陈永杰 社会政策（英语）Lecture 9 Health Policy in China.pptxVIP

 Health Policy in China The Health Care Dilemma… Blue Book on China’s Society 2012 Top Three Social Issues in China: Inflation 物價上漲 “Difficult to see a doctor, medical care is expensive” (看病難、看病貴) Income disparity (收入差距過大、貧富分化) 3 Objectives To examine China’s socialist health care system and the need for reform To analyze China’s health care reforms in rural and urban areas, the outcomes, and the problems To evaluate China’s strategies of health care from a theoretical perspective 4 Health Care in Socialist China Institutional Setting Three health care systems: Free state-funded health care (gongfei yiliao 公費醫療) for state employees and university students (state funding) Labour insurance health care (laobao yiliao 勞保醫療) for enterprise workers: free care for SOE and COE employees half of treatment cost for dependents (from enterprise welfare fund) 5 Health Care in Socialist China Cooperative health care (hezuo yiliao 合作醫療) for rural residents: low-cost treatment primarily funded by brigade and commune with small individual contributions covered 90% of rural population in mid-1980s favorable distribution of health resources in the Cultural Revolution 6 Health Care in Socialist China Health Care Providers Urban System Public Health hospitals and clinics run by the Ministry/Bureau of Health Enterprise-run hospitals, clinics and services Services run by other departments/bureaus (military, civil aviation, railway etc.) 7 Health Care in Socialist China Rural System Three-tier services brigade health stations (生產大隊衛生站) commune health centers (人民公社衛生院) county hospitals (on referral basis) (縣城醫院) Health care personnel “barefoot doctors” (赤腳醫生), health aides (衛生員) and midwives (助產師) 8 Health Care in Socialist China Merits: Universal coverage for urban residents Coverage even for peasants Free for patients Dramatic improvement in health indicators Emphasis on prevention Integration of Chinese western medicine 9 Health Care in Socialist China De