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Purchasing health care in China: Competing or non-competing third-party purchasers?

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  • Xu, Weiwei
  • van de Ven, Wynand P.M.M.
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    Abstract

    Objectives China's government has decided to increase government funding by 1-1.5% of the Gross Domestic Products in the health care sector. However, it is still a question how to turn the new funding into efficient health care.Methods To help to answer this question we analyze three prototype models of organizing the health care system that may be relevant for China, namely the "Government provision model", the "regulated market with non-competing third-party purchasers", and the "regulated market with competing third-party purchasers". The pre- and post-reform English health care system and the present Dutch health care system are used as examples of the three models. During the last 20 years these countries had, just as China, major health care reforms from a national centrally planned system to a market-based system. Based on the experiences in these countries we analyze the advantages and disadvantages of these three prototype models and discuss their relevance for China.Results and conclusions We conclude that the creation of prudent third-party purchasers, who have the incentive and ability to act on behalf of individual consumers, is a critical success factor, whatever model China chooses to implement.

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    Bibliographic Info

    Article provided by Elsevier in its journal Health Policy.

    Volume (Year): 92 (2009)
    Issue (Month): 2-3 (October)
    Pages: 305-312

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    Handle: RePEc:eee:hepoli:v:92:y:2009:i:2-3:p:305-312

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    Web page: http://www.elsevier.com/locate/healthpol

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    Keywords: China Market-based reform Purchasing care;

    References

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    1. Enthoven, Alain C., 1994. "On the ideal market structure for third-party purchasing of health care," Social Science & Medicine, Elsevier, vol. 39(10), pages 1413-1424, November.
    2. Chalkley, M. & Malcomson, J.M., 1995. "Contracting for health services with unmonitored quality," Discussion Paper Series In Economics And Econometrics 9510, Economics Division, School of Social Sciences, University of Southampton.
    3. Eggleston, Karen & Ling, Li & Qingyue, Meng & Lindelow, Magnus & Wagstaff, Adam, 2006. "Health Service Delivery in China: A Literature Review," Policy Research Working Paper Series 3978, The World Bank.
    4. Hsiao, William C., 2007. "The political economy of Chinese health reform," Health Economics, Policy and Law, Cambridge University Press, vol. 2(03), pages 241-249, July.
    5. Liu, Yuanli, 2002. "Reforming China's urban health insurance system," Health Policy, Elsevier, vol. 60(2), pages 133-150, May.
    6. Mark Dusheiko & Maria Goddard & Hugh Gravelle & Rowena Jacobs, 2008. "Explaining trends in concentration of healthcare commissioning in the English NHS," Health Economics, John Wiley & Sons, Ltd., vol. 17(8), pages 907-926.
    7. van de Ven, Wynand P.M.M. & Schut, Frederik T. & Rutten, Frans F.H., 1994. "Forming and reforming the market for third-party purchasing of health care," Social Science & Medicine, Elsevier, vol. 39(10), pages 1405-1412, November.
    8. Chalkley, Martin & Malcomson, James M, 1996. "Competition in NHS Quasi-markets," Oxford Review of Economic Policy, Oxford University Press, vol. 12(4), pages 89-99, Winter.
    9. Wagstaff, Adam & Lindelow, Magnus, 2005. "Can insurance increase financial risk ? The curious case of health insurance in China," Policy Research Working Paper Series 3741, The World Bank.
    10. Maynard, Alan, 1994. "Can competition enhance efficiency in health care? Lessons from the reform of the U.K. National Health Service," Social Science & Medicine, Elsevier, vol. 39(10), pages 1433-1445, November.
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    Cited by:
    1. Xu, Weiwei & van de Ven, Wynand P.M.M., 2013. "Consumer choice among Mutual Healthcare Purchasers: A feasible option for China?," Social Science & Medicine, Elsevier, vol. 96(C), pages 277-284.

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