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Cooperative medical schemes in contemporary rural China

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

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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 41 (1995)
    Issue (Month): 8 (October)
    Pages: 1111-1118

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    Handle: RePEc:eee:socmed:v:41:y:1995:i:8:p:1111-1118

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    Keywords: cooperative medical schemes China health finance rural health services;

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    Cited by:
    1. 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, vol. 1(2), pages 194-211, May.
    2. Jin Feng & Zheng Song, 2009. "Health care system in rural China: A quantitative approach based on heterogeneous individuals," Frontiers of Economics in China, Springer, vol. 4(2), pages 153-172, June.
    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 S7-S23, July.
    4. 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 S65-S82, July.
    5. 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.
    6. 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.
    7. 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.
    8. 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.

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