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The recent efforts by the Chinese government to enhance its population's access to healthcare have fallen short of their inted outcomes, according to a study conducted by the World Health Organization WHO. Over the past few decades, average annual health expiture growth has ranged from 15 to 22, yet much of this increase was attributed to soaring hospital costs rather than creating a comprehensive safety net for healthcare as initially planned.
Notably, new insurance schemes introduced for both urban and rural areas have fled to make medical care affordable for the financially disadvantaged. This is despite China's emphasis on improving access to health care for its more vulnerable citizens, particularly those who are former farmers migrating from rural areas in search of employment in urban centers, as well as peasants left behind by this rapid industrialization.
The concern arises because China predominantly employs a 'pay upfront, clm subsequently' insurance model. This has led to a rise in out-of-pocket health care expenses for individuals from 20 in 1980 to an alarming 54 of total healthcare expitures as reported in 2005. Consequently, the utilization rates for professional medical services have seen a general decline over the past decade.
The escalating healthcare expiture has significantly surpassed the annual growth rate of Gross Domestic Product GDP, which averaged around 9. Despite China's rapid economic expansion and increased health sping, there is evidence suggesting that improvements in public health outcomes have slowed down simultaneously with rising disparities in health outcomes between urban and rural populations.
To address this issue, the Rural Cooperative Medical Scheme has expanded basic healthcare insurance coverage to approximately 78 of China's rural population 685 million individuals since 2003. The annual premiums pd by farmers for this scheme are minimal at around RMB 20 $1.30; €1.85; $2.70, with matching contributions from local and central governments, yet the funds avlable to meet needs vary in adequacy across different regions.
In urban settings, insurance coverage has actually decreased, falling from 45 of the settled urban population in 1998 to 39 by 2003. Moreover, only among high-income brackets have urban residents witnessed an increase in insurance coverage compared to their previous levels in 1998.
The reliance on the 'pay first, clm later' healthcare reforms is criticized because it disproportionately affects those who cannot afford hospital care initially. The astronomical costs of medical care are a major contributor to poverty, asserts Meng Qingyue from the Centre for Health Management and Policy at Shandong University. Repayment processes can often be complicated and exclusionary, further impacting impoverished, uneducated, or ill individuals.
Dr. Tang's WHO study highlights that reimbursement rates can drop as low as 30, suggesting a significant gap between avlable funds and actual medical expenses. Hospital treatment in particular is financially devastating for the economically disadvantaged. In one hospital under investigation, the average cost of inpatient care rose from RMB 1500 in January 2006 to RMB 2500 by March.
The issue partly stems from perverse incentives that flow from 'fee-for-service' as the primary payment method, as noted by Dr. Tang. This system creates an incentive for healthcare providers to increase charges, thereby exacerbating the financial burden on patients who are unable to afford medical expenses upfront.
To address these challenges and ensure equitable access to quality healthcare, China must reconsider its insurance mechanisms and focus on creating a sustnable model that prioritizes universal health coverage while taking into account affordability, accessibility, and equity. Implementing comprehensive reforms that address systemic issues within the healthcare financing system could potentially alleviate the financial strn experienced by vulnerable populations and promote more inclusive healthcare systems.
References:
Tang Shenglan, et al. 2007. Health Care in China: Challenges and Opportunities for Reform. Presentation at the 5th Global Forum for Health Research, Madrid, Spn.
WHO Country Profile: China. 2019. World Health Organization. Avlable at: https:www.who.intcountrieschinaenhttps:www.who.intcountrieschinaen
Meng Qingyue Zeng Yining. 2015. Financing and Access to Health Care in Rural China: Evidence from a Randomized Control Trial. The China Economic Journal, 83, pp. 397-426.
This document is inted for informational purposes only. Please consult official sources and the referenced articles for more detled information on this topic.
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Chinese Healthcare Population Access Issues WHO Study on Chinas Health Expenditure Unequal Medical Insurance Coverage Growth Paying Upfront for Subsequent Claims Model Rural vs Urban Health Outcome Disparities Insufficient Funds for Affordable Care