For More Information

Size: px
Start display at page:

Download "For More Information"

Transcription

1 CHILDREN AND FAMILIES EDUCATION AND THE ARTS ENERGY AND ENVIRONMENT HEALTH AND HEALTH CARE INFRASTRUCTURE AND TRANSPORTATION INTERNATIONAL AFFAIRS LAW AND BUSINESS NATIONAL SECURITY POPULATION AND AGING PUBLIC SAFETY SCIENCE AND TECHNOLOGY TERRORISM AND HOMELAND SECURITY The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. This electronic document was made available from as a public service of the RAND Corporation. Skip all front matter: Jump to Page 16 Support RAND Browse Reports & Bookstore Make a charitable contribution For More Information Visit RAND at Explore the Pardee RAND Graduate School View document details Limited Electronic Distribution Rights This document and trademark(s) contained herein are protected by law as indicated in a notice appearing later in this work. This electronic representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of RAND electronic documents to a non-rand website is prohibited. RAND electronic documents are protected under copyright law. Permission is required from RAND to reproduce, or reuse in another form, any of our research documents for commercial use. For information on reprint and linking permissions, please see RAND Permissions.

2 This product is part of the Pardee RAND Graduate School (PRGS) dissertation series. PRGS dissertations are produced by graduate fellows of the Pardee RAND Graduate School, the world s leading producer of Ph.D. s in policy analysis. The dissertation has been supervised, reviewed, and approved by the graduate fellow s faculty committee.

3 Dissertation China s Health Insurance Reform and Disparities in Healthcare Utilization and Costs A Longitudinal Analysis Henu Zhao C O R P O R A T I O N

4 Dissertation China s Health Insurance Reform and Disparities in Healthcare Utilization and Costs A Longitudinal Analysis Henu Zhao This document was submitted as a dissertation in October 2014 in partial fulfillment of the requirements of the doctoral degree in public policy analysis at the Pardee RAND Graduate School. The faculty committee that supervised and approved the dissertation consisted of Hao Yu (Chair), Emmett Keeler, and Gema Zamarro. PARDEE RAND GRADUATE SCHOOL

5 The Pardee RAND Graduate School dissertation series reproduces dissertations that have been approved by the student s dissertation committee. The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND s publications do not necessarily reflect the opinions of its research clients and sponsors. R is a registered trademark. Permission is given to duplicate this document for personal use only, as long as it is unaltered and complete. Copies may not be duplicated for commercial purposes. Unauthorized posting of RAND documents to a non-rand website is prohibited. RAND documents are protected under copyright law. For information on reprint and linking permissions, please visit the RAND permissions page (http://www.rand.org/publications/permissions.html). Published 2015 by the RAND Corporation 1776 Main Street, P.O. Box 2138, Santa Monica, CA South Hayes Street, Arlington, VA Fifth Avenue, Suite 600, Pittsburgh, PA RAND URL: To order RAND documents or to obtain additional information, contact Distribution Services: Telephone: (310) ; Fax: (310) ;

6 Table of Contents Tables... v Figures... ix Abstract... xi Acknowledgements... xiii Chapter 1 Introduction... 1 Chapter 2 Background Health insurance reform in China Collapse of health insurance schemes in the 1970s and 1980s Early efforts in the 1980s and early 1990s Health insurance reform since the late 1990s Healthcare reform after Three Major Health Insurance Schemes The Basic Medical Insurance for Urban Employees The Basic Medical Insurance for Urban Residents The New Rural Cooperative Medical Insurance Trends and Current Status of Healthcare Disparities Chapter 3 Literature Review and Study Objectives Existing Research Literature on Rural Urban Disparities in Healthcare Utilization Literature on Disparities in Out of Pocket Expenditure and Healthcare Costs Literature on Disparities in Health Insurance Coverage Methodological Issues Gap in the Existing Literature Objectives and Research Questions Chapter 4 Study Design Data Study Periods Conceptual Model and Variable Selection Dependent Variables Independent Variables Analytic Approach Difference in Differences Analysis with Multiple Groups and Multiple Time Periods Multivariate Regression for the Variables that do not meet the Assumption of Parallel Trends Sensitivity analysis Controlling for Insurance Status Dropping the Richest Province or the Poorest Province iii

7 4.5.3 Including Interaction Terms with Household Income DID Analysis Results for Variables in Which Parallel Trends did not Hold Chapter 5 Results: Disparities in Healthcare Utilization Descriptive Analysis DID Analysis for Formal Care Utilization and Outpatient Utilization Multivariate Analysis Controlling for Existing Trends for Inpatient Utilization Sensitivity Analysis Controlling for Insurance Status Dropping the Richest Province or the Poorest Province Including Interaction Terms with Household Income DID Analysis for Inpatient Care Summary of Findings Chapter 6 Results: Disparities in healthcare costs Descriptive Analysis Multivariate Analysis Controlling for Existing Trends Sensitivity Analysis controlling for health insurance status dropping the richest province or the poorest province Including interaction terms with household income DID analysis results for cost variables Summary of Findings Chapter 7 Conclusion, Discussion, and Policy Implications Conclusion Discussion Comparing With the Published Research Strengths Limitations Future Directions Policy Implications Appendix Reference iv

8 Tables Table 4.1 Sample Size by Rural and Urban Residences and Registrations Table 4.2 Descriptive Statistics of Independent Variables by Rural and Urban Residences and Registrations Table 4.3 Results of DID Analysis Using 1993 and 1997 Waves for Healthcare Utilization Table 4.4 Results of DID Analysis Using 1993 and 1997 Waves for Healthcare Costs Table 5.1 DID Analysis Results for Formal Care Utilization and Outpatient Utilization Table 5.2 Test Results for DID Analysis of Formal Care Utilization and Outpatient Utilization Table 5.3 Multivariate Analysis Results for Inpatient Care Utilization Table 5.4 Test Results of Disparities for Inpatient Care Utilization Table 5.5 Test Results of Change in Disparities for Inpatient Care Utilization Table 5.6 DID Analysis Results of Formal Care and Outpatient Utilization (Controlling for Insurance Status) Table 5.7 Test Results for DID Analysis of Healthcare Utilization (Controlling for Insurance Status) Table 5.8 Multivariate Analysis Results for Inpatient Care Utilization (Controlling for Insurance Status) Table 5.9 Test Results of Disparities for Inpatient Care Utilization (Controlling for Insurance Status) Table 5.10 Test Results of Change in Disparities for Inpatient Care Utilization (Controlling for Insurance Status) Table 5.11 DID Analysis Results for Formal Care and Outpatient Utilization (Dropping the Richest Province) Table 5.12 Test Results for Formal Care and Outpatient Utilization (Dropping the Richest Province) Table 5.13 DID Analysis Results for Formal Care and Outpatient Utilization (Dropping the Poorest Province) Table 5.14 Test Results for Formal Care and Outpatient Utilization (Dropping the Poorest Province) v

9 Table 5.15 Multivariate Analysis Results for Inpatient Utilization (Dropping the Richest/Poorest Province) Table 5.16 Test Results of Disparities in Inpatient Utilization (Dropping the Richest/poorest Province) Table 5.17 Test Results of Change in Disparities for Inpatient Care Utilization (Dropping the Richest/poorest Province) Table 5.18 DID Analysis Results for Formal Care and Outpatient Utilizations (Including Interaction Term with Household Income) Table 5.19 Test Results for Formal Care and Outpatient Utilizations (Including Interaction Term with Household Income) Table 5.20 DID Analysis Results for Inpatient Care Utilization Table 5.21 Test Results for Inpatient Care Utilization (DID Analysis) Table 6.1 Multivariate Analysis Results for OOP Exceeding Certain Percentage of Household Income Table 6.2 Multivariate Analysis Results for Total Healthcare Costs Table 6.3 Test Results of Disparities for OOP Exceeding Certain Percentage of Household Income Table 6.4 Test Results of Changes in Disparities for OOP Exceeding Certain Percentage of Household Income Table 6.5 Bootstrap Results for Disparities in Total Health Costs Table 6.6 Multi variate Analysis Results for OOP Exceeding Certain Percentage of Household Income (Controlling for Insurance) Table 6.7 Test Results of Disparities for OOP Exceeding Certain Percentage of Household Income (Controlling for Insurance) Table 6.8 Test Results of Changes in Disparities for OOP Exceeding Certain Percentage of Household Income (Controlling for Insurance) Table 6.9 Bootstrap Results for Disparities in Total Health Cost (Controlling for Insurance) Table 6.10 Multi variate Analysis Results for OOP Exceeding Certain Percentage of Household Income (Dropping the Richest Province) Table 6.11 Test Results of Disparities for OOP Exceeding Certain Percentage of Household Income (Dropping the Richest Province) vi

10 Table 6.12 Test Results of Changes in Disparities for OOP Exceeding Certain Percentage of Household Income (Dropping the Richest Province) Table 6.13 Multi variate Analysis Results for OOP Exceeding Certain Percentage of Household Income (Dropping the Poorest Province) Table 6.14 Test Results of Disparities for OOP Exceeding Certain Percentage of Household Income (Dropping the Poorest Province) Table 6.15 Test Results of Changes in Disparities for OOP Exceeding Certain Percentage of Household Income (Dropping the Poorest Province) Table 6.16 Bootstrap Results for Disparities in Total Health Costs (Dropping the Richest Province) Table 6.17 Bootstrap Results for Disparities in Total Health Cost (Dropping the Poorest Province) Table 6.18 Multi variate Analysis Results for OOP Exceeding Certain Percentage of Household Income (Low income Families) Table 6.19 Test Results of Disparities for OOP Exceeding Certain Percentage of Household Income (Low income Families) Table 6.20 Test Results of Changes in Disparities for OOP Exceeding Certain Percentage of Household Income (Low income Families) Table 6.21 Multi variate Analysis Results for OOP Exceeding Certain Percentage of Household Income (Medium income Families) Table 6.22 Test Results of Disparities for OOP Exceeding Certain Percentage of Household Income (Medium income Families) Table 6.23 Test Results of Changes in Disparities for OOP Exceeding Certain Percentage of Household Income (Medium income Families) Table 6.24 Multi variate Analysis Results for OOP Exceeding Certain Percentage of Household Income (High income Families) Table 6.25 Test Results of Disparities for OOP Exceeding Certain Percentage of Household Income (High income Families) Table 6.26 Test Results of Changes in Disparities for OOP Exceeding Certain Percentage of Household Income (High income Families) Table 6.27 Bootstrap Results for Disparities in Total Health Costs (Low income Families) Table 6.28 Bootstrap Results for Disparities in Total Health Costs (Medium income Families) vii

11 Table 6.29 Bootstrap Results for Disparities in Total Health Costs (High income Families) Table 6.30 DID Analysis Results for OOP Exceeding Certain Percentage of Household Income Table 6.31 Test Results for OOP Exceeding Certain Percentage of Household Income (DID Analysis) Table 6.32 Bootstrap Results for Disparities in Total Health Costs (DID Analysis) viii

12 Figures Figure 2.1 Health Insurance Coverage in Urban and Rural Areas in China, Selected Years Figure 2.2 Health Service Utilization in Urban and Rural Areas in China (2003) Figure 2.3 Healthcare Spending in China, by Source and Year Figure 2.4 Per Capita Out of Pocket Health Expenses as a Percentage of Income Figure 4.1 Updated Structure of Anderson Model Figure 5.1 Probability of Formal Care Utilization in 4 Weeks by Rural and Urban Residences and Registrations Figure 5.2 Probability of Outpatient Care Utilization in 4 Weeks by Rural and Urban Residences and Registrations Figure 5.3 Probability of Inpatient Care Utilization in 4 Weeks by Rural and Urban Residences and Registrations Figure 5.4 Predicted Probability of Formal Care Utilization in 4 Weeks by Rural and Urban Residences and Registrations Figure 5.5 Predicted Probability of Outpatient Care Utilization in 4 Weeks by Rural and Urban Residences and Registrations Figure 5.6 Predicted Probability of Inpatient Care Utilization in 4 Weeks by Rural and Urban Residences and Registrations Figure 6.1 Probability of Having Out of pocket Medical Expense Exceeding 20% of Household Income by Rural and Urban Residences and Registrations Figure 6.2 Probability of Having Out of pocket Medical Expense Exceeding 40% Household Income by Rural or Urban Residences and Registrations Figure 6.3 Total Healthcare Costs by Rural and Urban Residences and Registrations Figure 6.4 Predicted Probability of Having OOP Exceeding 20% of Household Income by Rural and Urban Residences and Registrations Figure 6.5 Predicted Probability of Having OOP Exceeding 40% of Household Income by Rural and Urban Residences and Registrations Figure 6.6 Predicted Total Healthcare Costs by Rural and Urban Residences and Registrations ix

13

14 Abstract China s economic success during the past 30 years was not mirrored in its health care system. As a result, the rural urban disparities in health insurance coverage and the related health care areas became prominent. Since the late 1990s, China has been expanding insurance coverage, in order to provide accessible and affordable health care to all residents. My study analyzes whether the insurance expansion reduces rural urban disparities in terms of health care utilization and financial protection. To my knowledge, this is the first study to address the disparity issue by examining China s health care reform policies over an extended 18 year period ( ). It is also the first study to address the dynamic phenomenon of rural urban migration during the study period by separating the study group into 4 subgroups in terms of respondents in residential areas versus household registration type. Drawing on seven waves of data from the China Health and Nutrition Survey and applying multivariate analysis techniques, such as difference in difference analysis and generalized linear model, I find that rural urban disparities in formal care and outpatient utilization were significantly reduced by the expanded health insurance coverage in rural area in The rural urban disparity in total health costs is also significantly reduced. However, no evidence shows that the policy changes in health insurance coverage had impact on disparities in inpatient utilization or having high out of pocket payments. By conducting several sets of sensitivity analyses, my study also finds that the expanded health insurance coverage impacted richer province more than poorer provinces, and impact high income families more than medium and low income families. xi

15 The study findings have important policy implications for China s ongoing health care reform. First, China s policy makers should provide better health care coverage and more health care resources to rural areas to further reduce the rural urban disparity. Second, since prior policy changes affected rich province more than poor province, new policy should target specifically poor provinces. Third, given the finding that the positive impact on health care utilization of policy change in 2003 happening mainly in high income groups, new policy change should focus more on medium and low income group. xii

16 Acknowledgements I am grateful for the support provided by my wonderful dissertation committee: Dr. Hao Yu, Dr. Gema Zamarro, and Dr. Emmett Keeler. The successful completion of this dissertation was a consequence of their excellent guidance. I am especially thankful for mentorship of my Committee Chair, Hao. His timely feedbacks on our weekly meetings were crucial to keep me on the right track. I would also like to thank Gema and Emmett for their insightful and constructive advices on the policy context and methodological issues. I also want to thank my outside reader Teh wei Hu, Professor Emeritus of Health Economics, University of California, Berkeley, for his helpful and responsive comments on my dissertation. I would also like to thank my research mentor Nelson Lim. He taught me how to do research and how to write, and provided me with advices and encouragement during my dissertation work. I would also like to thank the PRGS faculty, staff and students for their help during my dissertation writing. The dissertation would not have been possible without the generous financial support provided by the Rosenfeld Dissertation Award. Lastly, I would like to extend special thanks to my parents for their trust and encouragement, and to my husband, Yong Fu, for his love and support. xiii

17

18 Chapter 1 Introduction China experienced rapid economic growth in the past two decades, benefiting many sectors of the economy. However, the economic success was not mirrored in the healthcare system. Instead, the transition from a centrally planned economy to a market oriented economy has caused problems in the public health arena. For example, after the economic reforms started in 1978, the existing health insurance providers faced increased operational challenges, and as a result, many residents lacked any form of health insurance. The condition was especially troublesome in rural areas, revealing sharp rural urban disparities in health insurance coverage and related healthcare services and costs. Since the late 1990s, there have been attempts to expand public health insurance coverage to both rural and urban residents in order to provide accessible and affordable healthcare to all residents. Another goal of the healthcare reforms was to provide healthcare to the poor and disadvantaged populations. As of the end of 2011, three health insurance programs, called schemes, were established, covering most of the rural and urban residents with some form of health insurance. However, the performance of the current health insurance schemes has not been well examined. Mixed findings have been presented regarding this issue. My dissertation focuses on the role of health insurance in reducing the rural urban disparities in terms of healthcare utilization and financial protection, in the context of the current health insurance schemes. The dissertation is organized as follows: Chapter 2 provides the background of the policy change. The chapter briefly reviews the history of the Chinese health insurance system reform, including the collapse and re establishment of the systems. I also provide 1

19 statistics of the trends and current status of rural urban healthcare disparities. Chapter 3 reviews existing literature on the topic of rural urban healthcare disparities and summarizes the research questions. Chapter 4 presents the study design, including data used, conceptual framework, and analytical approach. Chapters 5 and 6 present the results of the study. In Chapter 7, I conclude the study and present policy implications. 2

20 Chapter 2 Background The great economic reform in China brought changes to all areas of the economy, including the healthcare system. Unfortunately, as a result, many residents lost health insurance coverage. The existing health insurance schemes experienced difficulties in providing sufficient healthcare to insured residents. The cooperative medical scheme (CMS) providing rural health insurance experienced the greatest damage. In response to the emerging problems in its healthcare system, China has made numerous attempts to rebuild universal coverage system since the late 1990s. Through decades of effort, the Chinese government has developed three systems, in both urban and rural areas, which provide coverage for more than 90% of the population. During the launch of each new health insurance scheme, the government also proposed other measures to provide more healthcare resources to the targeted population. These measures work together with the health insurance systems to provide sufficient and affordable healthcare to all residents. Although there has been great progress, the health insurance system is far from perfect. The health insurance reform is still underway, and the effect of the expanded insurance coverage in China is still under debate. 2.1 Health insurance reform in China In this section, I review the history of health insurance reform in China. The health insurance system collapsed in the late 1970s, and a great number of residents left uninsured. Starting from the late 1990s, the government established three new health insurance systems in both rural and urban areas. In 2009, the government started a new round of healthcare reform. In the new round of reform, the major goal was to provide 3

21 universal coverage to all residents, and to target on disadvantage population to improve the healthcare service for them and reduce disparities Collapse of health insurance schemes in the 1970s and 1980s Since the late 1970s, the Chinese economic reforms have led to a period of prosperity. However, the economic success was not mirrored in the healthcare system. Instead, the economic transition caused problems in the public health arena. Prior to the economic reforms, there were three basic forms of insurance, which covered almost all Chinese citizens. The Government Insurance Scheme (GIS) covered government employees. The Labor Insurance Scheme (LIS) covered state owned enterprise (SOE) workers. Finally, the cooperative medical scheme (CMS) covered the rural agricultural workers. The economic reforms brought changes to the healthcare sector, weakening all three forms of insurance to some extent. First, the government run hospitals under the GIS experienced financial difficulties and thus were hard pressed to provide sufficient healthcare service to those insured under GIS. One reason for the financial crisis was that the economic reforms led to relaxation of price controls, and as a result, the costs incurred by the government run hospitals increased. Another reason is that the government contributed less to public hospitals: Government contributions shrank from 50% in the 1980s to less than 10% in 2000 (Wang 2004). Second, during the reform, financial autonomy was granted to the SOEs. As a result, a large number of SOEs closed, and many employees lost their jobs. Thus, the number of those insured by the LIS was reduced. Even those who kept their jobs found that their SOE employers faced difficulties in financing health insurance for workers (Li 2008). Finally, in the rural areas, the basic production unit 4

22 became households as the collective farms were dismantled. The CMS also collapsed with this change. In the 1990s, the vast majority of the rural population lacked any form of health insurance coverage (Hsiao 1984; Liu 2004). As mentioned, all three major health insurance systems experienced damages as a result of the changes brought by the economic reforms, and among them, the rural health insurance scheme CMS faced the biggest challenge. By 1998, the percentage of rural residents with any form of health insurance coverage had dropped to 13%, compared to 56% for residents covered in urban areas (China Ministry of Health, 2004). As the urban rural gap widened, the urban rural disparity in health insurance started to draw more attention Early efforts in the 1980s and early 1990s Before the major health reforms began in the late 1990s, there had been attempts to improve the existing health insurance systems. Even since the 1980s, actions had been taken in urban areas to relieve the financial burden on the health insurance systems. By introducing demand and supply side cost sharing, the attempts in the 1980s focused on reducing costs. These actions curbed the rapid healthcare cost growth, but they were not able to solve the fundamental financial problems (Liu 2002). Beginning in the early 1990s, the government introduced more actions to increase the level of risk pooling. In 1995, the government introduced a new model combining individual responsibility and social protection with city wide risk pooling. However, pilot programs of the new system were launched in only two cities and were not spread nationwide until the late 1990s. In rural areas, debate and research has focused on how to maintain the collapsing corporative insurance scheme from the 1980s and 1990s. The central government s effort 5

23 mainly focused on urban area; the local governments were advised to develop and complete the current CMS systems based on local economic conditions. However, the local actions only slightly increased the health insurance coverage in rural areas. Most of the coverage concentrated only on developed provinces and cities, such as Shanghai, Jiangsu, Guangdong, and Shandong. By the end of 1990s, most of the rural residents were left uninsured Health insurance reform since the late 1990s In response to the emerging problems in its healthcare system, China has made numerous attempts to rebuild universal coverage since the late 1990s. The goal of universal coverage is to provide safe, effective, convenient, and affordable basic medical services to all urban and rural residents (State Council, 2009). One of the most important components of universal coverage is health insurance. Before this goal of universal coverage was officially introduced in 2009 with the Chinese government s announcement of the blueprint for health system reform, health insurance reforms in both urban and rural areas had resulted in greater health insurance coverage. Three major health insurance schemes were established. The Urban Employees Basic Medical Insurance was launched in urban areas in 1998, and the Urban Residents Basic Medical Insurance was launched in In rural areas, the New Rural Cooperative Medical Insurance (NRCM) was established in In 2008, the two urban health insurance schemes covered about 65% of urban residents, and the rural scheme covered about 90% of rural residents (National Health Services Survey, 2008). The three major health insurance schemes are discussed in detail in the next section. 6

24 The expanded health insurance coverage provided residents with more financial protection and encouraged residents to use healthcare when needed. However, the utilization of healthcare was also subjected to medical resources available. Instead of only providing health insurance coverage to residents, the healthcare reform was a comprehensive system with other measures and actions. These measures and actions worked together with health insurance expansion, providing residents with more healthcare resources and granting them adequate healthcare access. First, the medical service system with basic facilities was constructed in rural areas. In 2003, together with the launch of NRCM, the State Council announced other measures designed to rebuild the rural medical system (State Council, 2002). One of the measures was to construct the medical service system with basic facilities. In order to achieve this goal, central and local governments increased their financial support to the medical system each year. From 2003 to 2010, the increased funding was partially used on the construction of the medical system. Local governments at the county level were responsible for the operational cost of the local medical facilities. The central government and local governments at the province level provided undeveloped areas with subsidies for infrastructure construction. Second, a medical assistance program was established in both rural and urban areas. In rural areas, the program was launched in The program was to provide financial assistance to low income households. The assistance could either be used to treat catastrophic disease or be used as premiums to join the local NRCM. Government subsidies for the program have been increasing since the program was launched. In urban areas, the 7

25 program was launched in The targeted populations were (a) urban residents living below the poverty line who did not join the Urban Residents Basic Medical Insurance; and (b) urban residents who joined the URBMI but were still carrying heavy financial burdens. The program was designed and funded by local governments. The central government also provided assistance through government transfers. Third, training of medical professionals was enhanced in rural areas. In its 2002 document No. 13, the State Council announced measures to improve the quality of medical professionals in rural areas. In post secondary medical schools, the Council introduced a 5 year program after middle school and a 3 year program after high school, in an effort to produce more medical professionals, especially for rural areas. Medical graduates and retired medical professionals from urban areas were encouraged to go back to work in rural areas (State Council, 2002). As a reflection of ongoing progress, measures to improve education and training of medical professional were introduced again in a new round of health reform (State Council, 2009). Healthcare workers were encouraged to attend formal education programs and obtain official licenses. The training of general practitioners for rural areas was included in the Ministry of Education 2010 work plan. The government provided the training costs (Meng and Tang 2010). Finally, the government undertook other actions to refine the whole medical system, such as regulation of drug policy, allocation of medical funding, and strengthening of administration and supervision system. All the measures worked as a whole to improve the medical service for both rural and urban areas. 8

Development of Health Insurance Scheme for the Rural Population in China

Development of Health Insurance Scheme for the Rural Population in China Development of Health Insurance Scheme for the Rural Population in China Meng Qingyue China Center for Health Development Studies Peking University DPO Conference, NayPyiTaw, Feb 15, 2012 China has experienced

More information

Health and Rural Cooperative Medical Insurance in China: An empirical analysis

Health and Rural Cooperative Medical Insurance in China: An empirical analysis Health and Rural Cooperative Medical Insurance in China: An empirical analysis Song Gao and Xiangyi Meng Abstract China abandoned its free universal health care system and privatized it since 1980s. The

More information

HSRA2011 The Impacts of Health Insurance on Health Care Utilization Among the Elderly in China

HSRA2011 The Impacts of Health Insurance on Health Care Utilization Among the Elderly in China The Impacts of Health Insurance on Health Care Utilization Among the Elderly in China Xin Li, PhD Shanghai Jiao Tong University, China Outline Background Literature Objectives Methods Results Conclusions

More information

An Impact Evaluation of China s Urban Resident Basic Medical Insurance on Health Care Utilization and Expenditure

An Impact Evaluation of China s Urban Resident Basic Medical Insurance on Health Care Utilization and Expenditure An Impact Evaluation of China s Urban Resident Basic Medical Insurance on Health Care Utilization and Expenditure Hong Liu China Economics and Management Academy Central University of Finance and Economics

More information

The Household Level Impact of Public Health Insurance. Evidence from the Urban Resident Basic Medical Insurance in China. University of Michigan

The Household Level Impact of Public Health Insurance. Evidence from the Urban Resident Basic Medical Insurance in China. University of Michigan The Household Level Impact of Public Health Insurance Evidence from the Urban Resident Basic Medical Insurance in China University of Michigan Jianlin Wang April, 2014 This research uses data from China

More information

Harmonization of Health Insurance Schemes in China

Harmonization of Health Insurance Schemes in China Harmonization of Health Insurance Schemes in China Hai Fang Professor of Health Economics China Center for Health Development Studies Peking University China Presentation at the First National Conference

More information

Developing and implementing equity-promoting health care policies in China A case study commissioned by the Health Systems Knowledge Network

Developing and implementing equity-promoting health care policies in China A case study commissioned by the Health Systems Knowledge Network Developing and implementing equity-promoting health care policies in China A case study commissioned by the Health Systems Knowledge Network Qingyue Meng Center for Health Management and Policy, Shandong

More information

1. Introduction. 1.1 Background and problem statement

1. Introduction. 1.1 Background and problem statement 1. Introduction 1.1 Background and problem statement Health and economic development should be understood as a mutual process. There are four pathways through which health can contribute to economic prosperity

More information

Regional Inequality in Healthcare in China

Regional Inequality in Healthcare in China Regional Inequality in Healthcare in China QIAN Jiwei* Regional inequality in healthcare in China is particularly wide. Since 2007, the central government has increased earmarked healthcare transfers to

More information

For More Information

For More Information CHILDREN AND FAMILIES EDUCATION AND THE ARTS ENERGY AND ENVIRONMENT HEALTH AND HEALTH CARE INFRASTRUCTURE AND TRANSPORTATION INTERNATIONAL AFFAIRS LAW AND BUSINESS NATIONAL SECURITY POPULATION AND AGING

More information

Medical Device Reimbursement In China

Medical Device Reimbursement In China Medical Device Reimbursement In China Reimbursement has long been an issue of major concern to U.S. pharmaceutical manufacturers trying to sell their products in China. Recent developments have made the

More information

Universal Coverage of Health Care in China: Challenges and Opportunities

Universal Coverage of Health Care in China: Challenges and Opportunities Universal Coverage of Health Care in China: Challenges and Opportunities Meng, Qingyue & Tang, Shenglan World Health Report (2010) Background Paper, 7 HEALTH SYSTEMS FINANCING The path to universal coverage

More information

Health insurance systems in China: A briefing note

Health insurance systems in China: A briefing note Health insurance systems in China: A briefing note Sarah L Barber and Lan Yao World Health Report (2010) Background Paper, 37 HEALTH SYSTEMS FINANCING The path to universal coverage World Health Organization,

More information

Do Different Health Insurance Plans in China Create Disparities in Health Care Utilization and Expenditures?

Do Different Health Insurance Plans in China Create Disparities in Health Care Utilization and Expenditures? Fang, Meng and Rizzo, International Journal of Applied Economics, 11(1), March 2014, 118 1 Do Different Health Insurance Plans in China Create Disparities in Health Care Utilization and Expenditures? Hai

More information

Health Care Financing in China

Health Care Financing in China Health Care Financing in China Social vs. private insurance Jin MA, Professor, MSc, MA, PhD Shanghai Jiao Tong University School of Public Health April 11, 2011, Atlanta, USA Outline Health Financing bet

More information

Colombia REACHING THE POOR WITH HEALTH SERVICES. Using Proxy-Means Testing to Expand Health Insurance for the Poor. Differences between Rich and Poor

Colombia REACHING THE POOR WITH HEALTH SERVICES. Using Proxy-Means Testing to Expand Health Insurance for the Poor. Differences between Rich and Poor REACHING THE POOR WITH HEALTH SERVICES 27 Colombia Using Proxy-Means Testing to Expand Health Insurance for the Poor Colombia s poor now stand a chance of holding off financial catastrophe when felled

More information

HEALTHCARE FINANCING REFORM: THE CASE in TURKEY. Prof. Ahmet Burcin YERELI. aby@hacettepe.edu.tr. Department of Public Finance,

HEALTHCARE FINANCING REFORM: THE CASE in TURKEY. Prof. Ahmet Burcin YERELI. aby@hacettepe.edu.tr. Department of Public Finance, HEALTHCARE FINANCING REFORM: THE CASE in TURKEY Prof. Ahmet Burcin YERELI aby@hacettepe.edu.tr Department of Public Finance, Faculty of Economics and Administrative Sciences, Hacettepe University Research

More information

Forecasting China's Medical Insurance Policy for Urban Employees Using a Microsimulation Model

Forecasting China's Medical Insurance Policy for Urban Employees Using a Microsimulation Model Copyright JASSS Linping Xiong and Xiuqiang Ma (2007) Forecasting China's Medical Insurance Policy for Urban Employees Using a Microsimulation Model Journal of Artificial Societies and Social Simulation

More information

Insurance Markets in China 1

Insurance Markets in China 1 Insurance Markets in China 1 Hanming Fang University of Pennsylvania Even though Chinese merchants have practiced risk transferring and distributing as early as 3000 BC, 2 modern insurance markets in China

More information

Can National Health Insurance Programs Improve Health Outcomes? Re-Examining the Case of the New Cooperative Medical Scheme in Rural China

Can National Health Insurance Programs Improve Health Outcomes? Re-Examining the Case of the New Cooperative Medical Scheme in Rural China Can National Health Insurance Programs Improve Health Outcomes? Re-Examining the Case of the New Cooperative Medical Scheme in Rural China Xueling Chu Foreign Economic Cooperation Center, Ministry of Agriculture,

More information

THE NEW COOPERATIVE MEDICAL SCHEME IN RURAL CHINA: DOES MORE COVERAGE MEAN MORE SERVICE AND BETTER HEALTH?

THE NEW COOPERATIVE MEDICAL SCHEME IN RURAL CHINA: DOES MORE COVERAGE MEAN MORE SERVICE AND BETTER HEALTH? HEALTH ECONOMICS Health Econ. 18: S25 S46 (2009) Published online in Wiley InterScience (www.interscience.wiley.com)..1501 THE NEW COOPERATIVE MEDICAL SCHEME IN RURAL CHINA: DOES MORE COVERAGE MEAN MORE

More information

The Effect of China s New Cooperative Medical Scheme. on Rural Utilization of Preventive Medical Care. and Rural Households Health Status

The Effect of China s New Cooperative Medical Scheme. on Rural Utilization of Preventive Medical Care. and Rural Households Health Status The Effect of China s New Cooperative Medical Scheme on Rural Utilization of Preventive Medical Care and Rural Households Health Status Li Xin Master of Pacific International Affairs 2011 UC San Diego

More information

Basic social medical insurance in China

Basic social medical insurance in China Basic social medical insurance in China Ni Yuan,MD Senior lecturer Dalian Medical University Dalian, China BSMI 1 The basic social medical insurance scheme for urban employees Launched by the central government

More information

Islamic Republic of Afghanistan Ministry of Public Health. Contents. Health Financing Policy 2012 2020

Islamic Republic of Afghanistan Ministry of Public Health. Contents. Health Financing Policy 2012 2020 Islamic Republic of Afghanistan Ministry of Public Health Contents Health Financing Policy 2012 2020 Table of Content 1. Introduction 1 1.1 Brief County Profile 1 1.2 Health Status Data 1 1.3 Sources

More information

3. Financing. 3.1 Section summary. 3.2 Health expenditure

3. Financing. 3.1 Section summary. 3.2 Health expenditure 3. Financing 3.1 Section summary Malaysia s public health system is financed mainly through general revenue and taxation collected by the federal government, while the private sector is funded through

More information

THE RELATIONSHIP BETWEEN URBAN RESIDENT BASIC MEDICAL INSURANCE AND HEALTH UTILIZATION OF THE URBAN UNEMPLOYED IN CHINA

THE RELATIONSHIP BETWEEN URBAN RESIDENT BASIC MEDICAL INSURANCE AND HEALTH UTILIZATION OF THE URBAN UNEMPLOYED IN CHINA THE RELATIONSHIP BETWEEN URBAN RESIDENT BASIC MEDICAL INSURANCE AND HEALTH UTILIZATION OF THE URBAN UNEMPLOYED IN CHINA A Thesis submitted to the Faculty of the Graduate School of Arts and Sciences of

More information

China s 12th Five-Year Plan: Healthcare sector

China s 12th Five-Year Plan: Healthcare sector China s 12th Five-Year Plan: Healthcare sector May 2011 KPMG CHINA One of the guiding principles of the 12th Five-Year Plan (5YP) is inclusive growth : helping ensure that the benefits of the country s

More information

Evaluating Sustainability of Medical Insurance Scheme for Urban Employed Individuals in China n

Evaluating Sustainability of Medical Insurance Scheme for Urban Employed Individuals in China n The Geneva Papers, 2010, 35, (600 625) r 2010 The International Association for the Study of Insurance Economics 1018-5895/10 www.genevaassociation.org for Urban Employed Individuals in China n Xiong Linping

More information

Pricing Private Health Insurance Products in China. Chen Tao

Pricing Private Health Insurance Products in China. Chen Tao Pricing Private Health Insurance Products in China Chen Tao Abstract In this paper an overview of how to price private health insurance products in China is given. In the beginning the Chinese private

More information

The New Cooperative Medical Scheme in Rural China: Does More Coverage Mean More Service and Better Health? Xiaoyan Lei

The New Cooperative Medical Scheme in Rural China: Does More Coverage Mean More Service and Better Health? Xiaoyan Lei The New Cooperative Medical Scheme in Rural China: Does More Coverage Mean More Service and Better Health? Xiaoyan Lei China Center for Economic Research Peking University, Beijing 100871, China xylei@ccer.edu.cn

More information

3. The first stage public consultation conducted from March to June 2008 aimed at consulting the public on

3. The first stage public consultation conducted from March to June 2008 aimed at consulting the public on EXECUTIVE SUMMARY The Government published the Healthcare Reform Consultation Document Your Health, Your Life (the Consultation Document ) on 13 March 2008 to initiate the public consultation on healthcare

More information

Medicare Beneficiaries Out-of-Pocket Spending for Health Care

Medicare Beneficiaries Out-of-Pocket Spending for Health Care Insight on the Issues OCTOBER 2015 Beneficiaries Out-of-Pocket Spending for Health Care Claire Noel-Miller, MPA, PhD AARP Public Policy Institute Half of all beneficiaries in the fee-for-service program

More information

Private Health Insurance Options in Egypt Discussion with EISA Chairman and senior staff

Private Health Insurance Options in Egypt Discussion with EISA Chairman and senior staff Private Health Insurance Options in Egypt Discussion with EISA Chairman and senior staff Ibrahim Shehata April 27, 2006 Background Health expenditure is dominated by household direct out-ofpocket payments

More information

Research on Perfecting the Rural Social Endowment Insurance System in Yangtze River Delta

Research on Perfecting the Rural Social Endowment Insurance System in Yangtze River Delta Research on Perfecting the Rural Social Endowment Insurance System in Yangtze River Delta Shufen Zhou 1, Lin Han 1, Hong Wang 1 & Keying Bi 1 1 College of Social Sciences, Shanghai University of Engineering

More information

Pension schemes are integral parts of China s social protection system

Pension schemes are integral parts of China s social protection system Dewen Wang World Bank March 26-27, 2014, Incheon, Republic of Korea Pension schemes are integral parts of China s social protection system SP programs Social Insurance Social Assistance Social Welfare

More information

The impact of China s Zero-Markup Drug Policy on county hospital revenue and government subsidy levels

The impact of China s Zero-Markup Drug Policy on county hospital revenue and government subsidy levels This is an original manuscript. The Accepted Manuscript of the article published by Taylor & Francis Group in Journal of Asian Public Policy on February 16 th 2015, available online at: http://dx.doi.org/10.1080/17516234.2015.1005561

More information

For Universal Health Coverage CHINA. Expanding Health Coverage to the Informal Sector SEPTEMBER Produced by R4D

For Universal Health Coverage CHINA. Expanding Health Coverage to the Informal Sector SEPTEMBER Produced by R4D For Universal Health Coverage CHINA Expanding Health Coverage to the Informal Sector SEPTEMBER 2015 Produced by R4D AUTHORSHIP Annette Ozaltin (R4D), Lara Wilson (Independent), Marilyn Heymann (R4D) ACKNOWLEDGEMENTS

More information

Overview of Medical Service Regime in Japan

Overview of Medical Service Regime in Japan Overview of Medical Service Regime in Japan 75 years or older 10% copayment (Those with income comparable to current workforce have a copayment of 30%) 70 to 74 years old 20% copayment* (Those with income

More information

Early Childhood Education Policy Development in China

Early Childhood Education Policy Development in China International Journal of Child Care and Education Policy Copyright 2011 by Korea Institute of Child Care and Education 2011, Vol. 5, No.1, 29-39 Early Childhood Education Policy Development in China Xin

More information

Mandatory Private Health Insurance as Supplementary Financing

Mandatory Private Health Insurance as Supplementary Financing Chapter 12 SUPPLEMENTARY FINANCING OPTION (5) MANDATORY PRIVATE HEALTH INSURANCE Mandatory Private Health Insurance as Supplementary Financing 12.1 Mandatory private health insurance is where private health

More information

Hai Fang, PhD Professor China Center for Health Development Studies Peking University

Hai Fang, PhD Professor China Center for Health Development Studies Peking University Hai Fang, PhD Professor China Center for Health Development Studies Peking University Presentation for Asia Health Policy Program at Stanford University November 7th, 2014 Outline Introduction Background

More information

Health Care and Insurance Among the Elderly in China: Evidence from the CHARLS Pilot

Health Care and Insurance Among the Elderly in China: Evidence from the CHARLS Pilot Health Care and Insurance Among the Elderly in China: Evidence from the CHARLS Pilot John Strauss University of Southern California Hao Hong Penn State University Xiaoyan Lei Peking University Lin Li Peking

More information

Economic Growth, Inequality and Poverty Reduction in China

Economic Growth, Inequality and Poverty Reduction in China Economic Growth, Inequality and Poverty Reduction in China Sangui Wang Renmin University of China Economic Growth, Poverty and Inequality in China 1 China has achieved remarkable economic growth since

More information

Yuanli Liu Harvard School of Public Health Philadelphia, July 20, 2005

Yuanli Liu Harvard School of Public Health Philadelphia, July 20, 2005 Liu s China Related Work Yuanli Liu Harvard School of Public Health Philadelphia, July 20, 2005 Overview of the Presentation On-going projects HSPH China Initiative Influencing policy: an example 2 Liu

More information

Current challenges in delivering social security health insurance

Current challenges in delivering social security health insurance International Social Security Association Afric ISSA Meeting of Directors of Social Security Organizations in Asia and the Pacific Seoul, Republic of Korea, 9-11 November 2005 Current challenges in delivering

More information

TOWARDS UNIVERSAL HEALTH COVERAGE IN RWANDA

TOWARDS UNIVERSAL HEALTH COVERAGE IN RWANDA TOWARDS UNIVERSAL HEALTH COVERAGE IN RWANDA Summary Notes from Briefing by Caroline Kayonga * Permanent Secretary, Ministry of Health, Rwanda 10/22/2007 10/23/2007 OUTLINE 1. A brief history of health

More information

State of Arkansas Department of Insurance

State of Arkansas Department of Insurance State of Arkansas Department of Insurance Consideration of the Basic Health Plan in Arkansas May 31, 2012 Purpose The Arkansas Insurance Department requested that PCG develop a report describing the potential

More information

COUNTRY CASE STUDY HEALTH INSURANCE IN SOUTH AFRICA. Prepared by: Vimbayi Mutyambizi Health Economics Unit, University of Cape Town

COUNTRY CASE STUDY HEALTH INSURANCE IN SOUTH AFRICA. Prepared by: Vimbayi Mutyambizi Health Economics Unit, University of Cape Town COUNTRY CASE STUDY HEALTH INSURANCE IN SOUTH AFRICA Prepared by: Vimbayi Mutyambizi Health Economics Unit, University of Cape Town Preparation of this material was funded through a grant from the Rockefeller

More information

Healthcare in rural China

Healthcare in rural China Student Research Projects/Outputs No.045 Healthcare in rural China Anna Malet MBA 2010 China Europe International Business School 699, Hong feng Road Pudong, Shanghai People s Republic of China Healthcare

More information

What can China learn from Hungarian healthcare reform?

What can China learn from Hungarian healthcare reform? Student Research Projects/Outputs No.031 What can China learn from Hungarian healthcare reform? Stephanie XU MBA 2009 China Europe International Business School 699, Hong Feng Road Pudong, Shanghai People

More information

Hospital Accountability Project. Health care affordability in Georgia

Hospital Accountability Project. Health care affordability in Georgia Hospital Accountability Project Health care affordability in Georgia A project of nonprofit consumer advocacy group Georgia Watch, the Hospital Accountability Project examines the financial practices of

More information

Number 2 2005 DESIGNING HEALTH FINANCING SYSTEMS TO REDUCE CATASTROPHIC HEALTH EXPENDITURE

Number 2 2005 DESIGNING HEALTH FINANCING SYSTEMS TO REDUCE CATASTROPHIC HEALTH EXPENDITURE Number 2 2005 DESIGNING HEALTH FINANCING SYSTEMS TO REDUCE CATASTROPHIC HEALTH EXPENDITURE Every year, more than 150 million individuals in 44 million households face financial catastrophe as a direct

More information

Pension Reform and Implicit Pension Debt in China

Pension Reform and Implicit Pension Debt in China Pension Reform and Implicit Pension Debt in China Jia Kang, Zhang Xiaoyun, Wang Min, Duan Xuezhong (Institute of Fiscal Science, MOF). Evolution of the Pension System for Enterprise Employees in China.

More information

Developing More Equitable and Efficient Health Insurance in China

Developing More Equitable and Efficient Health Insurance in China Developing More Equitable and Efficient Health Insurance in China Shenglan Tang October 2014 About the Author Shenglan Tang Shenglan Tang is Professor of Medicine and Global Health at Duke University.

More information

The Labor Market for Attorneys in the State of California

The Labor Market for Attorneys in the State of California R The Labor Market for Attorneys in the State of California Past, Present, and Future Tora Kay Bikson, Megan Beckett, Susan Gates, Cassandra Guarino, Karen Ross, Ron Zimmer Supported by the University

More information

Health Care System Reform in China: Issues, Challenges and Options. Rong Hu, Chunli Shen, and Heng-fu Zou

Health Care System Reform in China: Issues, Challenges and Options. Rong Hu, Chunli Shen, and Heng-fu Zou Health Care System Reform in China: Issues, Challenges and Options Rong Hu, Chunli Shen, and Heng-fu Zou Summary: This paper examines health care reform in urban and rural China. Before health care reform,

More information

An Internist s Practical Guide to Understanding Health System Reform

An Internist s Practical Guide to Understanding Health System Reform An Internist s Practical Guide to Understanding Health System Reform Prepared by: ACP s Division of Governmental Affairs and Public Policy Updated October 2013 How to cite this guide: American College

More information

Single Payer Systems: Equity in Access to Care

Single Payer Systems: Equity in Access to Care Single Payer Systems: Equity in Access to Care Lynn A. Blewett University of Minnesota, School of Public Health The True Workings of Single Payer Systems: Lessons or Warnings for U.S. Reform Journal of

More information

Consumption Structure Evolutions in an Aging Society and Implications for the Social Security System

Consumption Structure Evolutions in an Aging Society and Implications for the Social Security System Consumption Structure Evolutions in an Aging Society and Implications for the Social Security System Dr. Rui Mao School of Management, Zhejiang University, China PRI-ADBI joint conference, Tokyo Rui Mao

More information

China. Old Age, Disability, and Survivors. China. Exchange rate: US$1.00 = 6.78 yuan. Regulatory Framework. Coverage. Qualifying Conditions

China. Old Age, Disability, and Survivors. China. Exchange rate: US$1.00 = 6.78 yuan. Regulatory Framework. Coverage. Qualifying Conditions China Exchange rate: US$1.00 = 6.78 yuan. Old Age, Disability, and Survivors First law: 1951. Current laws: 1953 (regulations); 1978, 1995, 1997, 1999, and 2005 (directives); and 2009 (guideline on rural

More information

DISCUSSION PAPER NUMBER

DISCUSSION PAPER NUMBER HSS/HSF/DP.09.4 Financial risk protection of National Health Insurance in the Republic of Korea:1995-2007 DISCUSSION PAPER NUMBER 4-2009 Department "Health Systems Financing" (HSF) Cluster "Health Systems

More information

Lynn A. Blewett, Ph.D. Professor, University of Minnesota

Lynn A. Blewett, Ph.D. Professor, University of Minnesota Lynn A. Blewett, Ph.D. Professor, University of Minnesota Westlake Forum III Healthcare Reform in China and the US: Similarities, Differences and Challenges Emory University, Atlanta, GA April 10-12, 2011

More information

Income-related inequality in health insurance coverage: analysis of China Health and Nutrition Survey of 2006 and 2009

Income-related inequality in health insurance coverage: analysis of China Health and Nutrition Survey of 2006 and 2009 Liu et al. International Journal for Equity in Health 2012, 11:42 RESEARCH Open Access Income-related inequality in health insurance coverage: analysis of China Health and Nutrition Survey of 2006 and

More information

Social Health Insurance In Three Asian Countries: China, Thailand and Vietnam 1 July 2014 Roli Talampas Asian Center UP Diliman

Social Health Insurance In Three Asian Countries: China, Thailand and Vietnam 1 July 2014 Roli Talampas Asian Center UP Diliman Social Health Insurance In Three Asian Countries: China, Thailand and Vietnam 1 July 2014 Roli Talampas Asian Center UP Diliman Outline Objectives & Questions Framework Methods Findings Summary Objectives

More information

Urban Health Insurance and Financing in China

Urban Health Insurance and Financing in China Urban Health Insurance and Financing in China by Gordon Liu a Brian Nolan b Chen Wen c a Peking University, China, and University of North Carolina at Chapel Hill, USA b Economic and Social Research Institute,

More information

Health sector reforms in China

Health sector reforms in China Health sector reforms in China Speaker: Ms. Madhurima Nundy 30 July 2013 Institute of Chinese Studies Delhi The presenter started with the broader notion of health sector reforms across the world. The

More information

Alaska Employer Health-Care Benefits: A Survey of Alaska Employers

Alaska Employer Health-Care Benefits: A Survey of Alaska Employers Alaska Employer Health-Care Benefits: A Survey of Alaska Employers By Mouhcine Guettabi Rosyland Frazier Gunnar Knapp Institute of Social and Economic Research University of Alaska Anchorage 3211 Providence

More information

Health Care in Rural America

Health Care in Rural America Health Care in Rural America Health care in rural communities has many aspects access to physicians, dentists, nurses, and mental health services; the financial circumstances of rural hospitals; federal

More information

Colloquium for Systematic Reviews in International Development Dhaka

Colloquium for Systematic Reviews in International Development Dhaka Community-Based Health Insurance Schemes: A Systematic Review Anagaw Derseh Pro. Arjun S. Bed Dr. Robert Sparrow Colloquium for Systematic Reviews in International Development Dhaka 13 December 2012 Introduction

More information

Florida Study of Career and Technical Education

Florida Study of Career and Technical Education Florida Study of Career and Technical Education Final Report Louis Jacobson, Ph.D. Christine Mokher, Ph.D. 2014 IRM-2014-U-008790 Approved for Distribution Unlimited This document represents the best opinion

More information

Community-based health insurance in poor rural China: the distribution of net benefits

Community-based health insurance in poor rural China: the distribution of net benefits ß The Author 2005. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. doi:10.1093/heapol/czi045 Advance Access publication

More information

Determinants of access to health care in nine provinces of China: The impact of socioeconomic variables and the role of urban health. insurance.

Determinants of access to health care in nine provinces of China: The impact of socioeconomic variables and the role of urban health. insurance. Determinants of access to health care in nine provinces of China: The impact of socioeconomic variables and the role of urban health insurance. Ysaline PADIEU July, 2010 Abstract This work focuses on the

More information

On Designing Urban Medical Insurance for the Poor: A Study of Chinese Migrant Workers Access to Urban Health Care

On Designing Urban Medical Insurance for the Poor: A Study of Chinese Migrant Workers Access to Urban Health Care On Designing Urban Medical Insurance for the Poor: A Study of Chinese Migrant Workers Access to Urban Health Care Author: Huong Trieu Affiliation: University of Michigan, Department of Political Science

More information

Impact of China s Urban Resident Basic Medical Insurance on Health Care Utilization and Expenditure

Impact of China s Urban Resident Basic Medical Insurance on Health Care Utilization and Expenditure DISCUSSION PAPER SERIES IZA DP No. 6768 Impact of China s Urban Resident Basic Medical Insurance on Health Care Utilization and Expenditure Hong Liu Zhong Zhao July 2012 Forschungsinstitut zur Zukunft

More information

APPENDIX C HONG KONG S CURRENT HEALTHCARE FINANCING ARRANGEMENTS. Public and Private Healthcare Expenditures

APPENDIX C HONG KONG S CURRENT HEALTHCARE FINANCING ARRANGEMENTS. Public and Private Healthcare Expenditures APPENDIX C HONG KONG S CURRENT HEALTHCARE FINANCING ARRANGEMENTS and Healthcare Expenditures C.1 Apart from the dedication of our healthcare professionals, the current healthcare system is also the cumulative

More information

FINAL REPORT AND RECOMMENDATIONS. Johns Hopkins University Benefits Advisory Committee

FINAL REPORT AND RECOMMENDATIONS. Johns Hopkins University Benefits Advisory Committee FINAL REPORT AND RECOMMENDATIONS Johns Hopkins University Benefits Advisory Committee 2012 The Faculty and Staff Benefits Advisory Committee (BAC) was jointly appointed by Professor Sarah Woodson, Chair

More information

The Emergence of Private For-Profit Medical Facilities and their Roles in Medical Expenditures in China

The Emergence of Private For-Profit Medical Facilities and their Roles in Medical Expenditures in China The Emergence of Private For-Profit Medical Facilities and their Roles in Medical Expenditures in China Xiaohui Hou July 9 th IHEA The Evolution of of Public in China Maoist era largest national public

More information

HEALTH INSURANCE AND CATASTROPHIC ILLNESS: A REPORT ON THE NEW COOPERATIVE MEDICAL SYSTEM IN RURAL CHINA

HEALTH INSURANCE AND CATASTROPHIC ILLNESS: A REPORT ON THE NEW COOPERATIVE MEDICAL SYSTEM IN RURAL CHINA HEALTH ECONOMICS Health Econ. 18: S119 S127 (2009) Published online in Wiley InterScience (www.interscience.wiley.com)..1510 HEALTH INSURANCE AND CATASTROPHIC ILLNESS: A REPORT ON THE NEW COOPERATIVE MEDICAL

More information

Prescription Drugs as a Starting Point for Medicare Reform Testimony before the Senate Budget Committee

Prescription Drugs as a Starting Point for Medicare Reform Testimony before the Senate Budget Committee Prescription Drugs as a Starting Point for Medicare Reform Testimony before the Senate Budget Committee Marilyn Moon The nonpartisan Urban Institute publishes studies, reports, and books on timely topics

More information

ACTUARIAL VALUE AND EMPLOYER- SPONSORED INSURANCE

ACTUARIAL VALUE AND EMPLOYER- SPONSORED INSURANCE NOVEMBER 2011 ACTUARIAL VALUE AND EMPLOYER- SPONSORED INSURANCE SUMMARY According to preliminary estimates, the overwhelming majority of employer-sponsored insurance (ESI) plans meets and exceeds an actuarial

More information

Demand for and Supply of Supplementary Health Insurance in Shanghai Wen Chen 1, Xiaohua Ying 1, Shanlian Hu 1, Guozhen Sun 2, Li Luo 1, Wenwei Tang 2

Demand for and Supply of Supplementary Health Insurance in Shanghai Wen Chen 1, Xiaohua Ying 1, Shanlian Hu 1, Guozhen Sun 2, Li Luo 1, Wenwei Tang 2 Demand for and Supply of Supplementary Health Insurance in Shanghai Wen Chen 1, Xiaohua Ying 1, Shanlian Hu 1, Guozhen Sun 2, Li Luo 1, Wenwei Tang 2 1 School of Public Health, Fudan University, Shanghai

More information

Medical Insurance for the Poor: impact on access and affordability of health services in Georgia

Medical Insurance for the Poor: impact on access and affordability of health services in Georgia Medical Insurance for the Poor: impact on access and affordability of health services in Georgia The health care in Georgia is currently affordable for very rich and very poor Key informant Key Messages:

More information

Summary: Health Care spending in Massachusetts: To: Mass Care. From: Gerald Friedman 1

Summary: Health Care spending in Massachusetts: To: Mass Care. From: Gerald Friedman 1 To: Mass Care From: Gerald Friedman 1 Re.: Cost and funding of proposed Medicare for All in Massachusetts Bill Summary: This policy memo explores some of possible economic implications of the proposed

More information

Introduction of a national health insurance scheme

Introduction of a national health insurance scheme International Social Security Association Meeting of Directors of Social Security Organizations in the English-speaking Caribbean Tortola, British Virgin Islands, 4-6 July 2005 Introduction of a national

More information

A U.S. healthcare executive s recent visit to China By Richard F. Peisch

A U.S. healthcare executive s recent visit to China By Richard F. Peisch A U.S. healthcare executive s recent visit to China By Richard F. Peisch Richard F. Peisch is the founder and president of MDP, Inc., a medical revenue cycle management company headquartered in Boston.

More information

ASSESSING THE RESULTS

ASSESSING THE RESULTS HEALTH REFORM IN MASSACHUSETTS EXPANDING TO HEALTH INSURANCE ASSESSING THE RESULTS March 2014 Health Reform in Massachusetts, Expanding Access to Health Insurance Coverage: Assessing the Results pulls

More information

The Cost of Care for the Uninsured: What Do We Spend, Who Pays, and What Would Full Coverage Add to Medical Spending?

The Cost of Care for the Uninsured: What Do We Spend, Who Pays, and What Would Full Coverage Add to Medical Spending? The Cost of Care for the : What Do We Spend, Who Pays, and What Would Full Coverage Add to Medical Spending? Issue Update 2004 Jack Hadley, Ph.D. and John Holahan, Ph.D. Prepared for the Kaiser Commission

More information

NBER WORKING PAPER SERIES IMPACT OF CHINA'S URBAN EMPLOYEE BASIC MEDICAL INSURANCE ON HEALTH CARE EXPENDITURE AND HEALTH OUTCOMES.

NBER WORKING PAPER SERIES IMPACT OF CHINA'S URBAN EMPLOYEE BASIC MEDICAL INSURANCE ON HEALTH CARE EXPENDITURE AND HEALTH OUTCOMES. NBER WORKING PAPER SERIES IMPACT OF CHINA'S URBAN EMPLOYEE BASIC MEDICAL INSURANCE ON HEALTH CARE EXPENDITURE AND HEALTH OUTCOMES Feng Huang Li Gan Working Paper 20873 http://www.nber.org/papers/w20873

More information

Financing Innovative Medicines in Mainland China: The Role of Commercial Health Insurance

Financing Innovative Medicines in Mainland China: The Role of Commercial Health Insurance Chinese Studies 2013. Vol.2, No.3, 128-133 Published Online August 2013 in SciRes (http://www.scirp.org/journal/chnstd) http://dx.doi.org/10.4236/chnstd.2013.23020 Financing Innovative Medicines in Mainland

More information

Why Accept Medicaid Dollars: The Facts

Why Accept Medicaid Dollars: The Facts Why Accept Medicaid Dollars: The Facts If we accept federal Medicaid dollars, nearly 500,000 North Carolinians will gain access to health insurance. As many as 1,100 medically unnecessary deaths per year

More information

Payer-Industry Partnerships in Emerging Markets: Best Practices for Successful Market Access of New Pharmaceuticals STUDY EXTRACT: CHINA P3696

Payer-Industry Partnerships in Emerging Markets: Best Practices for Successful Market Access of New Pharmaceuticals STUDY EXTRACT: CHINA P3696 Payer-Industry Partnerships in Emerging Markets: Best Practices for Successful Market Access of New Pharmaceuticals STUDY EXTRACT: CHINA P3696 Report written by: Elena Akborisova, Anu Bharath, Cecilia

More information

7. Student Loan Reform in China: Problems and challenges

7. Student Loan Reform in China: Problems and challenges 7. Student Loan Reform in China: Problems and challenges Wei Jianguo and Wang Rong China Institute for Educational Finance Research, Peking University Development of Student Loans in China The development

More information

THE MEDICAID PROGRAM AT A GLANCE. Health Insurance Coverage

THE MEDICAID PROGRAM AT A GLANCE. Health Insurance Coverage on on medicaid and and the the uninsured March 2013 THE MEDICAID PROGRAM AT A GLANCE Medicaid, the nation s main public health insurance program for low-income people, covers over 62 million Americans,

More information

Access to Coverage and Care: Targeting Implementation of the Affordable Care Act to Improve Health in Connecticut

Access to Coverage and Care: Targeting Implementation of the Affordable Care Act to Improve Health in Connecticut AETNA FOUNDATION CHILDREN S FUND OF CONNECTICUT CONNECTICUT HEALTH FOUNDATION DONAGHUE MEDICAL RESEARCH FOUNDATION FOUNDATION FOR COMMUNITY HEALTH UNIVERSAL HEALTH CARE FOUNDATION OF CONNECTICUT KEY Findings:

More information

White Paper. Medicare Part D Improves the Economic Well-Being of Low Income Seniors

White Paper. Medicare Part D Improves the Economic Well-Being of Low Income Seniors White Paper Medicare Part D Improves the Economic Well-Being of Low Income Seniors Kathleen Foley, PhD Barbara H. Johnson, MA February 2012 Table of Contents Executive Summary....................... 1

More information

Hands-on China Report Jing Ulrich March 9, 2009. A New Direction in Social Welfare: China s National Healthcare Reforms

Hands-on China Report Jing Ulrich March 9, 2009. A New Direction in Social Welfare: China s National Healthcare Reforms A New Direction in Social Welfare: China s National Healthcare Reforms Roberta Lipson CEO, Chindex International, Chairwoman of United Family Hospitals Jing Ulrich Managing Director, Chairman, China Equities,

More information

For More Information

For More Information CHILDREN AND FAMILIES EDUCATION AND THE ARTS ENERGY AND ENVIRONMENT HEALTH AND HEALTH CARE INFRASTRUCTURE AND TRANSPORTATION INTERNATIONAL AFFAIRS LAW AND BUSINESS NATIONAL SECURITY POPULATION AND AGING

More information

South Africa s health system What are the gaps? Ronelle Burger

South Africa s health system What are the gaps? Ronelle Burger South Africa s health system What are the gaps? Ronelle Burger Features of SA health system Quadruple burden of disease (Mayosi et al, 2009) communicable diseases e.g. tuberculosis and HIV/AIDS growing

More information

Comparison of Chinese inpatients with different types of medical insurance before and after the 2009 healthcare reform

Comparison of Chinese inpatients with different types of medical insurance before and after the 2009 healthcare reform Wang et al. BMC Health Services Research 2014, 14:443 RESEARCH ARTICLE Open Access Comparison of Chinese inpatients with different types of medical insurance before and after the 2009 healthcare reform

More information

AN OVERVIEW OF THE MEDICARE PROGRAM AND MEDICARE BENEFICIARIES COSTS AND SERVICE USE

AN OVERVIEW OF THE MEDICARE PROGRAM AND MEDICARE BENEFICIARIES COSTS AND SERVICE USE AN OVERVIEW OF THE MEDICARE PROGRAM AND MEDICARE BENEFICIARIES COSTS AND SERVICE USE Statement of Juliette Cubanski, Ph.D. Associate Director, Program on Medicare Policy The Henry J. Kaiser Family Foundation

More information