:	World Bank, Washington DC 2013-01
Subjects:	Access to health services, access to services, accountability mechanisms, adverse selection, adverse selection problems, allocative efficiency, basic health care, basic health services, beds, breast cancer, budget allocation, care institutions, Center for Health, cervical cancer, cities, clinics, community health, community health services, contribution rate, cost control, cost structure, decision making, delivery system, developing countries, Development Goals, doctors, economic growth, elderly, elderly people, epidemic, equal access, equitable access, essential drugs, essential medicines, Expenditures, families, fee schedule, fee-for-service, fee-for-service system, financial barriers, financial contributions, financial incentives, Financial protection, financial risk, financial risk protection, financial risks, fiscal policies, fiscal policy, General Health System, general practitioners, global budgets, global campaign, health care, health care costs, health care delivery, health care reform, health care services, Health Care System, Health Care System Reform, health care workers, health centers, Health Coverage, health delivery, health delivery system, health education, Health Expenditure, Health Expenditures, health financing, health infrastructure, health institutions, health insurance coverage, health insurance program, health insurance scheme, Health Insurance Schemes, health insurance system, health management, Health Organization, health outcomes, health planning, health policy, health professionals, health programs, Health providers, health reform, health reforms, health resources, health sector, Health Service, health service utilization, Health Services, Health Status, Health System, health system reform, health systems, health workers, health workforce, healthcare services, hospital admission, Hospital admissions, hospital beds, hospital care, hospital cost, hospitalization, Hospitals, Human Resources, ill health, impact evaluations, impact on health outcomes, incentives for doctors, income, income countries, induced demand, informal sector, informatics, information system, information systems, inpatient care, insurance coverage, insurance funds, insurance premiums, insurers, integration, intervention, kidney diseases, large cities, laws, leukemia, living standards, local authorities, marginal costs, market economy, medical bills, medical care, medical education, medical expenses, Medical Insurance, medical records, medical resources, medical savings accounts, medical services, medical staff, medicines, mental illness, migrant, migrant workers, Ministry of Health, mortality, mortality rate, movement of People, National Development, National Health, national health expenditure, National Health Insurance, National Health Services, nurses, nursing, outpatient care, outpatient services, patient, patient outcomes, Patients, pharmaceutical companies, pharmacists, physician, physicians, pocket payment, policy framework, policy makers, political support, poor health, prescription drugs, primary care, Private Health Insurance, progress, provider incentives, provider payment, provision of care, psychiatric hospital, Public Health, Public Health Services, public health spending, public hospital, Public Hospitals, public sector, public services, public spending, quality care, quality of services, reimbursement rates, Rural Areas, rural health care, rural population, rural residents, safety net, school children, social development, social equity, social health insurance, Social Insurance, Social Security, Social Security benefits, Social Services, social welfare, tuberculosis, unemployment, universal access, urban areas, urbanization, vicious cycle, violence, waste, workers, working conditions, World Health Organization,
Online Access:	http://hdl.handle.net/10986/13303
Tags:	Add Tag No Tags, Be the first to tag this record!