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Cooperative medical schemes in contemporary rural China

Author

Listed:
  • Xueshan, Feng
  • Shenglan, Tang
  • Bloom, Gerald
  • Segall, Malcolm
  • Xingyuan, Gu

Abstract

Improvements in rural health care in China in the 1950s, 1960s and 1970s were largely due to the development of cooperative medical schemes (CMSs) and the establishment of a three-tier rural health network. Since the economic reforms were instituted in the late 1970s, the financing and delivery of rural health services have seen many changes, some positive, others not. Most CMSs have collapsed. In the absence of CMSs, the rural population has to pay for health care out-of-pocket and poor families have greater difficulty in getting access to essential health care. In the meantime, emphases of health services have tended to shift from lower to higher levels, from preventive to curative services, and from planning and management to market forces. This paper outlines the evolution of CMSs, reasons for their collapse, and their likely impact on rural health services. The main focus is on the development of a new generation of rural cooperative health care schemes, given their importance in the process of consolidating the rural three-tier health network after the impact of the economic reforms: the characteristics of some schemes, the apparent conditions for success, and government policy towards the development of cooperative health care financing are presented.

Suggested Citation

  • Xueshan, Feng & Shenglan, Tang & Bloom, Gerald & Segall, Malcolm & Xingyuan, Gu, 1995. "Cooperative medical schemes in contemporary rural China," Social Science & Medicine, Elsevier, vol. 41(8), pages 1111-1118, October.
    • Handle: RePEc:eee:socmed:v:41:y:1995:i:8:p:1111-1118
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    Citations

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    Cited by:

    1. Jin Feng & Zheng Song, 2009. "Health care system in rural China: A quantitative approach based on heterogeneous individuals," Frontiers of Economics in China, Springer;Higher Education Press, vol. 4(2), pages 153-172, June.
    2. Liu, Hong & Gao, Song & Rizzo, John A., 2011. "The expansion of public health insurance and the demand for private health insurance in rural China," China Economic Review, Elsevier, vol. 22(1), pages 28-41, March.
    3. Adam Wagstaff & Winnie Yip & Magnus Lindelow & William C. Hsiao, 2009. "China's health system and its reform: a review of recent studies," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 7-23, July.
    4. Liu, Hong & Sun, Qi & Zhao, Zhong, 2014. "Social learning and health insurance enrollment: Evidence from China's New Cooperative Medical Scheme," Journal of Economic Behavior & Organization, Elsevier, vol. 97(C), pages 84-102.
    5. Wu, Yanrui, 1997. "China's health care sector in transition: resources, demand and reforms," Health Policy, Elsevier, vol. 39(2), pages 137-152, February.
    6. Bloom, Gerald, 1998. "Primary health care meets the market in China and Vietnam," Health Policy, Elsevier, vol. 44(3), pages 233-252, June.
    7. Yu, Hao, 2015. "Universal health insurance coverage for 1.3 billion people: What accounts for China's success?," Health Policy, Elsevier, vol. 119(9), pages 1145-1152.
    8. Yu Rong Yang & Gail M Williams & Philip S Craig & Donald P McManus, 2010. "Impact of Increased Economic Burden Due to Human Echinococcosis in an Underdeveloped Rural Community of the People's Republic of China," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 4(9), pages 1-7, September.
    9. Tu, Feng & Tokunaga, Shoji & Deng, ZhouLu & Nobutomo, Koichi, 2002. "Analysis of hospital charges for cerebral infarction stroke inpatients in Beijing, People's Republic of China," Health Policy, Elsevier, vol. 59(3), pages 243-256, March.
    10. Zhang, Xuan & Nie, Huihua, 2021. "Public health insurance and pharmaceutical innovation: Evidence from China," Journal of Development Economics, Elsevier, vol. 148(C).
    11. Hong Wang & Winnie Yip & Licheng Zhang & William C. Hsiao, 2009. "The impact of rural mutual health care on health status: evaluation of a social experiment in rural China," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 65-82, July.
    12. Wang, Hongman & Gu, Danan & Dupre, Matthew Egan, 2008. "Factors associated with enrollment, satisfaction, and sustainability of the New Cooperative Medical Scheme program in six study areas in rural Beijing," Health Policy, Elsevier, vol. 85(1), pages 32-44, January.
    13. You, Xuedan & Kobayashi, Yasuki, 2009. "The new cooperative medical scheme in China," Health Policy, Elsevier, vol. 91(1), pages 1-9, June.
    14. Lingguo Cheng & Hong Liu & Ye Zhang & Ke Shen & Yi Zeng, 2015. "The Impact of Health Insurance on Health Outcomes and Spending of the Elderly: Evidence from China's New Cooperative Medical Scheme," Health Economics, John Wiley & Sons, Ltd., vol. 24(6), pages 672-691, June.
    15. Gonzalez Block, Miguel Angel, 1997. "Comparative research and analysis methods for shared learning from health system reforms," Health Policy, Elsevier, vol. 42(3), pages 187-209, December.
    16. Zhang, Licheng & Wang, Hong, 2008. "Dynamic process of adverse selection: Evidence from a subsidized community-based health insurance in rural China," Social Science & Medicine, Elsevier, vol. 67(7), pages 1173-1182, October.
    17. Hu, Hsin-Hui & Qi, Qinghui & Yang, Chih-Hai, 2012. "Analysis of hospital technical efficiency in China: Effect of health insurance reform," China Economic Review, Elsevier, vol. 23(4), pages 865-877.
    18. Hong Wang & Licheng Zhang & Heng-fu Zou, 2006. "Health Services in Rural China," CEMA Working Papers 563, China Economics and Management Academy, Central University of Finance and Economics.
    19. Huixia Liu & Linxiu Zhang & Gale Summerfield & Yaojiang Shi, 2009. "A gendered view of reforming health care access for farmers in China," China Agricultural Economic Review, Emerald Group Publishing Limited, vol. 1(2), pages 194-211, January.

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